Molecular Evolution and Increasing Macrolide Resistance of Bordetella pertussis, Shanghai, China, 2016-2022.

Resurgence and spread of macrolide-resistant Bordetella pertussis (MRBP) threaten global public health. We collected 283 B. pertussis isolates during 2016-2022 in Shanghai, China, and conducted 23S rRNA gene A2047G mutation detection, multilocus variable-number tandem-repeat analysis, and virulence genotyping analysis. We performed whole-genome sequencing on representative strains. We detected pertussis primarily in infants (0-1 years of age) before 2020 and older children (>5-10 years of age) after 2020. The major genotypes were ptxP1/prn1/fhaB3/ptxA1/ptxC1/fim2-1/fim3-1 (48.7%) and ptxP3/prn2/fhaB1/ptxA1/ptxC2/fim2-1/fim3-1 (47.7%). MRBP increased remarkably from 2016 (36.4%) to 2022 (97.2%). All MRBPs before 2020 harbored ptxP1, and 51.4% belonged to multilocus variable-number tandem-repeat analysis type (MT) 195, whereas ptxP3-MRBP increased from 0% before 2020 to 66.7% after 2020, and all belonged to MT28. MT28 ptxP3-MRBP emerged only after 2020 and replaced the resident MT195 ptxP1-MRBP, revealing that 2020 was a watershed in the transformation of MRBP.

Penicillin and Cefotaxime Resistance of Quinolone-Resistant Neisseria meningitidis Clonal Complex 4821, Shanghai, China, 1965-2020.

Clonal complex 4821 (CC4821) Neisseria meningitidis, usually resistant to quinolones but susceptible to penicillin and third-generation cephalosporins, is increasing worldwide. To characterize the penicillin-nonsusceptible (PenNS) meningococci, we analyzed 491 meningococci and 724 commensal Neisseria isolates in Shanghai, China, during 1965-2020. The PenNS proportion increased from 0.3% in 1965-1985 to 7.0% in 2005-2014 and to 33.3% in 2015-2020. Of the 26 PenNS meningococci, 11 (42.3%) belonged to the CC4821 cluster; all possessed mutations in penicillin-binding protein 2, mostly from commensal Neisseria. Genetic analyses and transformation identified potential donors of 6 penA alleles. Three PenNS meningococci were resistant to cefotaxime, 2 within the CC4821 cluster. With 96% of the PenNS meningococci beyond the coverage of scheduled vaccination and the cefotaxime-resistant isolates all from toddlers, quinolone-resistant CC4821 has acquired penicillin and cefotaxime resistance closely related to the internationally disseminated ceftriaxone-resistant gonococcal FC428 clone, posing a greater threat especially to young children.

Epidemiological characteristics of paediatric Omicron infection during the outbreak of SARS-CoV-2 infection during March-May in 2022 in Shanghai, China.

This study aims to understand the epidemiological characteristics of SARS-CoV-2 infection in the paediatric population during the outbreak of the Omicron variant in Shanghai. We retrospectively analysed the population-based epidemiological characteristics and clinical outcome of SARS-CoV-2 Omicron variant infection in children in Minhang District, Shanghai, based on the citywide surveillance system during the outbreak period in 2022 (March to May). During this time, a total of 63,969 cases of SARS-CoV-2 infection were notified in Minhang District, out of which 4,652 (7.3%) were children and adolescents <18 years. The incidence rate of SARS-CoV-2 infections in children was 153 per 10,000. Of all paediatric cases, 50% reported to be clinically symptomatic within 1-3 days after PCR confirmation by parents or themselves, with 36.3% and 18.9% of paediatric cases reporting fever and cough. Also, 58.4% of paediatric cases had received at least one dose of the COVID-19 vaccine and 52.1% had received two doses of the COVID-19 vaccination. Our findings are informative for the implementation of appropriate measures to protect children from the threat of SARS-CoV-2 infection.

Determination of Urban Formaldehyde Emission Ratios in the Shanghai Megacity.

We analyzed two data sets of atmospheric formaldehyde (FA) at an urban site in the Shanghai megacity during the summer of 2017 and the winter of 2017/18, with the primary objective of determining the emission ratio of formaldehyde versus carbon monoxide (CO). Through the photochemical age method and the minimum R squared (MRS) method, we derived the summer urban formaldehyde release ratios of 3.37 ppbv (ppmv of CO)-1 and 4.04 ppbv (ppmv of CO)-1, respectively. The error of both estimations is within ±20%, indicating the consistency of the results. We recognized the hourly minimum emission ratios determined from the MRS method to be indicative of actual formaldehyde emission ratios. Similarly, the emission ratio in winter is determined to be 2.10 ppbv (ppmv of CO)-1 utilizing the MRS method. The findings provide significant insights into the potential impact of motor vehicle exhaust on formaldehyde emissions in urban areas. This work demonstrates that the formaldehyde emission ratio determined by the MRS method can be used to represent the emissions of the freshest air mass. Formaldehyde photolysis contributed an average of 9% to the free radical primary reaction rate (P(ROx)) as a single chemical species during the daytime in summer, which was lower than the 11% recorded in winter. Formaldehyde emission reduction positively impacts local ozone production, so models describing ozone formation in Shanghai during summer need to reflect these emissions accurately. Evidence of the crucial catalytic role of formaldehyde in particulate matter formation has been confirmed by recent research. A potentially effective way to decrease the incidence of haze days in autumn and winter in the future is therefore to focus on reducing formaldehyde emissions.

