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Background and Aims Emerging evidence has raised an obesity paradox in observational studies of body mass index (BMI) and health among the oldest-old (aged ≥80 years), as an inverse relationship of BMI with mortality was reported. This study was to investigate the causal associations of BMI, waist circumference (WC), or both with mortality in the oldest-old people in China. Methods A total of 5306 community-based oldest-old (mean age 90.6 years) were enrolled in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) between 1998 and 2018. Genetic risk scores were constructed from 58 single-nucleotide polymorphisms (SNPs) associated with BMI and 49 SNPs associated with WC to subsequently derive causal estimates for Mendelian randomization (MR) models. One-sample linear MR along with non-linear MR analyses were performed to explore the associations of genetically predicted BMI, WC, and their joint effect with all-cause mortality, cardiovascular disease (CVD) mortality, and non-CVD mortality. Results During 24 337 person-years of follow-up, 3766 deaths were documented. In observational analyses, higher BMI and WC were both associated with decreased mortality risk [hazard ratio (HR) 0.963, 95% confidence interval (CI) 0.955–0.971 for a 1-kg/m2 increment of BMI and HR 0.971 (95% CI 0.950–0.993) for each 5 cm increase of WC]. Linear MR models indicated that each 1 kg/m2 increase in genetically predicted BMI was monotonically associated with a 4.5% decrease in all-cause mortality risk [HR 0.955 (95% CI 0.928–0.983)]. Non-linear curves showed the lowest mortality risk at the BMI of around 28.0 kg/m2, suggesting that optimal BMI for the oldest-old may be around overweight or mild obesity. Positive monotonic causal associations were observed between WC and all-cause mortality [HR 1.108 (95% CI 1.036–1.185) per 5 cm increase], CVD mortality [HR 1.193 (95% CI 1.064–1.337)], and non-CVD mortality [HR 1.110 (95% CI 1.016–1.212)]. The joint effect analyses indicated that the lowest risk was observed among those with higher BMI and lower WC. Conclusions Among the oldest-old, opposite causal associations of BMI and WC with mortality were observed, and a body figure with higher BMI and lower WC could substantially decrease the mortality risk. Guidelines for the weight management should be cautiously designed and implemented among the oldest-old people, considering distinct roles of BMI and WC. [ABSTRACT FROM AUTHOR]

Background: Adolescent suicidal ideation are associated with factors including psychological abuse/neglect, sleep problems, and depressed mood, but the systematic effects of these factors on suicidal ideation remain unclear, which is a research gap this work aims to fill. Methods: A multi-center, the cluster sampling method was employed to collect general demographic data, such as age, gender, the experience of being left behind, and parents' marital status, from 12,192 students across 17 secondary schools in China. The Child Psychological Abuse and Neglect Scale (CPANS), Pittsburgh Sleep Quality Index (PSQI), the Chinese version of the Depressed mood, Anxiety and Stress Scale − 21 Items (DASS-21) and Chinese version of Positive and Negative Suicide Ideation Inventory (PANSI) were utilized. Data were analyzed using t-tests, chi-square tests, correlation analyses, and structural equation modeling mediation analyses. Results: The prevalence of psychological abuse/neglect and adolescent suicidal ideation was 34.8% and 13%, respectively. This mediation analysis suggests that, in the relationship between psychological abuse/neglect and suicidal ideation, sleep problems and depressed mood play both parallel and sequential mediating roles. Conclusion: Sleep problems and depressed mood play a mediating role in the development of suicidal ideation in adolescents. Good sleep habits and depressed mood interventions help reduce the risk of suicidal ideation in adolescents who experience psychological neglect/abuse. [ABSTRACT FROM AUTHOR]

Objective: The associations between plasma vitamin B12 level and anemia under different dietary patterns in elderly Chinese people are poorly understood. We aimed to examine the associations between plasma vitamin B12 levels and anemia under different dietary patterns in adults aged 65 years and older in nine longevity areas in China. Methods: A total of 2405 older adults completed a food frequency questionnaire at the same time as a face-to-face interview. The dietary diversity score (DDS) was assessed based on the food frequency questionnaire, with the low DDS group referring to participants with a DDS score ≤ 4 points. Vitamin B12 levels were divided into two groups of high (>295 pg/mL) and low (≤ 295 pg/mL) with the median used as the cut-off point. Sub-analyses were also performed on older adults divided into tertiles of vitamin B12 levels: low (< 277 pg/mL), medium (277–375 pg/mL) and high (> 375 pg/mL) to study the association of these levels with anemia. Results: Six hundred ninety-five (28.89%) of these people were diagnosed with anemia and had a mean age of 89.3 years. Higher vitamin B12 levels were associated with a decreased risk of anemia (multi-adjusted OR, 0.59, [95% CI, 0.45 ~ 0.77] P < 0.001) in older adults with a low DDS, whereas no significant association between vitamin B12 levels and anemia was found in older adults with a high DDS in a full-model after adjustment for various confounding factors (multi-adjusted OR, 0.88, [95% CI, 0.65 ~ 1.19], P = 0.41). Conclusion: The relationship between vitamin B12 levels and the prevalence of anemia was significant only when the level of dietary diversity in the older adults was relatively low. The dietary structure of the population should be taken into consideration in combination in order to effectively improve anemia status by supplementing vitamin B12. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the impact of greenness and fine particulate matter <2.5 μm (PM2.5) on overweight/obesity among older adults in China. Methods: A total of 21,355 participants aged ≥65 years were included from the Chinese Longitudinal Healthy Longevity Survey between 2000 and 2018. Normalized difference vegetation index (NDVI) with a radius of 250 m and PM2.5 in a 1 × 1‐km grid resolution were calculated around each participant's residence. Cox proportional hazards models were used to estimate the effects of NDVI and PM2.5 on overweight/obesity. Interaction and mediation analyses were conducted to explore combined effects. Results: The study observed 1895 incident cases of overweight/obesity over 109,566 person‐years. For every 0.1‐unit increase in NDVI the hazard ratio of overweight/obesity was 0.91 (95% CI: 0.88–0.95), and for every 10‐μg/m3 increase in PM2.5 the hazard ratio was 1.11 (95% CI: 1.07–1.14). The effect of NDVI on overweight/obesity was partially mediated by PM2.5, with a relative mediation proportion of 20.10% (95% CI: 1.63%‐38.57%). Conclusions: Greenness exposure appears to lower the risk of overweight/obesity in older adults in China, whereas PM2.5, acting as a mediator, partly mediated this protective effect. [ABSTRACT FROM AUTHOR]

