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BACKGROUND: This study aims to compare the epidemiological, clinical and laboratory characteristics between patients with coronavirus disease (COVID-19) and influenza A (H1N1), and to develop a differentiating model and a simple scoring system. METHODS: We retrospectively analyzed the data from patients with COVID-19 and H1N1. The logistic regression model based on clinical and laboratory characteristics was constructed to distinguish COVID-19 from H1N1. Scores were assigned to each of independent discrimination factors based on their odds ratios. The performance of the prediction model and scoring system was assessed. RESULTS: A total of 236 patients were recruited, including 20 COVID-19 patients and 216 H1N1 patients. Logistic regression revealed that age >34 years, temperature ≤37.5 µC, no sputum or myalgia, lymphocyte ratio ≥20% and creatine kinase-myocardial band isoenzyme (CK-MB) >9.7 U/L were independent differentiating factors for COVID-19. The area under curves (AUCs) of the prediction model and scoring system in differentiating COVID-19 from H1N1 were 0.988 and 0.962, respectively. CONCLUSIONS: There are certain differences in clinical and laboratory features between patients with COVID-19 and H1N1. The simple scoring system may be a useful tool for the early identification of COVID-19 patients from H1N1 patients. [ABSTRACT FROM AUTHOR]

In the present study, an analytical method has been developed and validated for the simultaneous detection and quantification of 19 PFRs (14 legacy organophosphorus flame retardants (PFRs) and 5 emerging PFRs (ePFRs)) and 20 plasticizers (7 legacy plasticizers (LPs) and 13 alternative plasticizers (APs)). Sample preparation was based on the combination of previously validated analytical protocols including ultrasonic extraction and Florisil fractionation/cleanup. The analysis was performed by using liquid chromatography–tandem mass spectrometry (LC-MS/MS) for all targeted compounds, except for bis (2-ethylhexyl) phthalate (DEHP) and bis (2-ethylhexyl) terephthalate (DEHT), for which the separation of the isomers resulted in more favorable gas chromatography–electron ionization–mass spectrometry (GC-EI-MS). The new method was in-house validated by applying two levels of fortification in dust. The achieved linearity (R2) ranged between 0.993 and 0.999. Limits of detection and quantification (LODs and LOQs) ranged between 1 and 265 ng/g and between 1 and 870 ng/g for all analytes, respectively, except for DEHP and DEHT, for which relatively higher LODs (665 and 1100 ng/g, respectively) and LOQs (2100 and 3500 ng/g, respectively) were observed. Accuracy ranged between 75 and 125% for most of the targeted analytes, and repeatability was good with relative standard deviation (RSD) < 15% for most compounds. Finally, the method was applied for the determination and quantification of the targeted chemicals in house dust samples (n = 10) from the megacity of Guangzhou (China). Median values ranged from 3 to 210 ng/g for PFRs, from 4 to 165 ng/g for ePFRs, from 30 to 100,000 ng/g for LPs, and from 6 to 34,000 ng/g for APs. Main contributors to the total contamination were LPs 63% and APs 37% in total plasticizers, whereas PFRs and ePFRs contributed 90% and 10% in total flame retardants. [ABSTRACT FROM AUTHOR]

Indoor environments contribute a significant portion of human exposure to brominated flame retardants (BFRs) because of their extensive use in various household products. This study investigates the occurrence of a number of BFRs in the indoor and outdoor air in a megacity in southern China, in which little information on indoor BFRs contamination is available. The estimated total PBDE concentrations ranged from 1.43 to 57 pg/m 3 indoors and from 1.21 to 1522 pg/m 3 outdoors. The indoor concentrations of lower brominated PBDEs that are mainly derived from the technical penta- and octa-BDE mixtures were higher than or comparable to the outdoors, while the indoor levels of DecaBDEs and decabromodiphenyl ethane (DBDPE) were apparently lower than the outdoors. The seasonal variations of BFR concentrations indicated that evaporation from old indoor products is the primary source of Penta- and OctaBDEs in the air, whereas most DecaBDEs and DBDPE concentrations showing weak temperature-dependence are largely released from industrial activities. The PBDE congener profiles in the air were generally similar, which were dominated by BDE209, 28, and 47; whereas the appreciable indoor–outdoor differences in the compositions are possibly due to emission sources, photochemical degradation, or congener-specific transport of BFRs in the indoor and outdoor air. Significant correlations between the indoor and outdoor BFRs were observed suggesting the exchange of BFRs between the two compartments, which are more noticeable for PentaBDEs and DecaBDEs with strong indoor and outdoor emission sources, respectively. This study provides significant insights into the sources of BFRs in urban air in China. [ABSTRACT FROM AUTHOR]