Comprehensive evaluation of community human settlement resilience and spatial characteristics based on the supply-demand mismatch between health activities and environment: a case study of downtown Shanghai, China.

INTRODUCTION: Under globalization, human settlement has become a major risk factor affecting life. The relationship between humans and the environment is crucial for improving community resilience and coping with globalization. This study focuses on the key contradictions of community development under globalization, exploring community resilience by analyzing the mismatch between residents' health activities and the environment. METHODS: Using data from Shanghai downtown, including land use, Sports app, geospatial and urban statistics, this paper constructs a comprehensive community resilience index (CRI) model based on the DPSIR model. This model enables quantitative analysis of the spatial and temporal distribution of Community Human Settlement Resilience (CR). Additionally, the paper uses geodetector and Origin software to analyze the coupling relationship between drivers and human settlement resilience. RESULTS: i) The scores of CR showed a "slide-shaped" fluctuation difference situation; ii) The spatial pattern of CR showed a "pole-core agglomeration and radiation" type and a "ring-like agglomeration and radiation" type. iii) Distance to bus stops, average annual temperature, CO2 emissions, building density and number of jogging trajectories are the dominant factors affecting the resilience level of community human settlement. CONCLUSION: This paper contributes to the compilation of human settlement evaluation systems globally, offering insights into healthy community and city assessments worldwide. The findings can guide the creation of similar evaluation systems and provide valuable references for building healthy communities worldwide.

Variation in vitamin D status in infants and children: a two-year cross-sectional study in Shanghai, China.

BACKGROUND: Vitamin D deficiency (VDD) is a public health problem. The variation in vitamin D status across regions and populations remains unclear, and there is a lack of consensus regarding the screening for VDD in individuals. METHODS: Children who visited the hospital from January 2019 to December 2020 were included in this study. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were measured using an enzyme-linked immunosorbent assay. The cutoffs for serum 25(OH)D concentrations to define deficiency, insufficiency, and sufficiency were < 20 ng/mL, 20-30 ng/mL, and ≥ 30 ng/mL, respectively. RESULTS: A total of 7285 children aged 0-11 years were assessed; the mean 25(OH)D level was 31.4 ng/mL, and the median 25(OH)D level was 30.7 (interquartile range 24.4, 37.5) ng/mL. The 25(OH)D level declined with age in clinical visiting children aged 0-11 years, but maintained a consistently high level in health examination children aged 4-11 years. The percentages of 25(OH)D < 20 ng/mL and 25(OH)D < 30 ng/mL were 10.0% and 43.8%, respectively. Higher percentages of VDD were found in clinical visiting children than in health examination children within the 6-11-year group (53.3% vs. 14.7%) and winter (44.3% vs. 15.4%). CONCLUSION: Low vitamin D status (deficiency and insufficiency) was more common in clinic-visiting children than in health examinations, especially in schoolchildren and in the winter. The study implies the positive effects of vitamin D assessments included in child health checkups to optimize vitamin D status.

Procainamide-Provoked Brugada Pattern in a Patient Presenting with New-Onset Atrial Fibrillation or Flutter: When Does it Matter?

BACKGROUND: Brugada syndrome (BrS) is an inherited disease that can lead to sudden cardiac death. Medications, such as antidysrhythmics, and fevers can unmask or induce the Brugada pattern on an electrocardiogram (ECG). This case report highlights a patient who developed drug-induced Brugada type I pattern after a procainamide infusion for the treatment of new-onset atrial fibrillation (AF) or flutter and discusses the implications for this incidental but potentially lethal finding. CASE REPORT: We report a case of a young man who presented to the emergency department (ED) with new-onset AF with rapid ventricular response that began within 12 h of presentation. ED treatments included a crystalloid IV fluid bolus, diltiazem pushes, synchronized electrical cardioversion, and a procainamide infusion. After the procainamide infusion, the patient developed ECG findings consistent with Brugada pattern. Both the AF and Brugada pattern resolved spontaneously within 24 h. The patient was discharged without implantable cardioverter defibrillator placement due to presumed isolated procainamide-induced Brugada pattern and lack of concerning features, such as inducible dysrhythmia during electrophysiology study, family history of sudden death, and history of syncope. The patient was counseled to follow-up with genetics and avoid BrS-inducing medications. WHY SHOULD AN EMERGENCY PHYSICIANS BE AWARE OF THIS?: Procainamide, an option for the treatment of AF in the ED, can provoke Brugada pattern. If encountered, it is important to recall that some patients may not be diagnosed with BrS if determined to be low risk according to the Shanghai criteria. All patients should be referred to cardiology for further evaluation.