Introduction: About half of adults aged ≥80 years suffer from frailty. Exercise is considered effective in preventing frailty but may be inapplicable to adults aged ≥80 years due to physical limitations. As an alternative, we aimed to explore the association of leisure activities with frailty and identify potential interaction with established polygenic risk score (PRS) among adults aged ≥80 years. Methods: Analyses were performed in a prospective cohort study of 7,471 community-living older adults aged ≥80 years who were recruited between 2002 and 2014 from 23 provinces in China. Leisure activity was assessed using a seven-question leisure activity index and frailty was defined as a frailty index ≥0.25 using a validated 39-item health-related scale. The PRS was constructed using 59 single-nucleotide polymorphisms associated with frailty in a subsample of 2,541 older adults. Cox proportional hazards models were used to explore the associations of leisure activities, PRS with frailty. Results: The mean age of participants was 89.4 ± 6.6 years (range: 80–116). In total, 2,930 cases of frailty were identified during 42,216 person-years of follow-up. Each 1 unit increase in the leisure activity index was associated with 12% lower risk of frailty (hazard ratio: 0.88 [95% confidence interval, 0.85–0.91]). Participants with high genetic risk (PRS >2.47 × 10−4) suffered from 26% higher risk of frailty. Interaction between leisure activity and genetic risk was not observed. Conclusion: Evidence is presented for the independent association of leisure activities and genetic risk with frailty. Engagement in leisure activities is suggested to be associated with lower risk of frailty across all levels of genetic risk among adults aged ≥80 years. [ABSTRACT FROM AUTHOR]

Background The association between fine particular matter (PM2.5) and frailty is less studied, and the national burden of PM2.5-related frailty in China is unknown. Objective To explore the association between PM2.5 exposure and incident frailty in older adults, and estimate the corresponding disease burden. Design Chinese Longitudinal Healthy Longevity Survey from 1998 to 2014. Setting Twenty-three provinces in China. Subjects A total of 25,047 participants aged ≥65-year-old. Methods Cox proportional hazards models were performed to evaluate the association between PM2.5 and frailty in older adults. A method adapted from the Global Burden of Disease Study was used to calculate the PM2.5-related frailty disease burden. Results A total of 5,733 incidents of frailty were observed during 107,814.8 person-years follow-up. A 10 μg/m3 increment of PM2.5 was associated with a 5.0% increase in the risk of frailty (Hazard Ratio = 1.05, 95% confidence interval = [1.03–1.07]). Monotonic, but non-linear exposure-response, relationships of PM2.5 with risk of frailty were observed, and slopes were steeper at concentrations >50 μg/m³. Considering the interaction between population ageing and mitigation of PM2.5, the PM2.5-related frailty cases were almost unchanged in 2010, 2020 and 2030, with estimations of 664,097, 730,858 and 665,169, respectively. Conclusions This nation-wide prospective cohort study showed a positive association between long-term PM2.5 exposure and frailty incidence. The estimated disease burden indicated that implementing clean air actions may prevent frailty and substantially offset the burden of population ageing worldwide. [ABSTRACT FROM AUTHOR]

Background: It remains unsolved that whether blood uric acid (UA) is a neuroprotective or neurotoxic agent. This study aimed to evaluate the longitudinal association of blood UA with mild cognitive impairment (MCI) among older adults in China. Methods: A total of 3,103 older adults (aged 65+ years) free of MCI at baseline were included from the Healthy Aging and Biomarkers Cohort Study (HABCS). Blood UA level was determined by the uricase colorimetry assay and analyzed as both continuous and categorical (by quartile) variables. Global cognition was assessed using the Mini-Mental State Examination four times between 2008 and 2017, with a score below 24 being considered as MCI. Cox proportional hazards models were used to examine the associations. Results: During a 9-year follow-up, 486 (15.7%) participants developed MCI. After adjustment for all covariates, higher UA had a dose-response association with a lower risk of MCI (all P for trend < 0.05). Participants in the highest UA quartile group had a reduced risk [hazard ratio (HR), 0.73; 95% (CI): 0.55–0.96] of MCI, compared with those in the lowest quartile group. The associations were still robust even when considering death as a competing risk. Subgroup analyses revealed that these associations were statistically significant in younger older adults (65–79 years) and those without hyperuricemia. Similar significant associations were observed when treating UA as a continuous variable. Conclusions: High blood UA level is associated with reduced risks of MCI among Chinese older adults, highlighting the potential of managing UA in daily life for maintaining late-life cognition. [ABSTRACT FROM AUTHOR]

Objective we aimed to investigate the association of smoking cessation with risk of all-cause mortality amongst oldest old people (aged ≥ 80 years). Design this was a prospective cohort study. Setting the Chinese Longitudinal Healthy Longevity Survey, implemented in 23 provinces of China. Participants a total of 28,643 community-dwelling oldest old people (mean age, 92.9 ± 7.5 years) were included. Methods in this community-based cohort study, Cox proportional hazards models were used to examine the association of smoking cessation with risk of all-cause mortality. Results during 136,585 person-years of follow-up from baseline to 1 September 2014, compared with never smokers, hazard ratios and 95% confidence intervals for all-cause mortality were 1.06 (1.02–1.10) for current smokers, 1.23 (1.09–1.39) for transient quitters (≤1 consecutive years since smoking cessation), 1.22 (1.12–1.32) for recent quitters (2–6 consecutive years since smoking cessation) and 1.11 (1.02–1.22) for long-term quitters (>6 consecutive years since smoking cessation). Cox models with penalised splines revealed an increased risk of all-cause mortality after smoking cessation; the highest mortality risk was observed within 2–4 years after smoking cessation and the risk gradually decreased with duration of smoking cessation. We further conducted subgroup analyses and sensitivity analyses to reduce the impact of reverse causation. Conclusions smoking is harmful to health in all populations. Our study findings indicated smoking cessation in late life to be associated with increased risk of all-cause mortality amongst oldest old people who have smoked for a long time. [ABSTRACT FROM AUTHOR]

