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Cyclic methylsiloxanes (CMSs), widely found in wastewater treatment plants (WWTPs), are potentially hazardous to the environment and human health. In this study, the environmental behavior and human exposure risks of three CMSs (D4-D6) were evaluated in WWTPs located in Beijing and Kunming, Yunnan province. D5 had the highest concentrations in air, water, and sludge, with seasonal variation that consisted of a high concentration in summer and low concentration in winter. The CMS concentrations in air were 3-4-fold higher in the A 2 /O (Anaerobic-Anoxic-Oxic) treatment units than in the other units. CMS emissions to air, soil, and water from the Beijing WWTP were in the ranges of 3.4 × 10 4 -5.0 × 10 4  kg·a -1 , 4.5 × 10 2 -7.5 × 10 2  kg·a -1 , and 2.5 × 10 2 -2.9 × 10 2  kg·a -1 , constituting 98 %, 1.3 %, and 0.7 % of the total emissions, respectively. Total daily inhalation exposure doses of CMSs (ADD inh,CMSs ) associated with four different jobs in WWTPs showed that wastewater treatment technicians had the highest ADD inh,CMSs (51 μg/kg/day), indicating that these people had the highest occupational exposure risk in WWTPs. Therefore, this study identified that atmospheric emission was the main environmental fate of CMSs in WWTPs, and provide a basis for the improvement of WWTP process and risk management decisions. ENVIRONMENTAL IMPLICATION: Assessing the environmental fate and occupational exposure risk of cyclic methylsiloxanes (CMSs) found in wastewater treatment plants (WWTPs) is crucial. This is the first study to identify that atmospheric emission was the main environmental fate of CMSs in WWTPs, especially D5; the inhalation exposure doses of CMSs were all significantly higher in the occupational population working in WWTPs. The results described in our study will help enhance the understanding of current knowledge base of environmental fate and exposure risk of CMSs in WWTPs, and provide a basis for the improvement of WWTP process and risk management decisions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Few studies focused on human papillomavirus (HPV) in male patients. This study aimed to explore the detection rate and genotyping of HPV among male patients in Beijing to provide a reference for formulating prevention strategies for HPV infection. The cross-sectional study was conducted in Beijing Chaoyang Hospital from November 2015 to March 2023. It covered male patients from the urology and dermatology departments. Fifteen high-risk HPV genotypes were detected by the multiplex real-time polymerase chain reaction method. The overall detection rate of HPV was 25.19% (1288/5114, 95% confidence interval [CI] 24.00%-26.38%), of which the single infection rate was 16.99% (869/5114, 95% CI 15.97%-18.05%) and the co-infection rate was 8.19% (419/5114, 95% CI 7.46%-8.98%). The detection rate of HPV was 40.77% (521/1278), 35.58% (58/163), 32.69% (101/309), 31.91% (60/188), 12.63% (299/2367), and 32.35% (131/405) among male patients with balanitis, warts, rash, urethritis, prostatitis, and other urinary inflammation, respectively ( P  < 0.001). The top five HPV genotypes were HPV-52, HPV-58, HPV-16, HPV-51, and HPV-66. After the first positive HPV test, the proportion of male patients who turned negative was 22.47% within 3 months, 26.40% within 3-6 months, 24.72% within 6-12 months, 17.98% within 12-24 months, and 8.43% more than 24 months. The detection rate of HPV was high among male patients from the urology and dermatology departments in Beijing, which should be considered to develop HPV vaccines with better prevention effects.

Background: Graduate students exhibit vulnerability to problematic Internet use, which can result in adverse physical, psychological, and social consequences. However, limited studies have addressed this issue among graduate students, and even fewer have explored the unique factors contributing to their problematic Internet use. Therefore, to address this gap, the current study aims to probe the relationship between supervisor's neuroticism and problematic Internet use among graduate students, the mediating effect of the supervisor-student relationship quality, as well as the moderating effect of fear of the supervisor's negative evaluation., Methods: A cross-sectional study was conducted in 2018 at three universities in Beijing, China. Anonymous data from 448 graduate students were collected regarding problematic Internet use, supervisor's neuroticism, supervisor-student relationship quality, and the fear of the supervisor's negative evaluation. A moderated mediation analysis was performed using Hayes' PROCESS macro (Model 14)., Results: Supervisor's neuroticism was positively linked to graduate students' problematic Internet use, supervisor-student relationship quality mediated the linkage, and fear of the supervisor's negative evaluation played a moderating role in the second stage. Specifically, for students lower in fear of the supervisor's negative evaluation, supervisor-student relationship quality negatively predicted students' problematic Internet use. While for the graduate students higher in fear of the supervisor's negative evaluation, supervisor-student relationship quality could not significantly predict students' problematic Internet use. The mediating effect was only significant for graduate students lower in fear of the supervisor's negative evaluation., Conclusions: This study established a theoretical model linking supervisor's neuroticism to graduate students' problematic Internet use, highlighting the potential roles of supervisor-student relationship quality and fear of the supervisor's negative evaluation. Reducing the neuroticism level of the supervisor, enhancing the quality of the supervisor-student relationship, and mitigating students' fear of the supervisor's negative evaluation will contribute to the reduction of problematic Internet use among graduate students., (© 2024. The Author(s).)

Background: A significant percentage of patients with acute coronary syndrome (ACS) without standard modifiable cardiovascular risk factors (SMuRFs) are being identified. Nonetheless, the prognostic influence of the TyG index on adverse events in this type of patient remains unexplored. The aim of this study was to assess the prognostic value of the TyG index among ACS patients without SMuRFs for predicting adverse outcomes., Methods: This study involved 1140 consecutive patients who were diagnosed with ACS without SMuRFs at Beijing Anzhen Hospital between May 2018 and December 2020 and underwent coronary angiography. Each patient was followed up for a period of 35 to 66 months after discharge. The objective of this study was to examine major adverse cardiac and cerebrovascular events (MACCE), which included all-cause mortality, non-fatal myocardial infarction, non-fatal ischemic stroke, as well as ischemia-driven revascularization., Results: During the median follow-up period of 48.3 months, 220 (19.3%) MACCE events occurred. The average age of the participants was 59.55 ± 10.98 years, and the average TyG index was 8.67 ± 0.53. In the fully adjusted model, when considering the TyG index as either a continuous/categorical variable, significant associations with adverse outcomes were observed. Specifically, for each 1 standard deviation increase in the TyG index within the highest TyG index group, there was a hazard ratio (HR) of 1.245 (95% confidence interval CI 1.030, 1.504) for MACCE and 1.303 (95% CI 1.026, 1.653) for ischemia-driven revascularization (both P < 0.05), when the TyG index was analyzed as a continuous variable. Similarly, when the TyG index was examined as a categorical variable, the HR (95% CI) for MACCE in the highest TyG index group was 1.693 (95% CI 1.051, 2.727) (P < 0.05) in the fully adjusted model, while the HR (95% CI) for ischemia-driven revascularization was 1.855 (95% CI 0.998, 3.449) (P = 0.051). Additionally, the TyG index was found to be associated with a poor prognosis among the subgroup., Conclusion: The TyG index is correlated with poor prognosis in patients with ACS without SMuRFs, suggesting that it may be an independent predictive factor of adverse events among these individuals., (© 2024. The Author(s).)

Recombination events in human adenovirus (HAdV) have led to some new highly pathogenic or infectious types. It is vital to monitor recombinant HAdVs, especially in children with acute respiratory tract infections (ARIs). In the retrospective study, HAdV positive specimens were collected from pediatric patients with ARIs during 2015 to 2021, then typed by sequence analysis of the penton base, hexon and fiber gene sequence. For those with inconsistent typing results, a modified method with species-specific primer sets of a fiber gene sequence was developed to distinguish co-infections of different types from recombinant HAdV infections. Then, plaque assays combined with meta-genomic next-generation sequencing (mNGS) were used to reveal the HAdV genomic characteristics. There were 466 cases positive for HAdV DNA (2.89%, 466/16,097) and 350 (75.11%, 350/466) successfully typed with the most prevalent types HAdV-B3 (56.57%, 198/350) and HAdV-B7 (32.00%, 112/350), followed by HAdV-C1 (6.00%, 21/350). Among 35 cases (7.51%, 35/466) with inconsistent typing results, nine cases were confirmed as co-infections by different types of HAdVs, and 26 cases as recombinant HAdVs in six genetic patterns primarily clustered to species C (25 cases) in pattern 1-5, or species D (1 case) in pattern 6. The novel recombinant HAdV of species D was identified with multiple recombinant events among HAdV-D53, HAdV-D64, and HAdV-D8, and officially named as HAdV-D115. High-frequency recombination of HAdVs in six genetic recombination patterns were identified among children with ARIs in Beijing. Specifically, there is a novel Adenovirus D human/CHN/S8130/2023/115[P22H8F8] designed as HAdV D115.

