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Phthalate acid esters (PAEs) are frequently detected in the global environment and can cause potential health hazards. In this study, quantitative exposure risk assessment was undertaken to derive soil generic assessment criteria (GAC) for six representative PAEs under the agricultural land use in the evaluated Chinese regions, which coupled multi-media transport and human exposure models based on multiple exposure pathways including vegetables consumption, dermal absorption, ingestion of soil and dust, and the exposure from non-soil sources. It is identified that the PAEs in agricultural soil are dominated by DEHP and DnBP representing 72–96% of the total PAEs. The GAC for BBP and DEHP, calculated on the basis of region-specific exposure parameters and soil properties in various locations, are stringent, signifying greater potential health risks from exposure to them, warranting more rigorous contamination management. The proposed soil GAC for plastic debris are 100, 107, 73 and 88 mg kg−1 for Heilongjiang Province, Beijing City, Jiangsu and Guangdong Provinces respectively. Additionally, the potential risks of 1.68 × 10−6 and 7 × 10−6 are identified for BBP and DEHP in Guangdong Province as indicated by the exceedance of target risk level of 1 × 10−6, with the consumption of vegetables being the dominant contributor to the total estimated PAEs exposure. Overall, this methodology based on the coupled contaminant transport and exposure models incorporating region-specific data provides a technical framework to derive science-based soil GAC for representative PAEs for maintaining and assessing soil quality and food safety under the agricultural land use. [Display omitted] • Spatial distribution of typical phthalate acid esters (PAEs) was assessed in the selected regions of China. • The generic assessment criteria (GAC) of representative PAEs were firstly derived under agricultural land use. • Dietary vegetable consumption contributed significantly to the derived GAC. • Potential health risks are identified for BBP and particular, DEHP under agricultural land use. [ABSTRACT FROM AUTHOR]

• Holocene seawater was observed widespread along the coastline of eastern China. • Evolution of saline porewater is attributed to transgression and regression cycle. • Transport of porewater is controlled by diffusion in natural conditions. • Porewater salinity is impacted by advective flow in areas of extensive pumping. Aquitards can preserve paleo-saltwater and have a long and profound influence on the aquifer groundwater, yet they have received less attention. Here, five one-dimensional vertical profiles of the natural tracers, Cl−, Br−, δ2H, and δ18O of aquitard porewater were measured and combined with eight existing profiles collected from previous studies in three Eastern China coastal plains, Bohai bay, Laizhou bay, and Jiangsu coastal plain, to show the salinity origin and the timescale of the transport of porewater across aquitards since the mid-Holocene. Evidence of paleo-seawater impacted by Holocene transgression is noticed as peak Cl− concentration, enriched water isotopes, and lower Cl/Br ratios are observed in the porewater at about the bottom depth of Holocene of 25 m. The shape of Cl− profiles and associated 1-D transport models confirms Holocene seawater's presence in the sediment and the alternating transgression and regression control the salinity evolution of coastal aquitard porewater. Diffusion is the dominant transport across aquitard with an upward velocity between 0.03 and 0.6 mm/yr. Reverse advective flow has affected the solute transport in areas of extensive pumping. Anthropogenic activities enhance the leaching of salty porewater into aquifers in coastal areas, necessitating the need for research focused on marine aquitard salty water. [ABSTRACT FROM AUTHOR]

n experiment was carried out to evaluate the effects of phosphorus concentration (1, 4 and 10 mg l) and temperature (15 and 25°C) on chlorophyll a (chl a) contents and cell size/volume of green alga Scenedesmus obliquus and blue green alga Microcystis aeruginosa. Long-term field data from Lake Taihu, a large, shallow eutrophic lake between Jiangsu and Zhejiang Provinces, China, was also used to evaluate the effect of temperature on the model between chl a and total phosphorus (TP). The chl a content of both algae increased with an increase in phosphorus concentration and temperature. Temperatures showed a significantly different effect on chl a content of S. obliquus at a phosphorus concentration of 10 mg l, whereas there was no significant difference at the two lower phosphorus levels. For M. aeruginosa, temperatures presented significantly different effects on the chl a contents at three phosphorus concentrations. Chl a content of neither alga presented an interaction between the nutrient and the temperature. Long-term field data from Lake Taihu also indicated that the addition of temperature to the model increased predictability of chl a by TP. The length/diameter and volume of both algae were greater at the lower temperature and phosphorus concentration. Moderate negative correlations were observed between algal size, volume, and chl a content. Our results suggest that phosphorus concentration and temperature could change chl a contents and size in species-specific algal cells and that temperature should be considered when building the model of TP and chl a concentration. [ABSTRACT FROM AUTHOR]