Previous studies investigated factors associated with mortality. Nevertheless, evidence is limited regarding the determinants of lifespan. We aimed to develop and validate a lifespan prediction model based on the most important predictors. A prospective cohort study. A total of 23,892 community-living adults aged 65 years or older with confirmed death records between 1998 and 2018 from 23 provinces in China. Information including demographic characteristics, lifestyle, functional health, and prevalence of diseases was collected. The risk prediction model was generated using multivariate linear regression, incorporating the most important predictors identified by the Lasso selection method. We used 1000 bootstrap resampling for the internal validation. The model performance was assessed by adjusted R 2, root mean square error (RMSE), mean absolute error (MAE), and intraclass correlation coefficient (ICC). Twenty-one predictors were included in the final lifespan prediction model. Older adults with longer lifespans were characterized by older age at baseline, female, minority race, living in rural areas, married, with healthier lifestyles and more leisure engagement, better functional status, and absence of diseases. The predicted lifespans were highly consistent with observed lifespans, with an adjusted R 2 of 0.893. RMSE was 2.86 (95% CI 2.84–2.88) and MAE was 2.18 (95% CI 2.16–2.20) years. The ICC between observed and predicted lifespans was 0.971 (95% CI 0.971–0.971). The lifespan prediction model was validated with good performance, the web-based prediction tool can be easily applied in practical use as it relies on all easily accessible variables. [ABSTRACT FROM AUTHOR]

Abstract: A rapid fingerprint method was developed for investigating and inferring geographical origin of Chinese propolis by using high performance liquid chromatography–ultraviolet detection (HPLC–UV). 120 samples were analyzed from 17 different locations of 10 provinces of China in this study. In the HPLC chromatograms, eight major compounds were identified as flavonoids, including rutin, myricetin, quercetin, kaempferol, apigenin, pinocembrine, chrysin and galangin. Both correlation coefficient of similarity in chromatograms and relative peak areas of characteristic compounds were calculated for quantitative expression of the HPLC fingerprints. Our results revealed that the presence or absence of specific peaks and similarity evaluation in simulative mean chromatograms among different regions could efficiently identify and distinguish Chinese propolis from different geographical origins. [Copyright &y& Elsevier]

Currently the Chinese government has adopted World Health Organization interim target-1 values as the national ambient air quality standards values. However, the population-based evidence was insufficient, especially for the oldest old (aged 80+). We evaluated the association of fine particulate matters (PM 2.5) exposure and incidence of disability in activities of daily living (ADL) in 15 453 oldest old in 886 counties/cities in China from 2002 to 2014 using Cox model with penalized splines and competing risk models to evaluate the linear or non-linear association. After adjusting for potential confounders, a J-shaped association existed between PM 2.5 exposure with a threshold concentration of 33 μg/m3, and incident disability in ADL. Above this threshold, the risk magnitude significantly increased with increase of PM 2.5 concentrations; compared to 33 μg/m3, the hazard ratio ranged from 1.03 (1.00–1.06) at 40 μg/m3 to 2.25 (1.54–3.29) at 110 μg/m3. The risk magnitude was not significantly changed below this threshold. Each 10 μg/m3 increase in PM 2.5 exposure corresponded to a 7.7% increase in the risk of disability in ADL (hazard ratio 1.077, 95% CI 1.051–1.104). Men, smokers, and participants with cognitive impairment might be more vulnerable to PM 2.5 exposure. The study provided limited population-based evidence for the oldest old and detected a threshold of 33 μg/m3, and supported that reduction to current World Health Organization interim target-1value (35 μg/m3) and Chinese national ambient air quality standards (35 μg/m3) or lower may be associated with lower risk of disability in ADL. Image 1 • The dose-response relationship between long-term PM 2.5 exposure and ADL was J-shaped. • The identification of a threshold of 33 μg/m3 for PM 2.5 and ADL disability incidence. • The first cohort study to demonstrate effect of PM 2.5 on ADL for the oldest old. • Air pollution reduction may reduce the public health burden of disability in the elderly. A J-shaped association existed between long-term PM 2.5 exposure with a threshold concentration of 33 μg/m3 and incident disability in ADL. [ABSTRACT FROM AUTHOR]

Tetracyclines are widely used in Chinese apiculture. However, limited information is available on the presence of tetracycline residues in honey and the sources, degradation patterns, and associated health risks of these compounds. In this study, the presence of tetracyclines in honey samples across China was investigated over a four-year period. Additionally, the risks of dietary intake, as well as the sources and degradation patterns of tetracyclines in honey, were assessed. The three-dimensional spatial distributions (floral region, geographical region and entomological origin) of tetracyclines contamination varied significantly. Tetracycline residues in honey posed a moderate risk to children aged 3–10 years in Northwest China. Source analysis indicated that colony migration serves as the primary source of tetracyclines in honey. Based on the degradation patterns of tetracyclines in honey within colonies and during storage, oxytetracycline is more readily degraded than other tetracyclines. The main degradation products of tetracyclines are epimers and dehydration products, and the effects of these products on human health and the environment should be further evaluated in future studies. This comprehensive investigation provides valuable insights into the safe use and regulation of tetracyclines in Chinese apiculture. [Display omitted] • Tetracyclines profiles vary in honey samples from different sources. • OTC and TC exhibited the highest detection frequency and concentration. • Colony migration was the main source of tetracyclines in honey. • OTC was more readily degraded than other tetracyclines during production and storage. • Tetracyclines in honey posed moderate health risks to children aged 3-10 in NW China. [ABSTRACT FROM AUTHOR]