Background: The study evaluated the protective effect of 13-valent pneumococcal polysaccharide conjugate vaccine (PCV13) against all-cause hospitalized pneumonia in children in Beijing., Methods: Based on the vaccination record and inpatient medical record database of Beijing, children born in 2017 in Beijing, matched by age, gender, and district of the children with the ratio of 1:4, were selected as the vaccinated and unvaccinated groups according whether if vaccinated with PCV13. The incidence rate and 95 % confidence interval (95 %CI), vaccine effectiveness (VE) and direct medical costs of all-cause hospitalized pneumonia were calculated and compared within the same period of 12 months, 18 months, 24 months and 30 months after the birth of the child., Results: The decreased incidence rates of all-cause hospitalized pneumonia were observed at the four points in the PCV13 vaccinated group compared to the unvaccinated group, which were significant at the points of 12 months (0.42 % vs. 0.72 %, P = 0.001), 18 months (0.90 % vs. 1.26 %, P = 0.002) and 24 months (1.37 % vs. 1.65 %, P = 0.046). The VE of PCV13 against all-cause hospitalized pneumonia within 12 months was the highest as 41.9 % (95 % CI 19.6 %, 58.0 %), followed by 29.3 % (95 % CI 11.4 %, 43.5 %) within 18 months, 17.1 % (95 % CI 0.3 %, 31.1 %) within 24 months and it almost disappeared within 30 months. The VE of 4-dose vaccination within 18 months and 24 months were 39.9 % (95 % CI 20.3 %, 54.7 %) and 27.2 % (95 % CI 8.6 %, 42.0 %), respectively. The median hospitalization cost of the children in the vaccinated group was higher at the four points but without significance., Conclusions: PCV13 had a certain protective effect on all-cause hospitalized pneumonia, and the booster immunization strategy had the best protective effect with great public health significance to enter the immunization program., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Mixing states of aerosol particles are crucial for understanding the role of aerosols in influencing air quality and climate. However, a fundamental understanding of the complex mixing states is still lacking because most traditional analysis techniques only reveal bulk chemical and physical properties with limited surface and 3-D information. In this research, 3-D molecular imaging enabled by ToF-SIMS was used to elucidate the mixing states of PM 2.5 samples obtained from a typical Beijing winter haze event. In light pollution cases, a thin organic layer covers separated inorganic particles; while in serious pollution cases, ion exchange and an organic-inorganic mixing surface on large-area particles were observed. The new results provide key 3-D molecular information of mixing states, which is highly potential for reducing uncertainty and bias in representing aerosol-cloud interactions in current Earth System Models and improving the understanding of aerosols on air quality and human health.

Background: Under the pressure of non-pharmaceutical interventions (NPIs) targeting severe acute respiratory syndrome coronavirus 2, the prevalence of human adenovirus (HAdV) was monitored before and after NPIs launched on Jan 24, 2020 in pediatric patients in Beijing, China., Methods: Respiratory samples collected from children hospitalized with acute respiratory infections from Jan 2015 to Dec 2021 were screened by direct immunofluorescence test or capillary electrophoresis-based multiplex PCR assay. The hexon, penton base, and fiber genes were amplified from HAdV positive specimens, then sequenced. For HAdV typing, phylogenetic trees were built by MEGA X. Then clinical data of HAdV positive cases were collected. All data were evaluated using SPSS Statistics 22.0 software., Results: A total of 16,097 children were enrolled and 466 (2.89%, 466/16,097) were HAdV-positive. The positive rates of HAdV varied, ranging from 4.39% (151/3,438) in 2018 to1.25% (26/2,081) in 2021, dropped from 3.19% (428/13,408) to 1.41% (38/2,689) from before to after NPIs launched (P < 0.001). There were 350 cases typed into nine types of species B, C, or E and 34 recorded as undetermined. Among them, HAdV-B3 (51.56%, 198/384) was the most prevalent types from 2015 to 2017, and HAdV-B7 (29.17%, 112/384) co-circulated with HAdV-B3 from 2018 to 2019. After NPIs launched, HAdV-B3 and B7 decreased sharply with HAdV-B7 undetected in 2021, while HAdV-C1 became the dominant one and the undetermined were more., Conclusions: The endemic pattern of HAdV changed in Beijing because of the NPIs launched for COVID-19. Especially, the dominant types changed from HAdV-B to HAdV-C., (© 2023. The Author(s).)

During the period of 2015-2018, Chinese government had made great efforts to mitigate air pollutants, such as air quality monitoring, energy structure adjustment, and pollutant emission reduction from industry, transportation and household sectors. With the special investment of 152 billion Chinese Yuan (CNY) in the Beijing-Tianjin-Hebei (BTH) and surrounding "2 + 26" regions, the annual local concentrations of PM 2.5 , PM 10 , SO 2 and NO 2 decreased from 77, 132, 38 and 46 μg/m 3 to 60, 109, 20 and 43 μg/m 3 . It was estimated that the improvement in air quality avoided 27,021 (95 % CIs 12,548-39,738) premature deaths attributed to air pollution exposure based on an exposure-response function, including 45 %, 17 % and 15 % of cardiopulmonary, lung cancer and respiratory morality cases. Air pollution reduction was also effective in reducing work time loss, which reduced the total working time loss by 3.8 × 10 7 (95 % CIs 1.8 × 10 7 -5.6 × 10 7 ) h, and the per capita working time loss by 0.28 (95 % CIs 0.13-0.41) h/capita by 2018. From the economic aspect, air pollution control actions in those regions saved 95.6 (95 % CIs 44.2-141) billion CNY economic loss by using the value of statistical life (VSL). The total benefit-cost ratio was 63.7 % (95 % CIs 29.4 %-93.7 %). The cost-effectiveness in Beijing and Tianjin were relatively low due to the regional contribution from other cities of the air pollution transmission channel. Despite the uncertainties, the results clearly show the significance of the environmental, health and economic benefits of actions in the BTH and surrounding "2 + 26" regions for combating air pollution., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier B.V.)

Based on multi-source observation data, such as lidar ceilometer, aircraft AMDAR, and conventional sites, combined with numerical simulation (CAMx-PSAT), this study took the typical cities of the Beijing-Tianjin-Hebei region-Beijing (BJ) urban area and suburbs (Miyun) and Shijiazhuang (SJZ) urban area and suburbs (Pingshan) as the case study areas. The differences in boundary layer height between urban areas and suburbs (ΔPBLH), surface PM 2.5 mass concentration (ΔSurf&#95;PM 2.5 ), vertical PM 2.5 mass concentration (ΔVert&#95;PM 2.5 ), and transmission flux intensity and height distribution characteristics were analyzed. The results showed:due to factors such as anthropogenic heat sources, short-wave radiation, and thermal turbulence, the annual average planetary boundary layer height in urban areas was 8%-29% higher than that in the suburbs, and in different seasons, the monthly average planetary boundary layer height in urban areas was 2% (April in SJZ)-47% (July in BJ) higher than that in the suburbs. Due to the combined effects of anthropogenic emissions, inversions, and atmospheric turbulence, the annual average ρ (PM 2.5 ) in urban areas between 0-1260 m was higher than that in suburbs by 0.1 (SJZ)-29.7 (BJ) μg·m -3 and decreased with the increase in height. The annual average total net flux intensity in urban areas was much greater than that in suburbs, with outflows in urban areas and inflows in suburbs; due to the urban low pressure and the suburban high pressure, suburban thermal circulation was formed. The annual average total net flux intensity in BJ (44.77 t·d -1 ) was greater than that in SJZ (34.44 t·d -1 ). Affected by wind speed and PM 2.5 mass concentration, between 0-1260 m, the fluxes in urban areas and suburbs and surrounding areas showed an obvious trend of increasing net flux intensity with the increase in height above the ground. Furthermore, the transmission exchange between urban areas and suburbs and surrounding areas in January and April had the most obvious impact on the environment. The intensity of the maximum net flux in the lower urban areas and the suburbs in different seasons was significantly different, and the difference between the two was 2.23-4.48 times; however, the height characteristic difference in the intensity of the maximum net flux was small, mainly located at 611-1260 m.

Pollen allergy has already been an increasingly prominent ecosystem disservice in tourism attractions. However, few studies have assessed the tourist risk of pollen allergy through integrating multidisciplinary knowledge of ecology, medicine, phenology, and risk management. Basing on the conceptual framework of risk assessment proposed by UNISDR, we first established an index system of pollen-allergy risk for tourists in attractions and outlined assessment methods 18 available indexes were put forward to cover three aspects: hazard of plant allergen, tourist vulnerability, and resilience of assessment units. Subsequently, taking the Summer Palace as the case study area, we conducted a tourist risk assessment of pollen allergy. Values of nine available indexes were obtained via ecological investigation, phenological observation, and data mining of visitors' logs on Sina Weibo. Risk levels of spring pollen allergy for tourists in different assessment units were revealed by combining the green zone allergenicity index model and three-dimensional risk assessment matrix. The results showed that: (1) There were seven primary pollen-allergenic plants in the Summer Palace, including Platycladus orientalis, Sabina chinensis, Salix babylonica, Pinus tabulaeformis, Populus tomentosa Carr, Morus alba L . and Fraxinus chinesis , among which Platycladus orientalis and Salix babylonica were the highest allergenic. (2) Among 18 spots, tourists faced the highest risk level of pollen allergy in spring at three spots, namely the Hall of Serenity, Hall of Benevolence and Longevity, and Gallery of Literary and Prosperity. (3) The two routes of the Long Corridor and Longevity Hill scored high on the risk level. (4) Among four areas, risk levels of the Front-hill and Rear-hill areas were high. Given the increasing spatial-temporal uncertainty of pollen allergy and tourist behaviors under global warming and urbanization, the related monitoring should be strengthened in the future. Furthermore, the dynamic and improved assessment of pollen-allergy risk should be institutionalized and be integrated into the evaluation of tourism experience quality. Tourism administration should make full use of relevant assessment results and conduct more effective risk communication., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zhou, Dai, Liu and Liu.)