Fetal exposure to multiple organic contaminants (OCs) is a public concern because of the adverse effects of OCs on early life development. Infant hair has the potential to be used as an alternative matrix to identify susceptible fetuses, owing to its reliability, sensitivity, and advantages associated with sampling, handling, and ethics. However, the applicability of infant hair for assessing in utero exposure to OCs is still limited. In this study, 57 infant hair samples were collected in Guangzhou, South China, to evaluate the levels and compositions of typical OCs in the fetus. Most of the target OCs were detected in infant hair, with medians of 144 μg/g, 17.7 μg/g, 192 ng/g, 46.9 ng/g, and 1.36 ng/g for phthalate esters (PAEs), alternative plasticizers (APs), organophosphorus flame retardants (OPFRs), polybrominated diphenyl ethers (PBDEs), and organochlorine pesticides (OCPs), respectively. Meanwhile, paired maternal hair (0–9 cm from the scalp) was collected to examine the associations between maternal and infant hair for individual compounds. Low-brominated PBDEs tended to deposit in infant hair, with median concentrations approximately two times higher than those in maternal samples. Levels of PBDEs and 4,4′-dichlorodiphenyldichloroethylene (p,p'-DDE) in paired maternal and infant hair showed strong positive correlations (p < 0.05), while most plasticizers (PAEs and APs) were poorly correlated between paired hair samples. Exposure sources were responsible for the variation in correlation between OC levels in the paired infant and maternal samples. Crude relationships between fetal exposure to OCs and birth size were examined using the Bayesian kernel machine regression (BKMR) model. BDE-28 was found to be adversely associated with the birth size. This study provides referential information for evaluating in utero exposure to OCs and their health risks based on infant hair. [Display omitted] • PAEs, APs, OPFRs, PBDEs, and OCPs were examined in paired infant and maternal hair for the first time. • Low-brominated PBDEs had higher deposition in infant hair than that in maternal hair. • Infant hair can provide long-term exposure information for low-brominated PBDEs and p,p'-DDE. • Higher BDE-28 levels in infant hair were associated with lower birth sizes. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of dust–haze on mortality and to estimate the seasonal and individual-specific modification effects in Guangzhou, China. Mortality, air pollution and meteorological data were collected for 2006–2011. A dust–haze day was defined as daily visibility <10 km with relative humidity <90%. This definition was further divided into light (8–10 km), medium (5–8 km) and heavy dust–haze (<5 km). A distributed lag linear model (DLM) was employed. Light, medium and heavy dust–haze days were associated with increased mortality of 3.4%, 6.8% and 10.4% respectively, at a lag of 0–6 days. This effect was more pronounced during the cold season, for cardiovascular mortality (CVD), respiratory mortality (RESP), in males and people ≥60years. These effects became insignificant after adjustment for PM10. We concluded that dust–haze significantly increased mortality risk in Guangzhou, China, and this effect appears to be dominated by particulate mass and modified by season and individual-specific factors. [Copyright &y& Elsevier]