• Gender difference in toxic metals and essential metals partly explain the difference in longevity. • Toxic metals such as lead and cadmium were significantly higher in centenarians. • Essential metals were sufficient in centenarians and likely to be used as an index of malnutrition. • Providing reference values of metals for octogenarians, nonagenarians, centenarians. • The top four important metals in longevity were selenium, arsenic, lead and manganese. Metals can be either toxic or essential to health, as they play different role in oxidative stress and metabolic homeostasis during the ageing process. Population-based biomonitoring have documented levels and ranges in concentrations among general population of 0–79 years of age. In people aged 80 and above, toxic metals and essential metals may have different risk profiles, and thus need to be better studied. Our aim is to investigate concentrations of toxic metals (arsenic, cadmium, lead and mercury) and essential metals (chromium, cobalt, molybdenum, manganese, nickel and selenium) and their role in diseases, nutritional status among younger elderly, octogenarians, nonagenarians and centenarians. A total of 932 younger elderly, 643 octogenarians, 540 nonagenarians, 386 centenarians were included from the cross-sectional Healthy Aging and Biomarkers Cohort Study in 2017–2018. Blood or urine biological substrates were collected from each participant to determine the concentrations of toxic metals and essential metals by inductively coupled plasma mass spectrometry. Random forest was constructed to rank the importance of toxic metals and essential metals in longevity. LASSO penalized regressions were performed to select the most significant metals associated with diseases and nutritional status, of which simultaneously included all metals and adjusted for the confounding factors. Compared to women, we found higher biomarker concentrations in men for toxic metals (41.2 µg/L vs 34.4 µg/L for blood lead, 1.56 µg/L vs 1.19 µg/L for blood mercury) and lower concentration of essential metals (0.48 µg/L vs 0.58 µg/L for blood molybdenum, 10.0 µg/L vs 11.1 µg/L for blood manganese). These factors may contribute to gender difference observed in longevity, that women live longer than men. Blood lead and urine cadmium tended to increase with age (P <0.001); blood cobalt, molybdenum, manganese increased with age, blood selenium decreased with age while the prevalence of selenium deficiency was extremely low in centenarians. Among toxic metals and essential metals, LASSO penalized regression identified the most significant metals associated with chronic kidney disease was cadmium and arsenic; and it was manganese, cobalt, and selenium for diabetes; it was selenium, molybdenum, lead for anemia; it was mercury for underweight. In random forest model, the top four important metals in longevity were selenium, arsenic, lead and manganese both in men and women. Generally, toxic metals levels were significantly higher while essential metals were relatively sufficient in Chinese centenarians. Toxic metals and essential metals played different role in diseases, nutritional status and longevity in the process of aging. Our research provided real world evidence of biomonitoring reference values to be used for the ongoing population health surveillance in longevity. [ABSTRACT FROM AUTHOR]

In the past decades, China has observed rapid urbanization, the nation's urban population reached 50% in 2000, and is still in steady increase. Rapid urbanization in China has an adverse impact on urban hydrological processes, particularly in increasing the urban flood risks and causing serious urban flooding losses. Urban flooding also increases health risks such as causing epidemic disease break out, polluting drinking water and damaging the living environment. In the highly urbanized area, non-engineering measurement is the main way for managing urban flood risk, such as flood risk warning. There is no mature method and pilot study for urban flood risk warning, the purpose of this study is to propose the urban flood risk warning method for the rapidly urbanized Chinese cities. This paper first presented an urban flood forecasting model, which produces urban flood inundation index for urban flood risk warning. The model has 5 modules. The drainage system and grid dividing module divides the whole city terrain into drainage systems according to its first-order river system, and delineates the drainage system into grids based on the spatial structure with irregular gridding technique; the precipitation assimilation module assimilates precipitation for every grids which is used as the model input, which could either be the radar based precipitation estimation or interpolated one from rain gauges; runoff production module classifies the surface into pervious and impervious surface, and employs different methods to calculate the runoff respectively; surface runoff routing module routes the surface runoff and determines the inundation index. The routing on surface grid is calculated according to the two dimensional shallow water unsteady flow algorithm, the routing on land channel and special channel is calculated according to the one dimensional unsteady flow algorithm. This paper then proposed the urban flood risk warning method that is called DPSIR model based multiple index fuzzy evaluation warning method, and referred to as DMFEW method. DMFEW first selects 5 evaluation indexes based on the DPSIR model for flood risk warning evaluation, including driving force index, pressure index, state index, impact index and response index. Based on the values of all evaluation indexes, one evaluation index for the whole system evaluation result is determined by using the fuzzy comprehensive evaluation method. The flood risk level is divided into 4 levels, having Level 1 the most serious. Every evaluation index is also categorized as 4 levels, and a linear fuzzy subjection function is proposed to do the fuzzy comprehensive evaluation. Dongguan City is used as the study case to validate the proposed method. The urban flood forecasting model is set up with the topographic data, the city map, the underground pipelines and land cover types, and two flood events are simulated with observed precipitation, one is interpolated from the rain gauges data, and another is estimated by digital weather radar. The simulated results are compared with the investigated water depth, and the results show the model has very good performances. The results are further used for the flood risk warning simulation, and are very reasonable. [ABSTRACT FROM AUTHOR]