To explore the etiology of risk factors and quantify the mortality differences in systemic lupus erythematosus (SLE) patients with different initial disease activity. The Jiangsu Lupus database was established by collecting medical records from first-hospitalized SLE patients during 1999–2009 from 26 centers in Jiangsu province, China, and their survival status every five years. The initial SLEDAI scores [high (>12) vs. low–moderate (≤12)] differences in mortality attributable to risk factors were quantified using population attributable fraction (PAF), relative attributable risk (RAR) and adjusted relative risk (ARR). Among 2446 SLE patients, 83 and 176 deaths were observed in the low–moderate and high activity groups, with mortality rates of 7.7 and 14.0 per 1000 person years, respectively. Anemia was the leading contributor to mortality, with PAFs of 40.4 and 37.5 in the low–moderate and high activity groups, respectively, and explained 23.2% of the mortality differences with an ARR of 1.66 between the two groups. Cardiopulmonary involvement caused the highest PAFs in the low–moderate (20.5%) and high activity (13.6%) groups, explaining 18.3% of the mortality differences. The combination of anemia and cardiopulmonary involvement had the highest RAR, causing 39.8% of the mortality differences (ARR = 1.52) between the two groups. In addition, hypoalbuminemia and a decrease in the creatinine clearance rate accounted for 20–30% of deaths and explained 10–20% of the mortality differences between the two groups, while antimalarial drug nonuse accounted for about 35% of deaths and explained 3.6% of the mortality differences. Anemia, cardiopulmonary involvement and hypoalbuminemia may cause substantial mortality differences across disease activity states, suggesting additional strategies beyond disease activity assessment to monitor SLE outcomes. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the relative factors of improvement in disease activity (IDA) after first hospitalized treatment based on the systemic lupus erythematosus disease activity index (SLEDAI). Methods: A total of 1069 adult systemic lupus erythematosus (SLE) patients who were hospitalized for the first time in 26 hospitals in Jiangsu Province from 1999 to 2009 were retrospectively analyzed. SLEDAI decrease ≥ 4 during hospitalization was identified as IDA. Relative factors of IDA were assessed by univariate and multivariate logistic regression. Results: A total of 783 (73.2%) adult SLE patients showed IDA after the first hospitalization, while the remaining patients (n = 286) were in the non-IDA group. The IDA group had higher SLEDAI at admission; fewer patients had SLICC/ACR damage index (SDI) ≥ 1, comorbidities at admission, especially Sjögren's syndrome, abnormal serum creatinine, and glomerular filtration rate. More patients had mucocutaneous and musculoskeletal involvements, leukopenia, increased C-reactive protein, anti-dsDNA antibody positive, and hypocomplementemia at admission and were treated with methotrexate and leflunomide during hospitalization. After multivariate logistic regression analysis, SDI ≥ 1 (P = 0.005) and combined with Sjögren's syndrome (P < 0.001) at admission had negative association with IDA. Musculoskeletal involvement (P < 0.001), anti-dsDNA antibody positive (P = 0.012), hypocomplementemia (P = 0.001), and use of leflunomide (P = 0.030) were significantly related with IDA. Conclusion: Organ damage or comorbidities at admission were adverse to SLE improvement. Anti-dsDNA antibody positive, hypocomplementemia, musculoskeletal involvements, and leflunomide treatment had positive association with IDA of SLE. Key Points • Organ damage or comorbidities at admission were negatively correlated with SLE improvement. • Anti-dsDNA antibody positivity, hypocomplementemia, musculoskeletal involvements, and leflunomide treatment were positively associated with SLE improvement. [ABSTRACT FROM AUTHOR]