Ultrafine particles (UFPs) usually explosive growth during new particle formation (NPF) events. However, the risk of exposure to UFPs on NPF days has been ignored due to the prevalence of mass-based air quality standards. In this study, the daily deposited doses, i.e., the daily deposited particle number dose (D PNd ), mass dose (D PMd ), and surface area dose (D PSd ), of ambient particles in the human respiratory tract in Beijing were evaluated based on the particle number size distribution (3 nm-10 µm) from June 2018 to May 2019 utilizing a Multiple-Path Particle Dosimetry Model (MPPD) after the hygroscopic growth of particles in the respiratory tract had been accounted for. Our observations showed a high frequency (72.6%) of NPF on excellent air quality days, with daily mean PM 2.5 concentrations less than 35 μg m -3 . The daily D PNd on excellent air quality days was comparable with that on polluted days, although the D PMd on excellent air quality days was as low as 15.6% of that on polluted days. The D PNd on NPF days was ~1.3 times that on non-NPF days. The D PNd in respiratory tract regions decreased in the order: tracheobronchial (TB) > pulmonary (PUL) > extrathoracic (ET) on NPF days, while it was PUL > TB > ET on non-NPF days. The number of deposited nucleation mode particles, which were deposited mainly in the TB region (45%), was 2 times higher on NPF days than that on non-NPF days. Our results demonstrated that the deposition potential due to UFPs in terms of particle number concentrations is high in Beijing regardless of the aerosol mass concentration. More toxicological studies related to UFPs on NPF days, especially those targeting tracheobronchial and pulmonary impairment, are required in the future., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To understand the epidemiological characteristics of notifiable infectious diseases reported in Beijing in 2021 under the influence of the novel coronavirus pneumonia epidemic prevention and control policy, and provide reference evidence for the prevention and control of notifiable infectious diseases. Methods: Descriptive epidemiological methods were used to analyze the morbidity of notifiable infectious diseases reported in Beijing in 2021, with software R 4.1.2 for data process and ArcGIS 10.8 for visualization. Results: The morbidity of notifiable infectious diseases in Beijing in 2021 was 290.51/100 000, a decrease of 43.29% compared with 2020 and a decrease of 71.45% compared with the average during 2017-2019. The top 5 reported diseases with high morbidity were other infectious diarrhea, influenza, hand foot and mouth disease, pulmonary tuberculosis and syphilis. From the perspective of transmission route, intestinal infectious diseases were the main diseases, accounting for 50.15% (31 898/63 601) of the total cases. From the perspective of pathogens, viral infectious diseases were the main diseases, accounting for 59.63% (25 259/42 356) of the total cases. The laboratory diagnosis rate of notifiable infectious diseases reported in Beijing increased from the average of 16.47% (36 289/220 371) during 2017-2019 to 35.36% (22 490/63 601) in 2021. The laboratory diagnosis rate of parasitic infectious diseases was 83.33%. The districts with high incidence of intestinal infectious diseases were Pinggu, Miyun and Fengtai; Natural foci and insect borne infectious diseases were mainly reported in Yanqing, Mentougou, Fangshan and Daxing. Conclusion: The morbidity of notifiable infectious diseases in Beijing in 2021 showed a decrease trend. The laboratory confirmation rate of reported notifiable infectious disease cases increased, and there were great differences in the laboratory confirmation rate among different diseases. It is very necessary to improve the laboratory confirmation rate of the cases. The diseases with different transmission routes showed different geographical distributions. It is necessary to conduct the targeted prevention and control of infectious diseases in different areas.

Aims: The cost of drug regimens prescribed to Chinese patients has not been evaluated. This study aims to evaluate the medical costs and hypoglycemic agents for diabetes mellitus patients with or without chronic respiratory disease in Beijing, and to investigate the changes in the costs and number of antidiabetic medications used for diabetes patients with chronic respiratory disease from 2016 to 2018., Methods: This observational, retrospective study included diabetes patients with outpatient medication records from Beijing Medical Insurance between 2016 and 2018. The medications, including hypoglycemic and nonhypoglycemic drugs, insulin dosage, comorbidities, diabetes-related complications, treatment strategies, and annual medical costs, were recorded., Results: This study included 2,853,036 diabetes patients from 2016 to 2018. About 18.95%-20.53% of patients with chronic respiratory disease were predominantly distributed among those aged 45-84 years (88.7%-89.1%). Diabetes patients with chronic respiratory disease used more medications (4.48 ± 2.41 vs. 3.76 ± 2.33) and had higher total annual drug costs (¥12,286 ± 10,385 vs. ¥9700 ± 9202) to treat more comorbidities (2.52 ± 1.53 vs. 2.05 ± 1.85) than those without chronic respiratory disease ( p <.0001, respectively). From 2016 to 2018, diabetes patients with chronic respiratory disease had a 4.2% increase in medication, a 1.9% decrease in comorbidities, and a 5.4% decrease in total annual drug costs., Conclusions: In summary, diabetes patients with chronic respiratory disease had more comorbidities, required more hypoglycemic drugs, and had higher medical costs. During 2016-2018, diabetes patients with chronic respiratory disease used more medications and spent less money on medical care., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Qiao, Tan, Xu, Zhou, Wang, Luo, Fan, Pan and Guo.)

The molecular composition of atmospheric particulate matter (PM) in the urban environment is complex, and it remains a challenge to identify its sources and formation pathways. Here, we report the seasonal variation of the molecular composition of organic aerosols (OA), based on 172 PM 2.5 filter samples collected in Beijing, China, from February 2018 to March 2019. We applied a hierarchical cluster analysis (HCA) on a large nontarget-screening data set and found a strong seasonal difference in the OA chemical composition. Molecular fingerprints of the major compound clusters exhibit a unique molecular pattern in the Van Krevelen-space. We found that summer OA in Beijing features a higher degree of oxidation and a higher proportion of organosulfates (OSs) in comparison to OA during wintertime, which exhibits a high contribution from (nitro-)aromatic compounds. OSs appeared with a high intensity in summer-haze conditions, indicating the importance of anthropogenic enhancement of secondary OA in summer Beijing. Furthermore, we quantified the contribution of the four main compound clusters to total OA using surrogate standards. With this approach, we are able to explain a small fraction of the OA (∼11-14%) monitored by the Time-of-Flight Aerosol Chemical Speciation Monitor (ToF-ACSM). However, we observe a strong correlation between the sum of the quantified clusters and OA measured by the ToF-ACSM, indicating that the identified clusters represent the major variability of OA seasonal cycles. This study highlights the potential of using nontarget screening in combination with HCA for gaining a better understanding of the molecular composition and the origin of OA in the urban environment.

Background: It has been demonstrated that glycated albumin (GA) is significantly associated with diabetes complications and mortality. However, among patients diagnosed with non-ST-elevation acute coronary syndrome (NSTE-ACS) administered percutaneous coronary intervention (PCI), the predictive value of GA for poor prognosis is unclear., Methods: This study eventually included 2247 NSTE-ACS patients in Beijing Anzhen Hospital, Capital Medical University in January-December 2015 who received PCI. All patients were followed up until death or for 48 months post-discharge. The primary endpoint was major adverse cardio-cerebral events (MACCEs), including all-cause death, non-fatal myocardial infarction, ischemia-induced revascularization and non-fatal ischemic stroke., Results: In total, 547 (24.3%) MACCEs were recorded during the follow-up period. Upon adjusting for potential confounders, GA remained an important risk predictor of MACCEs (As nominal variate: hazard ratio [HR] 1.527, 95% confidence interval [CI] 1.236-1.886, P < 0.001; As continuous variate: HR 1.053, 95% CI 1.027-1.079, P < 0.001). GA addition significantly enhanced the predictive ability of the traditional risk model (Harrell's C-index, GA vs. Baseline model, 0.694 vs. 0.684, comparison P = 0.002; continuous net reclassification improvement (continuous-NRI) 0.085, P = 0.053; integrated discrimination improvement (IDI) 0.007, P = 0.020)., Conclusion: GA is highly correlated with poor prognosis in NSTE-ACS patients undergoing PCI, suggesting that it may be a major predictive factor of adverse events among these individuals., (© 2022. The Author(s).)

Background: The prevalence of coronary artery disease (CAD) continues to increase among young Chinese adults. Current smoking has been recognized as a major risk factor for premature CAD, and hyperhomocysteinaemia (HHcy) has also been suggested to be associated with CAD progression. However, the combined effect of current smoking and HHcy on the severity of coronary artery stenosis in young adults is still uncertain., Methods: We consecutively collected young patients (18-35 years of age), diagnosed with CAD and underwent coronary angiography (CAG) at Anzhen Hospital between January 2013 and May 2020. HHcy was defined as serum homocysteine (Hcy) level > 15 µmol/L. The severity of coronary artery stenosis was evaluated by Gensini Score. The co-effect of current smoking and HHcy on CAD severity as well as the relationship between plasma Hcy, pack-years of smoking and CAD severity were assessed by multivariate linear regression analysis., Results: A total of 989 participants (mean age, 33 years; 96.2% male) fulfilling the criteria were enrolled in this study. Patients with both HHcy and current smoking accounted for 39.1% of all the subjects. Multivariate liner analysis indicated both serum Hcy levels (β 0.302; 95% CI 0.141-0.462; P < 0.001) and pack-years of smoking (β 0.523; 95% CI 0.265-0.781; P < 0.001) were independently associated with the severity of coronary artery stenosis after adjusting for other traditional confounders. In addition, serum Hcy levels were correlated with pack-years of smoking in young CAD patients (r = 0.116, P = 0.001). Moreover, combination of HHcy and current smoking was suggested to have higher risk for CAD severity (β 17.892; 95% CI 11.314-24.469; P < 0.001), compared with HHcy (β 7.471; 95% CI 0.009-14.934; P = 0.048) or current smoking (β 7.421; 95% CI 0.608-14.233; P = 0.033) alone., Conclusion: Combination of HHcy and smoking is independently associated with the severity of CAD in young patients ≤ 35 years of age., (© 2021. The Author(s).)