Preparation of calibration curves is a critical step for large-scale quantification. However, this procedure is time-consuming, labor intensive. Herein, a novel isotopologue multipoint calibration (IMC) strategy, was proposed and demonstrated for the simultaneous quantitation of 120 pesticides and 83 veterinary drugs in surface water samples using Liquid Chromatography-High Resolution Mass Spectrometry (LC-HRMS). In this strategy, the natural isotopic distribution was used to generate external calibration curves, eliminating the need of analyst's adjustment and many sets of chemical standard solutions required in external calibration curves. Additionally, this strategy was comprehensively validated, and the results indicated this strategy had better performance in both accuracy and precision, fully meeting the requirements for the quantitative analysis. Interestingly, for the samples with high concentration beyond the upper limit of quantitation, the IMC strategy could avoid samples dilution by monitoring the less abundant isotopic channels. Furthermore, the IMC method was successfully applied in the surface water samples collected from Anhui province, China. Among which, sulfamethoxazole and imidacoprid were the main contributors. In conclusion, we present a promising LC-HRMS strategy for the accurate quantitation of small molecules, which has a potential application in food and environmental analysis. [Display omitted] • Isotopologue multipoint as a novel calibration strategy using LC-HRMS is presented. • The strategy was used to quantitate 120 pesticides and 83 veterinary drugs in water. • The strategy simplifies the preparation of calibration curves and sample dilution. [ABSTRACT FROM AUTHOR]

Excessive anthropogenic phosphorus (P) emissions put constant pressure on aquatic ecosystems. This pressure can be quantified as the freshwater eutrophication potential (FEP) by linking P emissions, P fate in environmental compartments, and the potentially disappeared fraction of species due to increase of P concentrations in freshwater. However, previous fate modeling on global and regional scales is mainly based on the eight-direction algorithm without distinguishing pollution sources. The algorithm fails to characterize the fate paths of point-source emissions via subsurface pipelines and wastewater treatment infrastructure, and exhibits suboptimal performance in accounting for multidirectional paths caused by river bifurcations, especially in flat terrains. Here we aim to improve the fate modeling by incorporating various fate paths and addressing multidirectional scenarios. We also update the P estimates by complementing potential untreated point-source emissions (PSu). The improved method is examined in a rapidly urbanizing area in Taihu Lake Basin, China in 2017 at a spatial resolution of 100 m × 100 m. Results show that the contribution of PSu on FEP (62.6%) is greater than that on P emissions (58.5%). The FEP is more spatially widely distributed with the improved fate modeling, facilitating targeted regulatory strategies tailored to local conditions.

Objectives: The relationships between socioeconomic status (SES) and blood pressure changes among older adults in China remain unclear. This study aimed to examine the associations between SES and rates of blood pressure changes among Chinese older adults., Study Design: Community-based, prospective, longitudinal cohort study., Methods: This study included 13,541 participants aged ≥65 years from the Chinese Longitudinal Healthy Longevity Survey between 2002 and 2018. SES was assessed by educational level, occupation, household yearly per capita income, and financial support. The estimated annual changes (EACs) of blood pressure were computed as the difference in blood pressure levels between any two adjacent surveys divided by the time interval. Associations between SES and EACs of blood pressure were evaluated using generalised estimating equations., Results: Lower SES was significantly associated with greater annual increases of blood pressure among Chinese older adults. The effect of SES on EACs of blood pressure was more pronounced among non-hypertensive participants. Compared to EACs among non-hypertensive participants with high SES, multivariable-adjusted EACs among those with low SES increased by 0.57 mmHg (95% confidence interval [CI]: 0.16, 0.99), 0.32 mmHg (95% CI: 0.07, 0.57), and 0.40 mmHg (95% CI: 0.13, 0.66) for systolic blood pressure, diastolic blood pressure, and mean arterial pressure, respectively., Conclusions: This study revealed strong associations between SES and EACs of blood pressure among Chinese older adults, especially in the non-hypertensive population. Findings suggest that prevention strategies for hypertension should pay more attention to the older population with low SES., (Copyright © 2024 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Objective: To explore the abnormal expression of HORMA domain containing protein 1 (HORMAD1) in chronic rhinosinusitis (CRS) patients and its correlation with the expression of inflammatory factors., Study Design: Observational study. Place and Duration of the Study: Department of Otolaryngology Head and Neck Surgery, the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, China, from August 2021 to October 2022., Methodology: Eighty CRS patients and 80 healthy volunteers participated in this study according to the inclusion and exclusion criteria. The plasma samples of the patients were collected and the level of HORMAD1 was determined by RT-qPCR methods. Commercially available ELISA kits were used for the detection of the levels of cytokines, and the correlation between HORMAD1 expression and the level of cytokines was analysed., Results: HORMAD1 expression was significantly increased in CRS patients as compared to the healthy subjects. Moreover, the results of ROC curve suggested AUC for HORMAD1 was 0.9442, 95% confidence interval, 0.9057 to 0.9827. IL-1β, TNF-α, IL-6 as well as IFN-γ were all markedly elevated in the CRS group. Positive correlations were found between HORMAD1 expression and the cytokines., Conclusion: HORMAD1 may trigger an inflammatory response in CRS patients. The results of the current study could be beneficial for improving the therapeutic efficacy of CRS patients., Key Words: HORMAD1, Chronic rhinosinusitis, Expression, Inflammatory factors, DNA damage, Cytokines.

Depressive symptoms have a significant impact on the quality-of-life among the oldest old (aged ≥ 80 years) in the population. Current research on the association of blood mercury with depressive symptoms has mainly targeted the general population. However, it is unclear whether this association is present in the oldest old. We used data from the Healthy Aging and Biomarker Cohort Study carried out in 2017-2018, with 1154 participants aged ≥ 80 years eligible for analysis. Inductively coupled plasma mass spectrometry (ICP-MS) was employed to detect blood mercury (Hg) levels, while the CES-D10 depression scale was used to assess depressive symptoms. The association between blood mercury levels and depressive symptoms was investigated using log-binomial and Poisson regression models. We also used restricted cubic splines (RCS) to assess the linear or nonlinear association of blood mercury with depressive symptoms scores. The 1154 participants ranged in age from 80 to 120 years, while the geometric mean of blood mercury concentration was 1.01 μg/L. After adjustment for covariates, log-binomial and Poisson regression analyses revealed a statistically significant, positive association of blood mercury with depressive symptoms. In comparison to the first tertile, the adjusted relative risks of blood mercury and the presence of depressive symptoms in the second and third tertiles were 1.55 (1.20-1.99) and 1.45 (1.11-1.90), respectively. The RCS model showed a linear association between blood mercury level and depressive symptoms scores. In conclusion, among the oldest old, we demonstrated that blood mercury levels were positively associated with depressive symptoms. Further surveys, especially cohort studies and clinical trials are needed to confirm these results., 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.)