The comprehensive utilization of straw plays an important role in GHG emissions reduction. The main breakthrough point of promoting straw resource utilization in China is on staple crops. In this study, the current straw utilization and treatment status of staple crops in rural China were studied based on data from the 2019 China Rural Development Survey, which included five provinces, 100 villages, and 1015 households. A life cycle assessment was conducted to identify the GHG emissions of the various crop straw utilization and treatment methods. The GHG emissions per unit area from the crop and household perspectives were also observed. Furthermore, the trend in GHG emissions from crop straw utilization and treatment was predicted through scenario simulation. The results showed that the comprehensive utilization rates of rice straw and wheat straw in rural China were 85.30% and 98.41%, respectively, in 2018, whereas the comprehensive utilization rate of maize straw was only 40.25%. Rice straw has the highest GHG emission level of 11771.90 kgCO 2 -eq/ha from a long-term perspective. On a national scale, the average GHG emissions per unit area of household is 1229.56 kgCO 2 -eq/ha, with significant differences between provinces, from a maximum of 12033.77 kgCO 2 -eq/ha in Jiangsu to a minimum of −3599.77 kgCO 2 -eq/ha in Jilin. According to the results of the scenario simulation, if the ambitious measures in reducing the straw incorporated into paddy soil are not taken, future GHG emissions of staple crop straw may persist and even rise rapidly in rural China. [Display omitted] • Realizing the resource utilization of straw in China mainly depends on staple crops. • Straw utilization rates of rice and wheat exceed 85%, but only 40.25% for maize. • The order of GHG emission intensity of straw of staple crops is rice > wheat > maize. • The GHG emissions of crop straw at household level is 1229.56 kgCO 2 -eq/ha in China. • Without measures, the life-cycle GHG emissions of crop straw will continue to rise. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of cyclophosphamide (CYC) on organ involvement and SLE patients' overall and cause-specific mortality. Methods: Information about CYC prescription was taken from the Jiangsu Lupus database, which was set up to collect medical records from SLE patients since their first admission during 1999–2009 in Jiangsu province, China. Follow-up studies were carried out in 2010 and 2015 to check the survival status of the patients. Cox regression models were used to estimate the hazard ratio (HR) and 95% CI. Kaplan–Meier model was used to assess the effect of CYC on mortality between organ involvement and non-involvement. Results: There were 221 deaths observed out of 2446 SLE patients. CYC users decreased overall mortality of SLE (8.4%) with adjusted HR (95% CI) of 0.74 (0.56–0.97), as compared to non-users. A decrease in overall mortality of SLE was found in the low dosage (< 600 mg) of CYC users, with adjusted HR (95% CI) of 0.54 (0.36–0.81). The protection of CYC on mortality of SLE was further observed in subgroups, such as female; SLEDAI score ≥ 15 group; and those with neuropsychiatric, renal, and hematological involvements, and low serum C3. In addition, CYC could eliminate the differences in mortality between organ involvement and non-involvement, including renal, neuropsychiatric, cardiopulmonary, gastrointestinal, and hematological involvement, but not for mucocutaneous and musculoskeletal involvement. Conclusion: Low dosage use of CYC decreased the risk of overall mortality of SLE. CYC might improve the survival of SLE patients with renal, neuropsychiatric, cardiopulmonary, gastrointestinal, and hematological involvements. Key Points • Cyclophosphamide decreases overall mortality of SLE patients. • Decreased mortality is mainly observed from low dosage use of cyclophosphamide. • Cyclophosphamide improves the survival of SLE patients when major systems such as renal, neuropsychiatric, cardiopulmonary, gastrointestinal, and hematological are involved. [ABSTRACT FROM AUTHOR]

Studies on clinical features of systemic lupus erythematosus among different age-onset patients are lacking in China. This multicentre study aimed to systemically compare clinical manifestations, comorbidities, organ involvement, and laboratory findings among 797 Chinese juvenile-onset, adult-onset, and late-onset SLE (JSLE, ASLE, and LSLE) patients. They were classified into JSLE, ASLE, and LSLE groups if first diagnosed at < 18, 18–50, and > 50 years old, respectively. Chi-square test and analysis of variance were employed for categorical and continuous variables respectively. In younger-onset patients, the SLE Disease Activity Index 2000 score was significantly higher (JSLE vs. ASLE vs. LSLE = 17.43 ± 9.139 vs. 16.34 ± 8.163 vs. 14.08 ± 6.474, p = 0.031). Mucocutaneous symptoms (79.5% vs. 73.4% vs. 62.0%, p = 0.042), especially malar rash (76.1% vs. 66.1% vs. 53.5%, p = 0.011) occurred more frequently, and proteinuria rate was higher (54.5% vs. 56.3% vs. 36.6%, p = 0.007). In later-onset patients, cardiopulmonary involvement increased (11.4% vs. 24.3% vs. 29.6%, p = 0.012). In ASLE, hypoalbuminemia rate elevated (46.6% vs. 59.9% vs. 47.9%, p = 0.015). Our study demonstrated in a Chinese population that JSLE may be more active and suffer mucocutaneous disorders, while LSLE tended to suffer cardiopulmonary involvement at-onset. These findings may help identify treatment priorities when facing different age-onset SLE patients. [ABSTRACT FROM AUTHOR]