Objective: To evaluate epidemiological characteristics and transmission dynamics of COVID-19 outbreak resurged in Beijing and to assess the effects of three non-pharmaceutical interventions., Design: Descriptive and modelling study based on surveillance data of COVID-19 in Beijing., Setting: Outbreak in Beijing., Participants: The database included 335 confirmed cases of COVID-19., Methods: To conduct spatiotemporal analyses of the outbreak, we collected individual records on laboratory-confirmed cases of COVID-19 from 11 June 2020 to 5 July 2020 in Beijing, and visitor flow and products transportation data of Xinfadi Wholesale Market. We also built a modified susceptible-exposed-infected-removed model to investigate the effect of interventions deployed in Beijing., Results: We found that the staff working in the market (52.2%) and the people around 10 km to this epicentre (72.5%) were most affected, and the population mobility entering-exiting Xinfadi Wholesale Market significantly contributed to the spread of COVID-19 (p=0.021), but goods flow of the market had little impact on the virus spread (p=0.184). The prompt identification of Xinfadi Wholesale Market as the infection source could have avoided a total of 25 708 (95% CI 13 657 to 40 625) cases if unnoticed transmission lasted for a month. Based on the model, we found that active screening on targeted population by nucleic acid testing alone had the most significant effect., Conclusions: The non-pharmaceutical interventions deployed in Beijing, including localised lockdown, close-contact tracing and community-based testing, were proved to be effective enough to contain the outbreak. Beijing has achieved an optimal balance between epidemic containment and economic protection., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Organic and inorganic pollutants are often co-sedimentary in soils and have the same sources in the urban environment. The identification of the sources and distribution of combined pollutants is a basic step in risk management. In this study, the levels of polycyclic aromatic hydrocarbons (PAHs) and heavy metals (HMs) were measured in urban park soils in Beijing. Bivariate local Moran's I and positive matrix factorization (PMF) source apportionment were used to identify the spatial clustering patterns and potential sources of PAHs and HMs, as well as to ultimately define a pollution risk control area. The results revealed an obvious clustered distribution of PAHs and HMs in the park soils. High-high areas were defined as sites containing a complex mixture of pollutants, which were mainly located in the center and north of Beijing. High-low and low-high areas were located outside the city center but had the potential for combined pollution, and therefore require continuous attention. Bivariate local indicators of spatial association (LISA) enabled a more accurate analyses of the mechanism controlling the spatial distribution of PAH and HM combinations in urban parks. The source apportionment indicated that industrial and traffic emissions were the most important sources of the pollutant combinations in urban parks, with traffic emissions accounting for most of the pollution., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objectives: To identify the patterns of antibiotic use and irrational antibiotic prescriptions in primary healthcare institutions (PHIs) in Dongcheng District of Beijing, China., Materials and Methods: All primary healthcare institutions (7 community healthcare centres and 59 community healthcare stations in total) in Dongcheng District were included in the study. Prescription data from January 2015 to December 2018 was derived from the Beijing Prescription Reviewing System of Primary healthcare institutions and analysed retrospectively. The antibiotic prescription rate was calculated and cases of irrational antibiotic prescriptions were identified., Results: We extracted 11,166,905 prescriptions from the database. Only 189,962 prescriptions were included in the study, among which 9167 (4.8%) contained antibiotics. The antibiotic prescription rate fell from 5.2% in 2015 to 4.1% in 2018 while irrational antibiotic prescription rate increased from 10.4 to 11.8%. Acute Bronchitis was the most prevalent diagnosis (17.6%) for antibiotic prescriptions, followed by Unspecified Acute Respiratory Tract Infection (14.4%), Acute Tonsillitis (9.9%), and Urinary Tract Infection (6.4%). Around 10% of the prescriptions for the top 7 diagnoses identified were rated as irrational. Cephalosporins, fluoroquinolones, and macrolides were the most prescribed antibiotics, which accounted for 89.3% of all antibiotic prescriptions. Of all the antibiotic prescriptions, 7531 were reviewed, among which 939 (12.5%) were rated as irrational because of antibiotic use. Among all the irrational prescriptions, prescriptions with inappropriate antibiotic use and dosage accounted for the majority (54.4%)., Conclusion: Although a relatively low level of antibiotic utilization was found in PHIs in Dongcheng District of Beijing, the utilization patterns differed considerably from developed countries and irrational prescriptions remained. Considering the imbalanced allocation of medical resources between primary healthcare setting and secondary and tertiary hospitals, there need to be more efforts invested in regions with different levels of economic development., (© 2021. The Author(s).)

Energy and water resources are drawing increasing attention in China as indispensable elements of economic development and social stability. Energy and water are interconnected in economic systems. Although the nexus between them has been widely studied, few insights can be acquired by the intermediate transmission pressures across supply chains. Combing betweenness-based method and multi-regional input-output (MRIO) analysis, we, in this study, identified critical transmission sectors and main driving factors resulting from the usage structure. In details, we found that Metallurgy (S14) in Shandong, Henan, Jiangxi, Anhui, Sichuan, Zhejiang, Hunan, and Jiangsu, Electricity and hot water production and supply (S22) in Beijing and Guizhou, and Nonmetal production (S13) in Henan are the most critical transmission sectors bearing energy-water nexus pressures, ranking at the top 100 in China's supply chain networks. Roughly, the usage structure was mainly dominated by fixed capital formation, urban household consumption and trade export, and therefore should be given priority to mitigate environmental pressures. Our study provides a novel perspective of sector-specific and province-typical policy recommendations for mitigating energy-water nexus pressures in China's supply chain networks., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Purpose: Although the cost and complexity of managing diabetes is increasing around the world, placing greater burden on patients and their families, the cost of drug regimens prescribed to Chinese patients has not been evaluated. This study was conducted to evaluate the temporal changes in the costs and drugs used for people with diabetes., Methods: Patients enrolled in Beijing Medical Insurance with outpatient medical records from 2016 through 2018 were included in this study. The outcomes of interest were: (1) the number of outpatient medications, (2) the number of comorbidities diagnosed, (3) the estimated annual cost of the outpatient drug regimen, (4) the drug therapy strategies used for diabetic patients, and (5) the most commonly prescribed classes of drugs., Results: Over the 3-year period, there was a significant decrease (9.0%, P <.001) in the average number of diabetes medications used. Both antiglycemic and non-antiglycemic drug use decreased by 3.6% and 12.9%, respectively. Similarly, for estimated annual costs of medication, an 18.4% ( P <.05) decrease was observed, with a gradual decreased from ¥6,868 ($1,059) in 2016 to ¥5,605 ($865) in 2018., Conclusion: This is the first large-scale cost analysis of the medical management of diabetes since the implementation of medical insurance in China. Despite the increasing availability of newer, more expensive diabetes drugs, there was a significant reduction in the number of diabetes medications used, that may be due to a more rational approach to optimizing metabolic targets., (© 2021 Annals of Family Medicine, Inc.)

Nosocomial infections are common in pediatric patients and can be fatal in infants and immunocompromised patients. In September 2018, a high positive rate of human adenovirus HAdV was occurred among hospitalized children in the Children's Hospital Affiliated to the Capital Institute of Paediatrics in Beijing. To investigate whether this outbreak of HAdV was related to nosocomial infections or the result of community infections, we collected respiratory specimens from patients with acute respiratory infections in a respiratory ward during June to December 2018, and screened for respiratory viruses. Among 1,840 cases included, 95 (5.2%, 95/1840) were positive for HAdV and 81 were genotyped based on phylogenetic analysis, including seven as HAdV-1 (8.6%), 30 HAdV-3 (37.0%), two HAdV-6 (2.5%), and 42 HAdV-7 (51.9%). More HAdV-positive samples were collected in August (4.7%, 12/255), September (15.0%, 41/274) and October (6.9%, 17/247), with a peak in September 2018. By combining the results of HAdV phylogenetic analysis with clinical data of patients, there were 77 cases (4.2%, 77/1840; 81.1%, 77/95) excluded from nosocomial infections, eight cases representing possible infections transmitted by visitors or attending parents, three cases without sequences that might have been due to infection transmitted by roommates positive for HAdV, one case of a roommate without an HAdV sequence, and six cases that shared highly homologous sequences with those of their roommates, for which nosocomial infections might be considered. In conclusion, genotyping of HAdVs based on phylogenetic analysis combined with clinical information provides a powerful method to distinguish nosocomial infections from community acquired infection, especially when tracing the origins of nosocomial infections.

Objective: To provide updated information about demographic variations and temporal trends in the prenatal use of multiple micronutrient (MMN) supplements in the metropolitan areas of China., Design: Descriptive analysis of routine prenatal healthcare data between 2013 and 2017., Setting: Chaoyang District, Beijing, China., Participants: A total of 197 346 pregnant women who attended their first prenatal care visit and provided information about MMN supplementation during the periconceptional period., Results: Of these pregnant women, 60·6 % reported consuming prenatal MMN supplements. In multivariate-adjusted models, there were significant gradients of age, education and parity in prenatal MMN supplementation, with the highest likelihood of MMN use among the oldest, the most highly educated and nulliparous women (Pfor trend < 0·001). Compared with that among unemployed women, prenatal MMN supplementation was more common among the employed, especially those engaged in business (adjusted relative risks (95 % CI): 1·08 (1·06, 1·10)) and management (1·10 (1·08, 1·12)). The proportion of prenatal MMN supplementation was 57·0 % in 2013, which increased to 63·5 % in 2017 (Pfor trend < 0·001). The trends varied by age, education and parity (Pfor heterogeneity < 0·001), whereas no significant difference was observed in trends across subgroups of ethnicity or occupation. The greatest magnitude increase in MMN supplement use occurred in women of age < 25 years (annual percent change: 5·7 %), less than high school education (9·6 %), parity ≥ 2 (6·8 %) or unemployment (6·1 %)., Conclusion: Approximately two-thirds of women consumed prenatal MMN supplements during the periconceptional period in the central area of Beijing and the proportion increased over time, indicating a need to evaluate the effectiveness and safety and to develop a guideline for relatively well-nourished women.