Abstract: The aim of the study was to compare the impact of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) on vascular function among older Chinese people. A random sample of 671 men and 603 women aged 50 to 85 years without known diabetes from the Guangzhou Biobank Study–CVD was examined in a cross-sectional study. Subjects with no previously confirmed or treated diabetes but with both fasting plasma glucose less than 5.6 mmol/L and 2-hour glucose from 7.8 to less than 11.0 mmol/L were classified as having isolated IGT, and those with no previously confirmed and treated diabetes but with both fasting plasma glucose from 5.6 to less than 7.0 mmol/L and 2-hour glucose less than 7.8 mmol/L were classified as having isolated IFG. A total of 11.0% of the men and 8.6% of the women had isolated IFG, and 17.7% of the men and 18.6% of the women had isolated IGT. The brachial-ankle pulse wave velocity and pulse pressure were increased in both the isolated IFG and isolated IGT subjects compared with the normoglycemia group (both Ps < .001). Compared with subjects with isolated IFG, those with isolated IGT appeared to have a higher age- and sex-adjusted brachial-ankle pulse wave velocity (1543 ± 22 vs 1566 ± 17, P = .07) and to be more insulin resistant (2-hour postload insulin: 54.2 ± 2.13 vs 26.8 ± 2.99 μU/mL, P < .001), had a worse lipid profile (apolipoprotein [apo] B: 1.07 ± 0.02 vs 0.97 ± 0.02g/L, P < .001; apo B/apo A-1 ratio: 0.80 ± 0.02 vs 0.69 ± 0.02, P < .001), but had lower glycosylated hemoglobin levels (6.03% ± 0.06% vs 5.86% ± 0.04%, P < .001) (values are mean ± SE). Subjects with isolated IGT had greater arterial stiffness, probably as a result of being more insulin resistant, with a worse lipid profile than those with isolated IFG. The sole use of fasting glucose level to identify prediabetic people would fail to identify a significant proportion of the at-risk population. [Copyright &y& Elsevier]

PD-1 blockade is highly efficacious for mismatch repair-deficient colorectal cancer in both metastatic and neoadjuvant settings. We aimed to explore the activity and safety of neoadjuvant therapy with PD-1 blockade plus an angiogenesis inhibitor and the feasibility of organ preservation in patients with locally advanced mismatch repair-deficient colorectal cancer. We initiated a single-arm, open-label, phase 2 trial (NEOCAP) at Sun Yat-sen University Cancer Center and the Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China. Patients aged 18–75 years with untreated mismatch repair-deficient or microsatellite instability-high or POLE/POLD1 -mutated locally advanced colorectal cancer (cT3 or N+ for rectal cancer, and T3 with invasion ≥5mm or T4, with or without N+ for colon cancer) and an Eastern Cooperative Oncology Group performance score of 0–1 were enrolled and given 200 mg camrelizumab intravenously on day 1 and 250 mg apatinib orally from day 1–14, every 3 weeks for 3 months followed by surgery or 6 months if patients did not have surgery. Patients who had a clinical complete response did not undergo surgery and proceeded with a watch-and-wait approach. The primary endpoint was the proportion of patients with a pathological or clinical complete response. Eligible enrolled patients who received at least one cycle of neoadjuvant treatment and had at least one tumour response assessment following the baseline assessment were included in the activity analysis, and patients who received at least one dose of study drug were included in the safety analysis. The study is registered with ClinicalTrials.gov (NCT04715633) and is ongoing. Between Sept 29, 2020, and Dec 15, 2022, 53 patients were enrolled; one patient was excluded from the activity analysis because they were found to be mismatch repair-proficient and microsatellite-stable. 23 (44%) patients were female and 29 (56%) were male. The median follow-up was 16·4 (IQR 10·5–23·5) months. 28 (54%; 95% CI 35–68) patients had a clinical complete response and 24 of these patients were managed with a watch-and-wait approach, including 20 patients with colon cancer and multiple primary colorectal cancer. 23 (44%) of 52 patients underwent surgery for the primary tumour, and 14 (61%; 95% CI 39–80) had a pathological complete response. 38 (73%; 95% CI 59–84) of 52 patients had a complete response. Grade 3–5 adverse events occurred in 20 (38%) of 53 patients; the most common were increased aminotransferase (six [11%]), bowel obstruction (four [8%]), and hypertension (four [8%]). Drug-related serious adverse events occurred in six (11%) of 53 patients. One patient died from treatment-related immune-related hepatitis. Neoadjuvant camrelizumab plus apatinib show promising antitumour activity in patients with locally advanced mismatch repair-deficient or microsatellite instability-high colorectal cancer. Immune-related adverse events should be monitored with the utmost vigilance. Organ preservation seems promising not only in patients with rectal cancer, but also in those with colon cancer who have a clinical complete response. Longer follow-up is needed to assess the oncological outcomes of the watch-and-wait approach. The National Natural Science Foundation of China, Guangdong Basic and Applied Basic Research Foundation, and the Cancer Innovative Research Program of Sun Yat-sen University Cancer Center. For the Chinese translation of the abstract see Supplementary Materials section. [ABSTRACT FROM AUTHOR]