It is widely recognized that air pollution exerts substantial detrimental effects in human health and the economy. The potential for harm is closely linked to the concentrations of pollutants like nitrogen dioxide (NO 2) and ozone (O 3), as well as their collective oxidative potential (O X). Yet, due to the challenges of directly monitoring O X as an independent factor and the influences of different substances' varying ability to contain or convey O X , uncertainties persist regarding its actual impact. To provide further evidence to the association between short-term exposures to NO 2 , O 3 , and O X and mortality, this study conducted multi-county time-series analyses with over-dispersed generalized additive models and random-effects meta-analyses to estimate the mortality data from 2014 to 2020 in Jiangsu, China. The findings reveal that short-term exposures to these pollutants are linked to increased risks of all-cause, cardiovascular, and respiratory mortality, where NO 2 demonstrates 2.11% (95% confidence interval: 1.79%, 2.42%), 2.28% (1.91%, 2.66%), and 2.91% (2.13%, 3.69%) respectively per every 10 ppb increase in concentration, and the effect of O 3 is 1.11% (0.98%, 1.24%), 1.39% (1.19%, 1.59%), and 1.82% (1.39%, 2.26%), and O X is 1.77% (1.58%, 1.97%), 2.19% (1.90%, 2.48%), and 2.90% (2.29%, 3.52%). Notably, women and individuals aged over 75 years exhibit higher susceptibility to these pollutants, with NO 2 showing a greater impact, especially during the warm seasons. The elevated mortality rates associated with NO 2 , O 3 , and O X underscore the significance of addressing air pollution as a pressing public health issue, especially in controlling NO 2 and O 3 together. Further research is needed to explore the underlying mechanisms and possible influential factors of these effects. • The latest study about short-term exposure to NO 2 , O 3 , and O X on daily mortality. • A large dataset of 4,276,989 participants collected over 7 years. • Multi-county time-series analyses with a 2-step statistical model. • NO 2 has the largest effect, and O 3 and O X shows similar significance. [ABSTRACT FROM AUTHOR]

Objective: To explore the association between the creatinine clearance rate (Ccr) and the prognosis of patients, and compared with estimated glomerular filtration rate (eGFR). Methods: We retrospectively collected information of patients with SLE who were first hospitalized between 1999 and 2009 in Jiangsu Province, China, and followed up in 2010 and 2015. Ccr was calculated and dichotomized into normal group (Ccr ≥ 70) and decreasing group (Ccr < 70). The clinical characteristics of the two groups were compared and Cox proportional-hazards regression models were used to calculate hazard ratio (HR) and 95% confidence interval (CI). Results: Among 1990 SLE patients, we observed 437 (22.0%) with decreased Ccr, including 237 cases (11.9%) with mild renal dysfunction, 136 cases (6.8%) with moderate renal dysfunction, and 64 cases (3.2%) with severe renal dysfunction. Compared to normal Ccr, decreasing Ccr had a higher risk for mortality with adjusted HR (95% CI) of 2.21 (1.59–3.06). Dose-response relationships were significantly found between increased mortality of SLE and decreased Ccr (p for trend < 0. 001), as well as eGFR. Positive associations were consistently observed in subgroups, such as systemic lupus disease activity index (SLEDAI) ≥ 15, without comorbidities and abnormal laboratory indexes. Decreasing Ccr was positively associated with mortality from infection and renal failure with HR (95% CI) of 1.80 (1.02–3.19) and 6.84 (3.05–15.36). Conclusions: A significant association has been observed between decreased Ccr and increased risk for mortality of SLE patients. Early clinical interventions to modulate the Ccr of SLE patients may be beneficial to their survival. Key points • Decreasing creatinine clearance rate (Ccr) was positively associated with an overall mortality of SLE patients, with a dose-response relationship. • Moreover, decreasing Ccr was associated with elevated mortality primarily due to infection and renal failure. [ABSTRACT FROM AUTHOR]