The presence of pharmaceuticals and personal care products (PPCPs) has become a global concern, as it poses a threat to the environment, especially to the aquatic ecosystem. This study focused on 30 PPCPs found in the Baiyangdian basin of the Xiong'an New Area, in the core of Beijing-Tianjin-Hebei region, with intensive human interventions during two seasons. In general, 30 PPCPs were all frequently detected, ranging from 42.3 to 7710 ng/L in May and 48.9 to 1300 ng/L in November. Sulfamethoxazole, ofloxacin, anhydro-erythromycin, carbamazepine, caffeine, and were screened as the predominant PPCPs. The rivers input was an essential source of PPCPs. The source apportionment with a series of analytical methods revealed that domestic sewage was the primary source, and untreated water also crucial for PPCPs contamination. The risk assessment suggested carbamazepine, caffeine, ofloxacin, and anhydro-erythromycin exhibited relatively high ecological risks for protecting most species such as algae, fish, and flowers in the aquatic ecosystem, especially near the outlet of WWTPs. Thus, management strategies for such PPCPs will be needed. Intensive human interventions, including a prohibition of fish breeding, water diversion project, and wastewater treatment in villages, were having an effective role in alleviating PPCPs contamination., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Rural residential coal combustion (RRCC) has detrimental effects on air quality, climate, and human health. There are large uncertainties regarding emissions from RRCC owing to the lack of consideration of several key factors (e.g. combination modes of coal and stoves, combustion modes, and high temporal resolution). In this study, we provided a new estimation framework for RRCC emissions through a case study in the Beijing-Tianjin-Hebei (BTH) region, China. The emission estimations were improved according to four aspects, namely (1) coal-specific and stove-specific coal consumption was calculated based on face-to-face field interviews of 6700 valid volunteers/households covering 288 villages in 50 counties; (2) the influences of combustion modes (flaming and smoldering modes) on emissions were considered; (3) emissions of different fuel-stove combinations were estimated based on coal, stove, and combustion mode-specific RRCC consumption and localised emission factors; and (4) a method for emission estimation with high temporal resolution (1 h) was developed. The results indicated that RRCC emitted 413.6 kt SO 2 , 55.7 kt NO x , 5717.3 kt CO, 149.4 kt VOCs, 167.1 kt PM 2.5 , 18.2 kt EC, 32.5 kt OC, and 8.2 kt NH 3 in 2016. The combination of bituminous coal and an advanced coal stove was the most significant contributor (20.7-71.8%) to various pollutant emissions. Coal combusted under the flaming mode contributed to most (81.9%) of the total coal consumption, and thus emitted the majority (50.8-99.8%) of pollutants, except for VOCs. Meanwhile, that under the smoldering mode only accounted for 18.1% of the total consumption, but contributed 49.2% and 74.7% of the CO and VOCs emissions, respectively. Two clear emission peaks occurred at approximately 7:00-9:00 and 18:00-20:00. The detailed coal consumption and emissions with high temporal and spatial resolution can provide sound data for further research on rural environmental issues and scientific support to pollution control strategies., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Bacillary dysentery is a global public health problem that exhibits manifest spatiotemporal heterogeneity. However, long-term variations and regional determinant factors remain unclear. In this study, the Bayesian space-time hierarchy model was used to identify the long-term spatiotemporal heterogeneity of the incidence of bacillary dysentery and quantify the associations of meteorological factors with the incidence of bacillary dysentery in northern and southern China from 2013 to 2017. GeoDetector was used to quantify the determinant powers of socioeconomic factors in the two regions. The results showed that the incidence of bacillary dysentery peaked in summer (June to August), indicating temporal seasonality. Geographically, the hot spots (high-risk areas) were distributed in northwestern China (Xinjiang, Gansu, and Ningxia) and northern China (including Beijing, Tianjin, and Hebei), whereas the cold spots (low-risk areas) were concentrated in southeastern China (Jiangsu, Zhejiang, Fujian, and Guangdong). Moreover, significant regional differences were found among the meteorological and socioeconomic factors. Average temperature was the dominant meteorological factor in both northern and southern China. In northern and southern China, a 1 °C increase in the average temperature led to an increase of 1.01% and 4.26% in bacillary dysentery risk, respectively. The dominant socioeconomic factors in northern and southern China were per capita gross domestic product and the number of health technicians, with q statistic values of 0.81 and 0.49, respectively. These findings suggest that hot, moist, and overcrowded environments or poor health conditions increase the risk of bacillary dysentery. This study provides suggestions and serves as a basis for surveillance efforts. Further, the suggestions may aid in the control of bacillary dysentery and in the implementation of disease prevention policies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: The prevalence of acute coronary syndrome (ACS) continues to increase among young Chinese adults. Homocysteine (HCY) has been suggested as a promoter of atherosclerosis leading to coronary artery disease (CAD). Yet, it remains uncertain whether HCY is associated with the ACS and the severity of coronary artery stenosis in young adults., Methods: Young patients (18-35 years of age) diagnosed with ACS who underwent coronary angiography (CAG) at Anzhen Hospital between January 2013 and June 2019 were assigned to the ACS group. As confirmed by CAG during the same period, an equivalent age-matched population without CAD was assigned to the non-CAD group. A serum HCY level > 15 µmol/L was defined as hyperhomocysteinemia (HHCY). The Gensini score assessed the severity of coronary artery stenosis., Results: A total of 1103 participants, including 828 ACS patients and 275 non-CAD subjects, were enrolled in this study. Young ACS patients had higher level of serum HCY and greater prevalence of HHCY compared with non-CAD subjects [for HCY, 16.55 (11.93-29.68) vs 12.50 (9.71-17.42), P < 0.001; for HHCY prevalence, 62.08% vs 26.18%, P < 0.001]. Multivariate logistic regression analysis with the stepwise method indicated that HHCY was an independent predictor associated with the presence of ACS, after adjusting for traditional confounders (OR, 4.561; 95% CI, 3.288-6.327; P < 0.001). Moreover, young ACS patients with HHCY had increased prevalence of ST-segment elevation myocardial infarction (STEMI) (P = 0.041), multi-vessel disease (P = 0.036), and decreased value of left ventricular ejection fraction (LVEF) (P = 0.01). Also, the HCY level was significantly correlated with Gensini Score in ACS patients (r = 0.142, P < 0.001)., Conclusion: HHCY is significantly associated with the presence of ACS and the severity of coronary artery stenosis in young adults ≤ 35 years of age.

Objective: To analyze the characteristics and citations of articles in National Medical Journal of China ( NMJC ) during 2016, and to discuss the academic level and quality of the journal. Methods: All the literature published in NMJC during 2016 were retrieved through the Chinese Medical Citation index, and the citation frequency data in China's core journals of science and technology from January 2017 to December 2018 was obtained through Institute of Scientific and Technical Information of China. The citation status of articles published in NMJC was statistically analyzed by the method of literature metrology. The main indicators included the citation rate of articles published in each year, the citation frequency of all articles, the citation status of individual papers and authors, the regional and high-yield institution distribution of cited authors, and the main citation journals. Results: In 2016, a total of 962 articles were published in 22 columns of NMJC . The total number of published pages was 3 940, and the average number of articles was 4.09 pages. A total of 28 key topics have been published. The total citation was 2 077 times, with 2.16 times per paper. Among them, 322 papers were not cited, accounting for 33.47%. The maximum citation frequency of a single paper was 66 times. There were good citations in the columns of Guidelines, Epidemiology, New technology and methods, Clinical research and Editorial. Oncology, neurology/psychiatry, imaging/ultrasound/radiology, respiratory medicine and orthopedics accounted for a large part [40.43% (389 articles)]. Articles in neurosurgery, respiratory medicine, preventive medicine and gastrointestinal surgery were all cited with high frequency (all ≥2.75 times/article). A total of 483(50.21%) articles had obtained fund support, and the rate (68.12%) of them cited was slightly higher than that of articles without fund support (64.93%). A total of 23 articles were cited ≥10 times, and 16 first authors were cited ≥10 times. In addation, 26 corresponding authors were cited ≥10 times and 10 institutions were cited more than 15 times. The authors of the cited papers were distributed in 29 provinces (autonomous regions, municipalities directly under the central government), and there were more articles and higher total citation frequency in Beijing, Shanghai, Jiangsu and Tianjin. From 2017 to 2018, papers published in NMJC were cited 2 077 times by a total of 490 journals. Conclusions: The guidelines published in NMJC is highly cited. The editorial department should adjust the column setting timely, strengthen the planning of key topic selection and the solicitation and publicity of excellent papers, and further improve the influence of the magazine.

While numerous studies have explored the spatial patterns and underlying causes of PM 2.5 at the urban scale, little attention has been paid to the spatial heterogeneity affecting PM 2.5 factors. In order to enrich this research field, we collected PM 2.5 monitoring data from 367 cities across China in 2016 and combined inverse distance weighted interpolation (IDW) and geographically weighted regression (GWR) model. As a result, we could dynamically describe the spatial distribution pattern of urban PM 2.5 at monthly, seasonal, and annual scales and investigate the spatial heterogeneity of the influential factors on urban PM 2.5 . Furthermore, in order to make the result more scientific and reasonable, the paper used selection.gwr function and bw.gwr function, respectively, to optimize model, thereby avoiding local collinearity caused by independent variables. The main results are as follows: (1) PM 2.5 in Chinese cities is characterized as time-space non-equilibrium pattern. The Beijing-Tianjin-Hebei region, the Yangtze River corner region, the Pearl River Delta region, and the northeast region have formed a pollution-concentrating core area with Beijing-Tianjin-Hebei region as the axis, which brings greater difficulties and challenges to PM 2.5 governance. (2) The effects of various factors of socio-economic activities on the concentration of PM 2.5 have significant spatial heterogeneity among Chinese cities. (3) There is an inverted "U" curve between economic growth and PM 2.5 . When the per capita income reaches 47,000 yuan, the PM 2.5 emission reaches the peak, which proves the existence of environmental Kuznets curve (EKC). These findings could provide a significant reference for policy makers in China to facilitate targeted and differentiated regional PM 2.5 governance measures.