Lead (Pb) is a widespread environmental contaminant, associated with a higher risk of functional impairment that can lead to frailty in older adults. However, few studies focused on the association of Pb exposure with frailty among the oldest old (aged ≥ 80 years). In this study, we aimed to assess the associations of Pb with frailty and its components in the oldest old. The included individuals were the oldest old aged ≥ 80 years who participated in a 2017 cross-sectional survey of the Healthy Aging and Biomarkers Cohort Study. Frailty was ascertained by the frailty index, which was created based on health deficits. We used logistic regression models to estimate the association of blood Pb with frailty and its components. The geometric mean and median of blood Pb were 38.51 μg/L and 36.27 μg/L among the oldest old, respectively. Compared with the first quartile of blood Pb, participants in the fourth quartile had higher risk of frailty and its components, the ORs are 1.71 (1.22-2.41), 1.99 (1.35-2.94), 1.91 (1.25-2.93), 1.57 (1.13-2.17) and 1.43 (1.05-1.96), for frailty, ADL disability, IADL disability, functional limitations, and hearing loss in the oldest old, respectively. There was a significant interaction between blood Pb and frailty in different age groups. In conclusion, our findings provide preliminary evidence that higher blood Pb may increase the risk of frailty among the oldest old by increasing the risk of disability in four physical functions: disability in ADL, disability in IADL, functional limitations, and hearing loss., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

National and international recommendations of healthy body mass index (BMI) are primarily based on evidence in young and middle-aged populations, with an insufficient representation of the oldest old (aged ≥80 years). Here, we report associations between BMI and mortality risk in 27,026 community-dwelling oldest old (mean age, 92.7 ± 7.5 years) in China from 1998 to 2018. Nonlinear curves showed reverse J-shaped associations of BMI with cardiovascular disease (CVD), non-CVD and all-cause mortality, with a monotonic decreased risk up to BMIs in the overweight and mild obesity range and flat hazard ratios thereafter. Compared to normal weight, overweight and obesity were significantly associated with decreased non-CVD and all-cause mortality, but not with CVD mortality. Similar associations were found for waist circumference. Our results lend support to the notion that optimal BMI in the oldest old may be around the overweight or mild obesity range and challenge the application of international and national guidelines on optimal BMI in this age group., (© 2022. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Objective: Globally, developed countries such as the United States, Canada, Germany, Korea, have carried out long-term and systematic biomonitoring programs for environmental chemicals in their populations. The China National Human Biomonitoring (CNHBM) was to document the extent of human exposure to a wide array of environmental chemicals, to understand exposure profiles, magnitude and ongoing trends in exposure in the general Chinese population, and to establish a national biorepository., Methods: CNHBM adopted three-stage sampling method to obtain a nationally representative sample of the population. A total of 21,888 participants who were permanent residents in 31 provinces were designed to interviewed in this national biomonitoring (152 monitoring sites × 3 survey units × 2 sexes × 6 age groups × 4 persons = 21,888 persons) in 2017-2018. Unlike the US National Health and Nutrition Examination Survey, the CNHBM will follow the same participants in subsequent cycles allowing for dynamic, longitudinal data sets for epidemiologic follow-up. Each survey cycle of CNHBM will last 2 years and each subsequent cycle will occur 3 years after the prior cycle's completion., Results: In 2017-2018, the CNHBM created a large cohort of Chinese citizens that included districts/counties questionnaire, community questionnaire collecting information on villages/communities, individual questionnaire, household questionnaire, comprehensive medical examination, and collection of blood and urine samples for measurement of clinical and exposure biomarkers. A total of 21,746 participants were finally included in CNHBM, accounting for 99.4% of the designed sample size; and 152 PSUs questionnaires, 454 community questionnaires, 21,619 family questionnaires, 21,712 cases of medical examinations, 21,700 individual questionnaires, 21,701 blood samples and 21,704 urine samples were collected, respectively. Planned analyses of blood and urine samples were to measure both inorganic and organic chemicals, including 13 heavy metals and metalloids, 18 poly- and per-fluorinated alkyl substances, 12 phthalate metabolites, 9 polycyclic aromatic hydrocarbons metabolites, 4 environmental alkylated phenols, and 2 benzene metabolites., Conclusions: CNHBM established the first nationally representative, prospective cohort in the Chinese population to understand the baseline and trend of internal exposure of environmental chemicals in general population, and to understand environmental toxicity., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background & Aims: Dietary diversity is widely advocated in national and international recommendations although whether the beneficial effects on survival or longevity still apply in the final phase of the lifespan remains understudied. We aimed to prospectively examine the association of dietary diversity, food items with all-cause mortality among the oldest old (80+) and determine whether dietary diversity recommendations were appropriate for this population., Methods: The study included 28,790 participants aged 80+ (9957 octogenarians, 9925 nonagenarians, and 8908 centenarians). A baseline dietary diversity score (DDS) was constructed based on nine food items of a food frequency questionnaire. Cox models with penalized splines evaluated non-linear associations of DDS as continuous variable with mortality to identify cut-offs of DDS., Results: We documented 23,503 deaths during 96,739 person-years of follow-up. Each one unit increase in DDS was associated with a 9% lower risk of mortality (adjusted hazard ratio (HR): 0.91; 95% confidential interval (CI): 0.90-0.92). Compared to participants whose DDS less than 2 scores, those with a DDS of 2, 3, 4, 5, and higher than 6 scores had a lower mortality risk, the HRs were 0.86 (0.82-0.89), 0.78 (0.75-0.81), 0.69 (0.66-0.72), 0.65 (0.62-0.68), and 0.56 (0.53-0.58) respectively, and a significant trend emerged (p < 0.001). Protein-rich food items were associated with prominent beneficial effects on mortality including meat (HR and 95% CI for high vs low frequency: 0.70 (0.68-0.72)), fish and sea food (HR, 0.74 (0.72-0.77)), egg (HR, 0.75 (0.73-0.77)), and bean (HR, 0.80 (0.78-0.82))., Conclusions: Even after the age of 80, the DDS tool may offer a simple and straightforward mean of identifying and screening individuals at high risk for mortality. Recommendation of dietary diversity, especially consumption of protein-rich food, may be advocated to reduce mortality risk and promote longevity in the oldest old., (Copyright © 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background: Research on the relationship between long-term exposure to particulate matter with aerodynamic diameter ≤ 2.5 μ m ( PM 2.5 ) and poor cognitive function is lacking in developing countries, especially in highly polluted areas., Objectives: We evaluated associations of long-term exposure to PM 2.5 with poor cognitive function in a diverse, national sample of older adults in China., Methods: This analysis included data on 13,324 older adults (5,879 who were 65-79 years of age, 3,052 who were 80-89 years of age, 2,634 who were 90-99 years of age, and 1,759 who were ≥ 100  years of age) with normal cognitive function at baseline from March 2002 to September 2014, with 64,648 person-years of follow-up. We used a geographic information system analysis to estimate the annual average satellite-derived PM 2.5 concentration for the geocoded location of the participants' baseline residences. Poor cognitive function was defined as a score of less than 18 on the Chinese version of the Mini-Mental State Examination (MMSE). Competing risk models were performed to explore the association of PM 2.5 with poor cognitive function., Results: Each 10 - μ g / m 3 increase in PM 2.5 was associated with a 5.1% increased risk of poor cognitive function [adjusted hazard ratio (HR): 1.051; 95% confidence interval (CI): 1.023, 1.079]. Compared to the lowest quartile of PM 2.5 ( < 41.4   μ g / m 3 ), adjusted HR values were 1.20 (95% CI: 1.09, 1.33), 1.27 (95% CI: 1.15, 1.41), and 1.21 (95% CI: 1.09, 1.34) for the second ( ≥ 41.4 - 50.3  ug / m 3 ), third ( ≥ 50.3 - 60.7 μ g / m 3 ), and fourth ( ≥ 60.7   μ g / m 3 ) quartiles of PM 2.5 , respectively ( p for trend < 0.001 ). Subgroup analyses suggested stronger associations between PM 2.5 and poor cognitive impairment in men than women. The association was positive in the 65- to 79- and ≥ 100 - y age group but not significant and positive in the other two age groups with similar results., Conclusion: PM 2.5 was identified as a risk factor for poor cognitive function in Chinese older adults. Improving air quality may reduce the future population burden of poor cognitive function, especially in areas with high air pollution. https://doi.org/10.1289/EHP5304.