Objective: To identify early signs associated with poor prognosis in Chinese patients with systemic lupus erythematosus (SLE) through a large population-based follow-up study. Methods: Medical records of > 2,500 SLE patients that first hospitalized between 1999–2009 were collected from 26 centers across Jiangsu province, China, and entered into a database. These patients were followed-up for 5 to 15 years, and those remained contact and had known survival status in 2015 were assessed for the association of factors presented at the initial hospitalization with mortality at two time points (≤1year and > 1year). The independency of mortality factors was evaluated using multivariate Cox regression analysis. Results: Among 1,372 patients we assessed, 92.3% were women and 17.2% were deceased in 2015. The main causes of death were infection (30.1%), neuropsychiatric impairment (14.8%), renal failure (14.4%) and cardiopulmonary involvement (8.5%). Hazard ratios (HR) of independent predictors for mortality (≤1year and > 1year, respectively) included hospital presentation of neuropsychiatric involvement (2.03 and 1.91), cardiopulmonary involvement (1.94 and 1.61) and increased serum creatinine (2.52 and 2.58). Patients older than 45 years and with disease durations more than 2 years at admission had unfavorable short-term outcome (HR 1.76 and 1.79), while the presence of anti-dsDNA and anti-Sm antibodies indicated diverse prognosis after 1 year (HR 1.60 and 0.45). Treatment with cyclophosphamide was beneficial for patient’s first-year outcome (HR 0.50), and anti-malarial drugs significantly reduced the risk of mortality over different time points (HR 0.48 and 0.54). SLEDAI score, proteinuria or hypocomplementemia was not independently associated with the outcome in this cohort. Conclusion: SLE patients presented with vital organ damages rather than active disease at initial hospitalization are likely to have a poor outcome, especially for those with neuropsychiatric, cardiopulmonary involvements and renal insufficiency. Early and effective intervention with the use of anti-malarial drugs may decrease mortality. [ABSTRACT FROM AUTHOR]

Salt stress is a major negative factor affecting the sustainable development of agriculture. Phosphorus (P) deficiency often occurs in saline soil, and their interaction inhibits plant growth and seed yield for canola (Brassica napus L.). P supply is considered an effective way to alleviate the damage of salt stress. However, the knowledge of how P supply can promote plant growth in saline environment was limited. A field experiment was conducted to explore the effects of P rate on accumulation, and partitioning, of biomass and P, leaf photosynthesis traits, and yield performance in saline soil in the coastal area of Yancheng City, Jiangsu Province, China, during the 2018–2019 and 2019–2020 growing seasons. P supply increased biomass and P accumulation in all organs, and root had the most increments among different organs. At flowering stage, P supply increased the biomass and P partitioning in root and leaf, but it decreased the partitioning in stem. At maturity stage, P supply facilitated the biomass and P partitioning in seed, but it decreased the partitioning in stem and shell, and it increased the reproductive-vegetative ratio, suggesting that P supply can improve the nutrients transporting from vegetative organs to reproductive organs. Besides, P supply improved the leaf area index and photosynthetic rate at the flowering stage. As a result, the seed yield and oil yield were increased. In conclusion, P supply can improve the canola plant growth and seed yield in a saline environment. P fertilizer at the rate of 120 kg P2O5 ha−1 was recommended in this saline soil. [ABSTRACT FROM AUTHOR]

Abstract: The coast of Jiangsu Province in China – where Ulva prolifera has always been firstly spotted before developing into green tides – is uniquely characterized by a huge intertidal radial mudflat. Results showed that: (1) propagules of U. prolifera have been consistently present in seawater and sediments of this mudflat and varied with locations and seasons; (2) over 50,000 tons of fermented chicken manure have been applied annually from March to May in coastal animal aquaculture ponds and thereafter the waste water has been discharged into the radial mudflat intensifying eutrophication; and (3) free-floating U. prolifera could be stranded in any floating infrastructures in coastal waters including large scale Porphyra farming rafts. For a truly integrated management of the coastal zone, reduction in nutrient inputs, and control of the effluents of the coastal pond systems, are needed to control eutrophication and prevent green tides in the future. [Copyright &y& Elsevier]