In recent years, implementation of aggressive and strict clean air policies has resulted in significant decline in observed PM 2.5 concentration in the Beijing-Tianjin-Hebei (BTH) region and its surrounding areas (i.e., the "2 + 26" region). To eliminate the effects of interannual and seasonal meteorological variation, and to evaluate the effectiveness of emission abatement policies, we applied a boosted regression tree model to remove confounding meteorological factors. Results showed that the annual average PM2.5 concentration normalized by meteorology for the "2 + 26" region declined by 38% during 2014-2019 (i.e., from 96 to 60 μg/m 3 ); however, the BTH region exhibited the most remarkable decrease in PM 2.5 concentration (i.e., a 60% reduction). Certain seasonal trend in normalized PM 2.5 level remained for four target subregions owing to the effects of anthropogenic emissions in autumn and winter. Although strong interannual variations of meteorological conditions were unfavorable for pollutant dispersion during the heating seasons of 2016-2018, the aggressive abatement policies were estimated to have contributed to reductions in normalized PM 2.5 concentration of 19%, 10%, 19%, and 17% in the BTH, Henan, Shandong, and Shanxi subregions, respectively. Our study eliminated the meteorological contribution to concentration variation and confirmed the effectiveness of the implemented clean air policies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Heavy metals in reclaimed water are a global problem that leads to ecological risks for the replenishment water body. This study investigated concentrations and ecological risks posed by heavy metals in SH River, Beijing, which is supplied by reclaimed water. Results showed that Cr was not detected in the sample, Cd and Pb exceeded threshold values according to regulations by 1.19% and 25.00%, respectively. The characterization of temporal and spatial of heavy metals was studied. The potential ecological risks posed by heavy metals in SH River were found to be low and safe. The risk decreased in the order Pb > Cu > Zn > Ni > Cd > As by comprehensive index assessment; this changed to Pb > Cd > As > Ni > Cu > Zn according to potential ecological risk assessment. Pb posed the greatest ecological risks and was identified as most contaminated metal. According to discussion of sampling sites and water quality, it was proposed that reclaimed water and exogenous discharges were the main sources of the heavy metals identified. This should be considered when developing catchment management strategies for heavy metals elimination and protection of the aquatic environment. If a higher level of ecological risk management is required, Pb, Cd, and Cu should be considered first and should be removed in situ through ecological remediation methods. PRACTITIONER POINTS: Reclaimed water and exogenous discharges were the main sources of the heavy metals identified. The potential ecological risks posed by heavy metals in SH River were found to be low and safe. The risk decreased in the order Pb > Cu > Zn > Ni > Cd > As by comprehensive index assessment. Potential ecological risk assessment showed Pb > Cd > As > Ni > Cu > Zn. Pb posed the greatest ecological risks and was identified as most contaminated metal., (© 2020 Water Environment Federation.)

Neonicotinoid insecticide (NEO) concentrations in ambient fine particulate matter (PM 2.5 ) and daily exposure via inhalation were investigated during spring and fall in an urban area in Beijing and in urban and rural areas of Zhengzhou, Henan Province, China. Four NEOs, including imidacloprid, acetamiprid, thiamethoxam and clothianidin, were assessed using a QuEChERS (quick, easy, cheap, effective, rugged, safe) extraction procedure coupled to liquid chromatography-tandem mass spectrometry. Of 64 PM 2.5 samples, 100% contained at least two NEOs (imidacloprid and acetamiprid). Imidacloprid was detected at the highest levels, ranging from 4.33 to 1.13 × 10 2 pg m -3 . A relative potency factor method that considered different toxicities was used to integrate the four NEO concentrations. The total NEO concentrations in air in the Zhengzhou rural area (mean: 80.86 pg m -3 ) were higher than those in urban areas. Differences between seasons were not significant (p > 0.05). The highest value for the total average daily dose via inhalation of four NEOs (ADD inh,total ), 91.0 pg kg -1 day -1 , was found in rural children <6 years old. The ADD inh,total of rural residents was significantly higher than that of urban residents when there was no intensive pesticide application. Although the ADD inh,total values were below the current chronic reference dose, when possible joint toxicity and the increasing use of NEOs are considered, a potential health risk via inhalation is evident. We believe this study is the first to characterize NEO levels in fine particulate matter and to evaluate inhalation exposure in urban and rural residents under nonoccupational scenarios in China. It will enhance our understanding of exposure to NEOs and provide a basis for risk management decisions., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

This retrospective study assessed the risk factors for adverse events following off-pump coronary artery bypass graft (CABG) surgery with dual antiplatelet therapy (DAPT). Records (between 2013 and 2017) were reviewed for patients who discontinued DAPT (clopidogrel 75 mg and aspirin 100 mg) ≤5 days before off-pump CABG. The primary outcome was the incidence of a Bleeding Academic Research Consortium (BARC) type 4 major event. Factors associated with bleeding events and perioperative myocardial ischemia were evaluated using multivariable logistic regression. The incidence of major bleeding events was 17.6% in 2012 patients. Adjusted multiple logistic regression analysis showed that the risk of postoperative bleeding increased when DAPT was discontinued <3 days before surgery (day 2: adjusted odds ratio [OR]: 1.70, 95% confidence interval [CI]: 1.09-2.64; day 1: adjusted OR: 2.37, 95% CI: 1.49-3.77; day 0: adjusted OR: 2.45, 95% CI: 1.53-3.92). The adjusted risk of mortality (OR: 13.14, 95% CI: 4.55-37.94) was increased with bleeding complications. In subgroup analysis, perioperative myocardial ischemia was related to increased blood loss (adjusted OR: 1.10, 95% CI: 1.02-1.18). Aspirin and clopidogrel should optimally be discontinued > 3 days before CABG to reduce the risk of bleeding complications, myocardial ischemia, and death.

Taking the "9.3" military parade in 2015 and two red alerts of heavy air pollution in December of the same year as examples, the characteristics of meteorological factors and pollutant concentration variation were compared. Based on the estimation of pollutant emission reduction under different periods, the WRF-CAMx model was used to evaluate the effect of PM 2.5 pollution improvement. The results showed that the daily average PM 2.5 concentration (19.0 μg·m -3 ) during the parade (from August 20 to September 4) decreased by 60.0% and 48.0%, respectively, in comparison to that before (August 15-19) and after (September 5-15) the parade. The daily average PM 2.5 concentration (232.3 μg·m -3 ) during the first red alert period was higher than that of the second red alert (216.6 μg·m -3 ). The air quality before the second red alert was better than that before the first red alert. The proportion of emission reduction during the parade was generally larger than that during the red alert periods, which provided a controllable and favorable condition for the realization of the "Parade Blue". The PM 2.5 concentration in Beijing decreased by 32.4%, 17.1%, and 22.0% under the control measures during the periods of the "9.3" parade, the first red alert, and second red alert, respectively. The higher proportion of PM 2.5 concentration reduction could be attributed to the more intensive regional emission reduction and the favorable meteorological conditions. The intensity of the pollution reduction, the timing of the implementation of emergency control measures, and meteorological conditions were the most important factors that may have influenced the improvement of pollution.

BACKGROUND The aim of this study was to determine whether an elevated lateral recumbent position, compared to regular lateral recumbent position, may reduce the number of needle passes and attempts required for success subarachnoid puncture in spinal aesthesia before surgery in elderly patients with hip fractures. MATERIAL AND METHODS This was a randomized controlled interventional study in Beijing Jishuitan Hospital. Patients older than 65 years of age with hip fracture orthopedics who were planned to receive subarachnoid block in the lateral recumbent position before surgery were enrolled. The eligible patients were randomly allocated into the experimental group, in which a lateral recumbent position with head and chest elevated 30° was taken during subarachnoid puncture. In the control group, subarachnoid puncture was performed in the lateral recumbent position. The main outcome was the numbers of needle passes required for a success puncture. Other outcomes included success rate in different numbers of attempts, patients reported discomfort score, and complications. RESULTS A total of 90 patients were enrolled, with 45 patients in each group. The number of needle passes (2.00 versus 3.00, P=0.001) and the number of attempts (1.00 versus 2.00, P<0.001) required for a successful subarachnoid puncture were significantly less in the experimental group than in the control group. Patients in the experimental group also had lower discomfort scores. The procedure process, including overall times needed for puncture, anesthesia, and surgery did not show differences between the 2 groups. Complications were few and similar between the 2 groups. CONCLUSIONS An elevated lateral recumbent position during the subarachnoid puncture in spinal anesthesia significantly reduced the needle pass numbers needed for success dural puncture, and reduced discomfort in elderly patients with hip fractures.

As the country with the largest carbon emissions globally, the effective operation of China's carbon emissions trading scheme (ETS) is of great importance to the global community in terms of mitigating climate change. This paper considers China's pilot ETS launched in 2013 as a quasi-natural experiment. Exploring provincial industrial-level data that are more in line with the ETS coverage, the difference-in-difference-in-difference (DDD) model is used to evaluate the impact of the ETS on carbon productivity. Considering different pilot regions and industries, we also analyze the heterogeneous effect of ETS. Moreover, the mediating effects of technical progress and capital investment are explored. We find that China's pilot ETS boosted carbon productivity. Among pilot regions, the best policy effectiveness appeared in Beijing, while the weakest effectiveness appeared in Chongqing. Among the pilot industries, the pilot ETS had better effectiveness in petrochemical and electric power industries and weaker effectiveness in building materials and transportation industries. Additionally, the pilot ETS promoted carbon productivity through both technological progress and capital investment, and the former contributed more. Our findings can provide empirical references and policy implications for nationwide implementation of ETS to further promote low-carbon economic transformation.