Hair is a promising, non-invasive, human biomonitoring matrix that can provide insight into retrospective and integral exposure to organic pollutants. In the present study, we measured the concentrations of organophosphate flame retardants (PFRs) in hair and serum samples from university students in Guangzhou, China, and compared the PFR concentrations in the female hair segments using paired distal (5~10 cm from the root) and proximal (0~5 cm from the root) samples. PFRs were not detected in the serum samples. All PFRs except tricresyl phosphate (TMPP) and tri-n-propyl phosphate (TPP) were detected in more than half of all hair samples. The concentrations of total PFRs varied from 10.1 to 604 ng/g, with a median of 148 ng/g. Tris(chloroisopropyl) phosphate (TCIPP) and tri(2-ethylexyl) phosphate (TEHP) were the predominant PFRs in hair. The concentrations of most PFRs in the distal segments were 1.5~8.6 times higher than those in the proximal segments of the hair ( t -test, p <0.05), which may be due to the longer exposure time of the distal segments to external sources. The values of log (PFR concentrations-distal/PFR concentrations-proximal) were positively and significantly correlated with log K OA of PFRs ( p <0.05, r=0.68), indicating that PFRs with a higher log K OA tend to accumulate in hair at a higher rate than PFRs with a lower log K OA . Using combined segments of female hair, significantly higher PFR concentrations were observed in female hair than in male hair. In contrast, female hair exhibited significantly lower PFR concentrations than male hair when using the same hair position for both genders (0–5 cm from the scalp). The controversial results regarding gender differences in PFRs in hair highlight the importance of segmental analysis when using hair as an indicator of human exposure to PFRs. [ABSTRACT FROM AUTHOR]

Abstract: Effects of ozone on mortality have been widely assessed in developed countries but rarely in developing countries, and the effects of season and temperature on these associations remain unclear. The present study aimed to explore the modifying effects of temperature on the association of ozone with mortality, and to examine the lag effect structure in Guangzhou, China. Daily non-accidental mortality, air pollution and meteorological data from January 1st 2006 to December 31st 2008 in Guangzhou were collected. Generalized additive models (GAM) and distributed lag models (DLM) were used to estimate the excess risk (ER) of ozone on daily mortality and capture the lag effect structure. Results revealed that, in cold season, an increment in the ozone concentration of 10 μg m− 3 was associated with a 0.87% (95% CI: −0.06 to 2.29%) and 3.34% (95%CI: 1.36–5.35%) increase of mortality for lag0 and lag0–6, respectively. However, no significant effects were observed in the warm season. Daily average temperature and ozone concentration had interactive negative effects on non-accidental mortality in the cold season and at daily average temperatures in the 0–25th percentile, and mortality displacement was also found in these conditions. Therefore, the short-term effect of ambient ozone on mortality is modified by temperature in Guangzhou, China. [Copyright &y& Elsevier]

Abstract: We aimed to investigate the effects of ambient air pollutants on daily mortality in a relatively stable and homogeneous population in Guangzhou, China. Daily mortality, air pollution, and weather data between 2006 and 2009 were collected. The generalized additive model with poison regression was used to estimate the excessive risks (ERs) of air pollutants (PM10, SO2, and NO2) on total, cardiovascular and respiratory mortality. The effects of lag0–1 were the greatest for total non-accidental and cardiovascular deaths. The increments of 10μgm−3 in SO2, NO2, and PM10 were associated with ERs of 1.54% (95%CI: 1.03–2.06%), 1.42% (95%CI: 1.06–1.78%), and 1.26% (95%CI: 0.86–1.66%) respectively for total non-accidental deaths, and 2.28% (95%CI: 1.40–3.16%), 1.81% (95%CI: 1.20–2.41%), and 1.79% (95%CI: 1.11–2.47%) respectively for cardiovascular deaths. For persons who died from respiratory disease, however, the maximum effects occurred at lag0. The ERs for SO2, NO2, and PM10 were 1.36% (95%CI: 0.23–2.50%), 1.47% (95%CI: 0.66–2.29%) and 0.93% (95%CI: 0.03–1.83%), respectively. The effects of the three air pollutants on mortality were stronger in elderly and in women. The ERs in the present study were higher than those reported in Europe, the U.S., and most other Asian cities. Our findings show relatively higher ERs of daily mortality by ambient air pollutants in the center of Guangzhou, China, compared with estimates in other cities. Further studies with accurate exposure measurement among homogeneous population are needed to evaluate the precise magnitudes of the effects of the air pollutants. [ABSTRACT FROM AUTHOR]