Objective: Although some people with mild cognitive impairment may not suffer from dementia lifelong, about 5% of them will progress to dementia within 1 year in community settings. However, a general tool for predicting the risk of cognitive impairment was not adequately studied among older adults., Design: Prospective cohort study., Setting: Community-living, older adults from 22 provinces in China., Participants: We included 10,066 older adults aged 65 years and above (mean age, 83.2 ± 11.1 years), with normal cognition at baseline in the 2002-2008 cohort and 9354 older adults (mean age, 83.5 ± 10.8 years) in the 2008-2014 cohort of the Chinese Longitudinal Healthy Longevity Survey., Methods: We measured cognitive function using the Chinese version of the Mini-Mental State Examination. Demographic, medical, and lifestyle information was used to develop the nomogram via a Lasso selection procedure using a Cox proportional hazards regression model. We validated the nomogram internally with 2000 bootstrap resamples and externally in a later cohort. The predictive accuracy and discriminative ability of the nomogram were measured by area-under-the-curves and calibration curves, respectively., Results: Eight factors were identified with which to construct the nomogram: age, baseline of the Mini-Mental State Examination, activities of daily living and instrumental activities of daily living score, chewing ability, visual function, history of stroke, watching TV or listening to the radio, and growing flowers or raising pets. The area-under-the-curves for internal and external validation were 0.891 and 0.867, respectively, for predicting incident cognitive impairment. The calibration curves showed good consistency between nomogram-based predictions and observations., Conclusions and Implications: The nomogram-based prediction yielded consistent results in 2 separate large cohorts. This feasible prognostic nomogram constructed using readily ascertained information may assist public health practitioners or physicians to provide preventive interventions of cognitive impairment., (Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.)

Neonicotinoids are the most widely used insecticides worldwide, but there is mounting evidence demonstrating that they have adverse effects on nontarget organisms. However, little is known about the extent of environmental neonicotinoids contamination in China. In this study, a total of 693 honey samples from across China, from both Apis melifera and Apis cerana , were analyzed to examine neonicotinoid concentrations and their geographical distribution, and correlation with the primary plant species from which the honey was obtained. Furthermore, chronic and acute exposure risk and risk ranking for humans eating honey were investigated, and risks to bees were also considered. The results revealed that 40.8% of the samples contained at least one of the five neonicotinoids tested. Honeys from commercial crops were found to be more frequently contaminated with neonicotinoids than those from noncommercial crops. Honey samples from Apis mellifera were more frequently contaminated than those from Apis cerana . The concentrations of neonicotinoids found in honey overlapped with those that have been found to have significant adverse effects on honeybee health. The dietary risk assessments indicated that the levels of neonicotinoids detected in honey were likely to be safe for human consumption.