Understanding the atmospheric new particle formation (NPF) process within the global range is important for revealing the budget of atmospheric aerosols and their impacts. We investigated the seasonal characteristics of NPF in the urban environment of Beijing. Aerosol size distributions down to ∼1 nm and H 2 SO 4 concentration were measured during 2018-2019. The observed formation rate of 1.5 nm particles ( J 1.5 and NPF frequency in urban Beijing show a clear seasonal variation with maxima in winter and minima in summer, while the observed growth rates are generally within the same range around the year. We show that ambient temperature is a governing factor driving the seasonal variation of J 1.5 and NPF frequency in urban Beijing show a clear seasonal variation with maxima in winter and minima in summer, while the observed growth rates are generally within the same range around the year. We show that ambient temperature is a governing factor driving the seasonal variation of J 1.5 . In contrast, the condensation sink and the daily maximum H 2 SO 4 concentration show no significant seasonal variation during the NPF periods. In all four seasons, condensation of H 2 SO 4 and (H 2 SO 4 ) n (amine) n clusters contributes significantly to the growth rates in the sub-3 nm size range, whereas it is less important for the observed growth rates of particles above 3 nm. Therefore, other species are always needed for the growth of larger particles.

Objective: To understand the awareness of smoking hazards and intention of smoking concession in residents aged 18-65 years in Beijing, and provide scientific evidence for the development and improvement of tobacco control policies and measures. Methods: Data were collected from the 2017 Beijing Non-communicable and Chronic Disease surveillance. A multi-stage stratified cluster sampling method was used to take samples from 165 communities in 16 districts of Beijing. Logistic regression was used to analyze the influencing factors. Results: Among 11 594 participants, 49.93% had no intention of smoking concession. The percentage of refusing smoking concession was higher in men (50.39%) than in women (43.01%), the difference was significant ( χ (2)=14.211, P =0.002), and higher in suburban residents (56.78%) than in urban residents (45.30%), the difference was significant ( χ (2)=51.977, P <0.001). For the smoking cessation motivation, "illness" was the reason for more former smokers (29.88%) compared with current smokers (11.50%), the difference was significant ( χ (2)=85.865, P <0.001). The awareness rates of smoking hazards was higher in women (34.97%) than in men (32.63%), the difference was significant ( Z =5.612, P <0.001), higher in suburban residents (35.44%) than in urban residents (33.03%), the difference was significant ( Z =-3.734, P <0.001), and higher in never smokers (35.15%) than in smokers (30.06%), the difference was significant ( χ (2)=62.277, P =0.005). Multiple logistic regression analysis results showed people with general awareness ( OR =0.61, 95 %CI : 0.39-0.94) and poor awareness ( OR =0.67, 95 %CI : 0.50-0.90) of smoking hazards were less likely to quit smoking and people with general awareness ( OR =0.64, 95 %CI : 0.53-0.76) and poor awareness ( OR =0.87, 95 %CI : 0.78-0.98) of smoking hazards were more likely to smoke. Conclusions: Smokers aged 18-65 in Beijing had low willingness for smoking cessation. Health problem was main consideration for smoking cessation. Never-smokers had better awareness of smoking hazards than smokers, and the awareness of smoking hazards was an influencing factor of smoking status.

Urban parks play an important role in the urban ecosystem and are also used by residents for recreation. The environmental quality of urban park soils might influence human health following long-term exposure. To assess potential sources and pollution risks of heavy metal(loid)s in the topsoil of urban parks, we subjected metal concentrations in soil samples from 121 parks in the Beijing urban area to geostatistical analyses, conditional inference tree (CIT) analyses, ecological risk and human health risk assessment. CIT effectively explained the influence of human activity on the spatial variation and accumulation of soil metal(loid)s and identified the contributions of natural and anthropogenic inputs. The main factors influencing the accumulation of heavy metal(loid)s, including urbanization duration, park age, per capita GDP, industrial output, and coal consumption, were evaluated by CIT. Except for Cr and Ni, the average concentrations of the metal(loid)s tested (Cu, Pb, Zn, Hg, As, and Cd) were higher than the background values. In the urban parks, Ni and Cr derived mostly from soil parent materials. Concentrations of Cu, Zn, Pb, Cd, As, and Hg were strongly associated with human influences, including industrial, agricultural, and traffic activity. After assessing health and ecological risks, we conclude that heavy metal(loid)s in the soil of Beijing urban parks pose no obvious health risk to humans, and the ecological risk is also low., Competing Interests: Declaration of competing interest This manuscript is an original work, it has not been previously published, and it is not under consideration for publication elsewhere. All authors have read the manuscript, agree that the work is ready for submission to a journal, and accept responsibility for the manuscript’s contents. All authors have disclosed any competing financial interests in this work, and in fact, there were none., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objectives: For the past decade, the epidemic of multidrug resistance tuberculosis (MDR-TB) stays high in China. We investigated the possible driving forces behind the epidemics from phylogenetic and historical perspectives., Methods: 420 representative strains were selected from the first national drug resistance survey based on their genotypes, drug susceptibility patterns and geographic information. We reconstructed the phylogeny by whole genome sequencing and compared it to the global phylogeny including MDR outbreaks reported in other settings. We estimated the historical trajectory of population dynamics by Bayesian Skygrid plot for all strains and MDR-TB alone. Integrating geographic information and mutations in drug resistance related genes, we investigated the spatial scale of transmission, recent selection of drug resistant mutant, and mechanism for fitness restoration., Results: Three new subgroups within Beijing clade are described for the first time, but none of the MDR-TB outbreak strains reported in other high MDR-TB burden settings is identified. The overall epidemics experienced two successive phases of expansion at different rates between 1660s and 1950s, followed by a sharp decline till today. Four fifths of the clustered MDR-TB strains suggest transmission of DR strains and nearly half suggest recent selection of (additional) mutations in rpoB. Among all identified transmission events, about one fifth occurred between far distant locations. Possible intergenic and intragenic compensatory mutations both presented in our dataset at comparable frequencies., Conclusions: MDR-TB epidemic in China is not yet driven by the spread of a few highly successful clonal expansions but by repeated emergence of smaller and currently less successful clusters. However, internal migration and undertreatment could escalate MDR-TB epidemic. To prevent generating of drug resistance and restoration of fitness as well as to stop transmission of MDR-TB at early stage, national TB control program needs to strengthen management of floating populations and promote universal drug susceptibility testing in China., Competing Interests: Declaration of Competing Interest The authors declare that there are no conflicts of interest., (Copyright © 2020. Published by Elsevier Ltd.)

Background : Domestic migrant populations are highly mobilized at a sexually active age, and often fail to meet their needs for contraception. Moreover, they assume sexual and reproductive health (SRH) risks and utilize fewer family planning services. Method : A quasi-experimental trial (community intervention) was adopted. Two-stage stratified cluster sampling was applied to recruit participants in Beijing and Chongqing. A comprehensive SRH/family planning intervention was implemented from August 4 2014 to August 3 2015. Propensity score matching (PSM) and multivariate probit models were adopted. Results: In total, 2100 and 2024 eligible participants were involved, and 815 and 629 pairs were matched by PSM in Beijing and Chongqing, respectively. The knowledge and attitudes of the participants regarding SRH and contraception were significantly improved through the comprehensive intervention. Reversible contraceptive methods were the most prevalent; couples largely decided to utilize condoms and family planning services. Conclusions : The comprehensive intervention had positive effects on knowledge, attitudes, and practices (KAP) for SRH/family planning among the domestic migrant population. The results acquired can be extrapolated to some extent, and the pattern of this intervention is well geared toward other similar settings in China.

Background: Many studies have reported the predictive value of the atherogenic index of plasma (AIP) in the progression of atherosclerosis and the prognosis of percutaneous coronary intervention (PCI). However, the utility of the AIP for prediction is unknown after PCI among type 2 diabetes mellitus (T2DM)., Methods: 2356 patients with T2DM who underwent PCI were enrolled and followed up for 4 years. The primary outcome was major cardiovascular and cerebrovascular adverse events (MACCEs), considered to be a combination of cardiogenic death, myocardial infarction, repeated revascularization, and stroke. Secondary endpoints included all-cause mortality, target vessel revascularization (TVR), and non-target vessel revascularization (non-TVR). Multivariate Cox proportional hazards regression modelling found that the AIP was correlated with prognosis and verified by multiple models. According to the optimal cut-off point of the ROC curve, the population was divided into high/low-AIP groups. A total of 821 pairs were successfully matched using propensity score matching. Then, survival analysis was performed on both groups., Results: The overall incidence of MACCEs was 20.50% during a median of 47.50 months of follow-up. The multivariate Cox proportional hazards regression analysis before matching suggested that the AIP was an independent risk factor for the prognosis of T2DM after PCI (hazard ratio [HR] 1.528, 95% CI 1.100-2.123, P = 0.011). According to the survival analysis of the matched population, the prognosis of the high AIP group was significantly worse than that of the low AIP group (HR (95% CI) 1.614 (1.303-2.001), P < 0.001), and the difference was mainly caused by repeat revascularization. The low-density lipoprotein-cholesterol (LDL-C) level did not affect the prognosis of patients with T2DM (P = 0.169), and the effect of the AIP on prognosis was also not affected by LDL-C level (P < 0.001)., Conclusions: The AIP, a comprehensive index of lipid management in patients with T2DM, affects prognosis after PCI. The prognosis of diabetic patients with high levels of the AIP included more MACCEs and was not affected by LDL-C levels. It is recommended to monitor the AIP for lipid management in diabetic patients after PCI and ensure that the AIP is not higher than 0.318. Trial registration This is an observational cohort study that does not involve interventions. So we didn't register. We guarantee that the research is authentic and reliable, and hope that your journal can give us a chance.