Air samples were collected in June of 2004 from four sites in the city of Guangzhou, a typical urban center in South China, to determine the levels, compositional profiles, and gas-particle distribution of 11 polybrominated diphenyl ether (PBDE) congeners (BDE-28, -47, -66, -100, -99, -85, -154, -153, -138, -183, and -209). The arithmetic mean atmospheric concentrations of ∑PBDEs (sum of all target PBDE congeners except for BDE-209) in samples from the urban and city background sites were comparable to or slightly higher than those from other places around the world. The arithmetic mean atmospheric concentrations of BDE-209, however, were higher than those in North America and Europe, and similar to the values from Japan. Congener compositions were dominated by BDE-209 in all (>70%) but an industrial site, with an average abundance of 48% for BDE-209. The PBDE patterns were generally similar to that in the technical penta-BDE mixture, Bromkal 70-5DE. Partitioning of PBDEs between the gas and particle phases (Kp) was well correlated with the subcooled liquid vapor pressure (PL°) for all of the samples, but the relationship differed between samples from different sites. The measured fractions of PBDEs in the particulate phase were compared to the predictions from the Junge-Pankow adsorption and KOA-based absorption models. The results indicated that the KOA-based model worked better than the Junge-Pankow model that tended to overestimate the particulate fractions for most PBDE congeners. [ABSTRACT FROM AUTHOR]

• PFRs, ePFRs, LPs, and APs were investigated in dust and air from bedroom and offices. • Different types of dust showed specific levels and patterns for each group of chemicals. • A/Cs were the main source of PFRs/ePFRs, and high levels of LPs/APs were found in floor dust. • Levels in dust and air correlated for chemicals with log K oa < 14. • Dust ingestion was the main human exposure route to these chemicals in South China. Indoor dust has been extensively used for assessment of indoor contamination, especially for semi-volatile organic compounds (SVOCs). In the present study, the occurrence of four groups of SVOCs, i.e. organophosphorus flame retardants (PFRs), emerging PFRs (ePFRs), legacy phthalates (LPs), and alternative plasticizers (APs), was investigated in the indoor dust and air collected from floors, table surfaces, windows, and air conditioner (A/C) filters in bedrooms and offices in Guangzhou, South China. In bedrooms, A/C filter dust showed the highest median concentrations of PFRs (4670 ng/g) and ePFRs (586 ng/g), whilst the highest median concentrations of LPs and APs were found in floor (240,880 ng/g) and window dust (157,160 ng/g), respectively. In offices, A/C filter dust showed the highest median concentrations for PFRs (6750 ng/g) and APs (504,520 ng/g), while the highest ePFR median level was found in PC table dust (5810 ng/g) and LPs in floor dust (296,270 ng/g). Median air concentrations of PFRs, ePFRs, LPs, and APs were measured at 4.6, 0.12, 399, and 25 ng/m3 in bedrooms, and at 8.0, 0.05, 332, and 43 ng/m3 in offices, respectively. Tris(1-chloro- iso -propyl) phosphate (TCIPP) was the predominant PFRs/ePFRs in both dust and air. Di(2-ethylhexyl) phthalate (DEHP), di- iso -decyl phthalate (DIDP) and di- iso -nonyl phthalate (DINP) were the main LP/AP compounds in dust, whilst di- iso -butyl phthalate (DIBP) and di-n-butyl phthalate (DNBP) were the most abundant LPs/APs in air. A significant correlation (p < 0.05) was found between dust and air levels for chemicals with log K oa < 14, indicating that equilibrium was achieved for these chemicals but not for those with log K oa > 14. Among the investigated human exposure pathways (i.e. dust ingestion, dermal absorption, and air inhalation), dust ingestion was the predominant one for all chemicals. Human exposures of this magnitude to these chemicals through the investigated pathways was unlikely to present a health risk in the present study. [ABSTRACT FROM AUTHOR]