Currently the Chinese government has adopted World Health Organization interim target-1 values as the national ambient air quality standards values. However, the population-based evidence was insufficient, especially for the oldest old (aged 80+). We evaluated the association of fine particulate matters (PM 2.5 ) exposure and incidence of disability in activities of daily living (ADL) in 15 453 oldest old in 886 counties/cities in China from 2002 to 2014 using Cox model with penalized splines and competing risk models to evaluate the linear or non-linear association. After adjusting for potential confounders, a J-shaped association existed between PM 2.5 exposure with a threshold concentration of 33 μg/m 3 , and incident disability in ADL. Above this threshold, the risk magnitude significantly increased with increase of PM 2.5 concentrations; compared to 33 μg/m 3 , the hazard ratio ranged from 1.03 (1.00-1.06) at 40 μg/m 3 to 2.25 (1.54-3.29) at 110 μg/m 3 . The risk magnitude was not significantly changed below this threshold. Each 10 μg/m 3 increase in PM 2.5 exposure corresponded to a 7.7% increase in the risk of disability in ADL (hazard ratio 1.077, 95% CI 1.051-1.104). Men, smokers, and participants with cognitive impairment might be more vulnerable to PM 2.5 exposure. The study provided limited population-based evidence for the oldest old and detected a threshold of 33 μg/m 3 , and supported that reduction to current World Health Organization interim target-1value (35 μg/m 3 ) and Chinese national ambient air quality standards (35 μg/m 3 ) or lower may be associated with lower risk of disability in ADL., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Fraudulent acts regarding honey authenticity that use Apis mellifera honey as a substitute for Apis cerana honey have garnered considerable concern in China and triggered a trust crisis from consumers. In this study, untargeted metabolomics analysis was carried out based on volatile fractions in honey from A. cerana and A. mellifera using headspace gas chromatography-ion mobility spectrometry (HS-GC-IMS). Honey from A. cerana and A. mellifera was discriminated by HS-GC-IMS profiling, principal component analysis, and orthogonal partial least-squares discrimination analysis. Tentative markers were identified from p -values and the variable importance in projection analysis and confirmed using the retention index, mass fragments, and reference standards by gas chromatography-mass spectrometry (GC-MS). A targeted method was established using the headspace solid phase coupled with microextraction GC-MS (HS-SPME-GC-MS) to quantitate the markers. The results demonstrated that the developed untargeted and targeted metabolomics approach performed well when discriminating honey from A. cerana and A. mellifera .

Background: Air pollution and its adverse effects on public health remain a considerable problem in China, where policies have been implemented to improve the situation. We aimed to estimate the disease burden associated with particulate matter (PM) 2·5 across China for 2020 and 2030 to identify the populations and regions most at risk, quantify the health benefits of air quality improvement targets, and determine the effect of population growth and ageing on this disease burden., Methods: In this modelling study, we investigated premature deaths associated with PM 2·5 across China on the basis of air quality scenarios proposed by the expert group involved in the formulation of the 13th Five-Year Plan for Eco-Environmental Protection and population scenarios based on the Shared Socioeconomic Pathways of the Intergovernmental Panel on Climate Change. We used the integrated exposure-response model used for the Global Burden of Disease Study to estimate the number of PM 2·5 -related premature deaths under each scenario., Findings: The projected health benefits of the air-quality-improving targets are substantial, and could reduce the number of PM 2.5 -related premature deaths in China by approximately 129 278 by 2020 and 217 988 by 2030, compared with 2010. However, since China's population is increasing and ageing, the number of PM 2.5 -related premature deaths was estimated to increase by 84 102 by 2020 and by 244 191 by 2030, indicating that the health benefits induced by air quality improvements could be offset by the effect of the population increasing in size and ageing., Interpretation: To reduce the future disease burden in China, targets that are stricter than the interim target and stringent policies to improve air quality and protect public health are needed, especially for at-risk population groups, such as older individuals (aged >55 years) and patients with cardiovascular diseases, particularly in regions with a high disease burden., Funding: National Key Research and Development Program of China, National Natural Science Foundation of China, Beijing Natural Science Foundation, National High-level Talents Special Support Plan of China for Young Talents, and Special Foundation of Basic Science and Technology Resources Survey of Ministry of Science and Technology of China., (Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

The aim of this study was to predict the geographical origin of acacia honey of China through analysis of physicochemical parameters combination with chemometrics. Samples from six different origins were investigated on parameters of δ 13 C value, oligosaccharides and polyphenols, using EA-IRMS/LC-IRMS, GC-MS and HPLC-MS, respectively. The results indicated that the δ 13 C value of honey from Gansu region were lower than those of other regions. Oligosaccharides of honey from Shanxi and Shaanxi regions were both higher than other four regions. Polyphenols of honey from Shandong region was the highest and were better parameters than both δ 13 C and oligosaccharides in discrimination of geographical origins. Partial Least Square Discriminant Analysis (PLS-DA) showed that when all 31 different parameters were combined, a correct classification rate of 94.12% could be achieved using external cross validation method. In conclusion, the method in discrimination of geographical can be used to provide reliable and useful reference information., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The aim of this study was to develop an analytical method for the analysis of a wide range of veterinary drugs in honey and royal jelly. A modified sample preparation procedure based on the quick, easy, cheap, effective, rugged and safe (QuEChERS) method was developed, followed by liquid chromatography tandem mass spectrometry determination. Use of the single sample preparation method for analysis of 42 veterinary drugs becomes more valuable because honey and royal jelly belong to completely different complex matrices. Another main advantage of the proposed method is its ability to identify and quantify 42 veterinary drugs with higher sensitivity than reference methods of China. This work has shown that the reported method was demonstrated to be convenient and reliable for the quick monitoring of veterinary drugs in honey and royal jelly samples., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

A high performance liquid chromatography-diode array detection-tandem mass spectrometry (HPLC-DAD-MS/MS) method for the floral origin traceability of chaste honey and rape honey samples was firstly presented in this study. Kaempferol, morin and ferulic acid were used as floral markers to distinguish chaste honey from rape honey. Chromatographic fingerprinting at 270 nm and 360 nm could be used to characterise chaste honey and rape honey according to the analytical profiles. Principal component analysis (PCA), partial least squares (PLS), partial least squares-discrimination analysis (PLS-DA) and soft independent modeling of class analogy (SIMCA) were applied to classify the honey samples according to their floral origins. The results showed that chaste honey and rape honey could be successfully classified by their floral sources with the analytical methods developed through this study and could be considered encouraging and promising for the honey traceability from unifloral or multifloral nectariferous sources., (Copyright © 2013 Elsevier Ltd. All rights reserved.)