Background: The prevalence of asthma and allergic diseases has increased rapidly in urban China since 2000. There has been limited study of associations between home environmental and lifestyle factors with asthma and symptoms of allergic disease in China., Methods: In a cross-sectional analysis of 2214 children in Beijing, we applied a two-step hybrid Least Absolute Shrinkage and Selection Operator (LASSO) algorithm to identify environmental and lifestyle-related factors associated with asthma, rhinitis and wheeze from a wide range of candidates. We used group LASSO to select variables, using cross-validation as the criterion. Effect estimates were then calculated using adaptive LASSO. Model performance was assessed using Area Under the Curve (AUC) values., Results: We found a number of environmental and lifestyle-related factors significantly associated with asthma, rhinitis or wheeze, which changed the probability of asthma, rhinitis or wheeze from -5.76% (95%CI: -7.74%, -3.79%) to 27.4% (95%CI: 16.6%, 38.3%). The three factors associated with the largest change in probability of asthma were short birth length, carpeted floor and paternal allergy; for rhinitis they were maternal smoking during pregnancy, paternal allergy and living close to industrial area; and for wheeze they were carpeted floor, short birth length and maternal allergy. Other home environmental risk factors identified were living close to a highway, industrial area or river, sharing bedroom, cooking with gas, furry pets, cockroaches, incense, printer/photocopier, TV, damp, and window condensation in winter. Lifestyle-related risk factors were child caretakers other than parents, and age<3 for the day-care. Other risk factors included use of antibiotics, and mother's occupation. Major protective factors for wheeze were living in a rural/suburban region, air conditioner use, and mother's occupation in healthcare., Conclusions: Our findings suggest that changes in lifestyle and indoor environments associated with the urbanization and industrialization of China are associated with asthma, rhinitis, and wheeze in children., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: The Woman's Condom, a newly designed condom for women, has obtained market approval in China, but it remains relatively unfamiliar to the migrant population. The aim of this study is to evaluate the short-term acceptability of the Woman's Condom and influencing factors among internal migrants., Methods: A longitudinal study was conducted among 1800 migrants in Beijing, Chongqing, and Shanghai in China between August 2013 and August 2014.Three-level model was implemented with the Statistical Analysis System software (v.9.4 SAS Institute) to analyze within-individual changes, between-individuals effects, and between-group effects., Results: Three-level model analysis revealed statistically higher short-term acceptability of the Woman's Condom among subjects who lived in Shanghai (β = 6.50, t = 2.76, p < 0.01), unmarried and not in a cohabiting relationship (β = 3.05, t = 2.76, p < 0.01) than those who lived in Beijing, married and in a cohabiting relationship. Female (β = - 1.69, t = - 7.55, p < 0.01) and lower educational attainment (β = - 2.30, t = - 1.94, p = 0.05) were negatively related, while occupations of education, health, and civil staff (β = 1.50, t = 2.92, p < 0.01) were positively related to acceptability. It was predicted that migrants' acceptability of the Woman's Condom would significantly increase over time (β = 1.09, t = 5.54, p < 0.01)., Conclusions: The findings indicate that the Woman's Condom enjoyed relatively high short-term acceptability among migrants in China. In order to popularize the Women's Condoms in migrants, more publicity, consultation and training in open and prosperous areas should be strengthened.

Introduction: Child emotional or behavioral problems and insufficient social development has been a heavy burden on family and society. However, currently large-scale studies on emotional and behavioral problems as well as social competence among school children in China are still lacking. This cross-sectional study analyzed the current status and risk factors of behavioral problems and social competences in Beijing students., Method: A total of 9,295 students, with ages ranging from 6 to 16 years old, were enrolled in the study. The Child Behavior Checklist (CBCL) was used to screen emotional and behavioral problems, social competences of students. We then assessed significant predictors factors associated with children behavioral problems and social competences., Results: The total detection rate of behavioral problems of this cohort was 16.7%. All kinds of social competence scores of boys were lower than girls (P <0.05). The scores of social and learning ability in children with behavioral problems were significantly lower than those without behavior problems (P <0.05). Gender, developmental delay, recent life events, negative relationships and negative child-rearing styles were the shared influencing factors for behavioral problems and social competence. In addition, age, macrosomia, threatened abortion, hospitalization for physical illness, physical illness, poor sleep were independent risk factors for children's emotional and behavioral problems, and non-breastfeeding was an independent risk factor for abnormal social competence., Conclusion: The social competence, emotional and behavioral problems are serious among students in Beijing. More attention should be paid to mental health and effective intervention measures should be provided., Competing Interests: The authors have declared that no competing interests exist.

Due to potential adverse effects and bioaccumulation in biota and humans, perfluoroalkyl substances (PFASs) have raised wide attention in recent years. Ingestion is a vital pathway for PFASs to transmit to humans especially through water and fish. In present study, PFASs in water and fish from the drinking water source of Beijing in China were investigated. Three layers of water were collected in order to find the connection between concentrations of PFASs and depth of water, which showed no prominent correlation. PFASs in water from Miyun Reservoir with concentrations of 5.30-8.50 ng/L, were relatively lower compared with other reports on raw drinking water. Perfluorobutanoic acid (PFBA) and perfluorooctanoic acid (PFOA) were the dominant PFASs. In addition, six species of fish (including Cyprinus carpio, Carassius auratus, Erythroculter dabryi, Pseudohemiculter dispar, Hypophthalmichthys molitrix and Siniperca chuatsi) were analyzed, with concentrations of PFASs ranging from 1.70 to 14.32 ng/g wet weight (w.w.). Due to relatively stronger bioaccumulation potential, long chain perfluorinated carboxylates (PFCAs) and perfluorinated sulfonates (PFSAs) were detected with higher concentrations, especially perfluoroundecanoic acid (PFUdA) and perfluorodecanoic acid (PFDA). The estimated daily intake (EDI) of PFASs through drinking water and fish consumption were 0.20-0.34 and 3.44-12.61 ng/kg bw/day based on Exposure Factors Handbook of Chinese Population, respectively. In addition, the EDI of high-priority concern PFASs via pork, chicken and dust were also calculated, with value of 0.015-0.043, 0.003-0.013 and 0.074-0.390 ng/kg bw/day, respectively. The total EDI of PFOS and PFOA via diverse pathways were less than suggested tolerable daily intake (PFOS, 150 ng/kg bw/day; PFOA, 1500 ng/kg bw/day), indicating that the detected levels would not cause severe health effects on Beijing residents., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Concurrent hearing and genetic screening of newborns is expected to play important roles not only in early detection and diagnosis of congenital deafness, which triggers intervention, but also in predicting late-onset and progressive hearing loss and identifying individuals who are at risk of drug-induced HL. Concurrent hearing and genetic screening in the whole newborn population in Beijing was launched in January 2012. This study included 180,469 infants born in Beijing between April 2013 and March 2014, with last follow-up on February 24, 2018. Hearing screening was performed using transiently evoked otoacoustic emission (TEOAE) and automated auditory brainstem response (AABR). For genetic testing, dried blood spots were collected and nine variants in four genes, GJB2, SLC26A4, mtDNA 12S rRNA, and GJB3, were screened using a DNA microarray platform. Of the 180,469 infants, 1,915 (1.061%) were referred bilaterally or unilaterally for hearing screening; 8,136 (4.508%) were positive for genetic screening (heterozygote, homozygote, or compound heterozygote and mtDNA homoplasmy or heteroplasmy), among whom 7,896 (4.375%) passed hearing screening. Forty (0.022%) infants carried two variants in GJB2 or SLC26A4 (homozygote or compound heterozygote) and 10 of those infants passed newborn hearing screening. In total, 409 (0.227%) infants carried the mtDNA 12S rRNA variant (m.1555A>G or m.1494C>T), and 405 of them passed newborn hearing screening. In this cohort study, 25% of infants with pathogenic combinations of GJB2 or SLC26A4 variants and 99% of infants with an m.1555A>G or m.1494C>T variant passed routine newborn hearing screening, indicating that concurrent screening provides a more comprehensive approach for management of congenital deafness and prevention of ototoxicity., (Copyright © 2019 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.)

Background: Children and adolescents are in the developmental periods with the highest risk of experiencing multiple types of traumatic experiences (TEs). Immigrant children are more likely than other children to be exposed to TEs and have a higher risk of mental health problems. However, no epidemiological study has reported the prevalence of TEs and the associated development of posttraumatic stress disorder (PTSD) among Chinese children., Methods: The present study focused on trauma exposure among rural-to-urban migrant Chinese children. A large-scale (N = 16,140) cross-sectional survey of rural-to-urban migrant workers' children in grades 4 to 9 was conducted in Beijing. Lifetime exposure to accidents and injuries, interpersonal violence, and trauma within the social network or witnessing traumatic events were measured along with PTSD., Results: Nearly half of the participants (47.06%) had experienced TEs, and 6.68% of those children met the cutoff for PTSD. Trauma exposure was associated with gender, age, quality of life, parents' marital status, caregivers before the child started school and father's education level. Overall, interpersonal violence was associated with the highest rates of PTSD, and disasters were associated with the lowest rates of PTSD., Limitations: The cross-sectional survey design limited the ability to document temporal ordering, and the assessment of lifetime TEs was based on retrospective recall., Conclusions: The present study is the first epidemiological study of TEs in Chinese rural-to-urban migrant children. TEs are potentially fairly common among this population. Interventions designed to prevent PTSD should target different TE types according to the victim's gender., (Copyright © 2019. Published by Elsevier B.V.)