Observation-based sources evolution of non-methane hydrocarbons (NMHCs) in a megacity of China.

Both concentrations and emissions of many air pollutants have been decreasing due to implement of control measures in China, in contrast to the fact that an increase in emissions of non-methane hydrocarbons (NMHCs) has been reported. This study employed seven years continuous NMHCs measurements and the related activities data of Shanghai, a megacity in China, to explore evolution of emissions and effectiveness of air pollution control measures. The mixing ratio of NMHCs showed no statistical interannual changes, of which their compositions exhibited marked changes. This resulted in a decreasing trend of ozone formation potential by 3.8%/year (p < 0.05, the same below), which should be beneficial to ozone pollution mitigation as its production in Shanghai is in the NMHCs-limited regime. Observed alkanes, aromatics and acetylene changed by +3.7%/year, -5.9%/year and -7.4%/year, respectively, and alkenes showed no apparent trend. NMHCs sources were apportioned by a positive matrix factorization model. Accordingly, vehicular emissions (-5.9%/year) and petrochemical industry emissions (-7.1%/year) decreased significantly, but the decrease slowed down; significant reduction in solvent usage (-9.0%/year) appeared after 2010; however, emissions of natural gas (+12.6%/year) and fuel evaporation (with an increasing fraction) became more important. The inconsistency between observations and inventories was found in interannual trend and speciation as well as source contributions, emphasizing the need for further validation in NMHCs emission inventory. Our study confirms the effectiveness of measures targeting mobile and centralized emissions from industrial sources and reveals a need focusing on fugitive emissions, which provided new insights into future air policies in polluted region.

Evaluation of the household solid waste mandatory sorting policy in Shanghai: A 1-year public opinion survey.

Sustainable management of household solid waste (HSW) is an essential step in realizing the development of a circular economy (CE). However, for many developing countries, HSW sorting is evolving incrementally, and focusing on the intervention role of policy and the sorting behaviour of residents can help achieve sustainable waste management. This study aims to investigate the main determinants of residents' HSW sorting behaviour and how policy particularly contributes to it. Drawing upon the theory of planned behaviour (TPB) and incorporating experiences, a conceptual framework is tested on a sample of Chinese residents in Shanghai (n = 560, from November to December 2020) using structural equation modelling analysis. The empirical results show that experience and behavioural intention greatly influence HSW sorting behaviour. Moreover, the positive attitude of residents promotes the success of HSW sorting. Subjective norms and perceived behaviour control indirectly affect behavioural intention and behaviour via attitude. The findings of this study provide policymakers with critical factors for the successful implementation of HSW sorting. We also propose policy implications to maintain and improve sorting efficiency from the perspective of residents (education, communication and publicity), neighbourhood committees (degree and efficiency of supervision) and property management companies (good infrastructure, services and processes).

Religious Beliefs Shaping Health Care and Transforming Health Concepts: The Case of Shanghai.

This study examines the connection between health and religious beliefs in modern Chinese society and builds a model reimagining the conception of health. The study draws on interviews with 108 patients (52 were women and 56 were men) at Huashan Hospital (Shanghai City, China). The survey ran between May 10 and May 14, 2021. More than 50% of female and male respondents reported having religious beliefs. Most acknowledged the crucial role of faith and religious beliefs in overcoming treatment challenges and alleviating patient suffering. The role of faith and religious beliefs in physical/mental treatment and health maintenance received the highest average percent positive score among female respondents. According to the multiple regression results of demographic parameters (age, ethnicity, gender, education, and urban or rural residence), only gender had a statistically significant effect on the impact of religious beliefs on health care attitudes. The proposed model builds on the Confucian concept of Ren (humanity), which refers to a harmonious relationship between people within a family or society bound by specific rules. The results of this study can help expand awareness about religion and its role in healthcare as a means to support patients' spiritual and physical health.

An epidemiological analysis of imported malaria in Shanghai during a COVID-19 outbreak.

BACKGROUND: The goal of this study was to understand the epidemiological characteristics of imported malaria in Shanghai specifically during the epidemic period of novel corona-virus pneumonia (COVID-19), to provide a reference for preventing the transmission of imported malaria after this disease had been previously eliminated. METHODS: The data of malaria cases reported in Shanghai from 2020 to 2021 were obtained from the China Information System for Disease Control and Prevention (CISDCP) and the Information System for Parasitic Disease Control and Prevention (ISPDCP). The characteristics of demographic and epidemiological distribution, travel-related information, diagnosis information, regions of infection acquisition and disposal information of epidemic situation were analysed with descriptive statistics. RESULTS: A total of 112 cases of malaria were reported in Shanghai from January 2020 to December 2021. There were 18 cases and 94 cases in 2020 and 2021, respectively, reaching the lowest and highest levels in the past 10 years. The incidence of malaria associated with seasons had an increasing trend (χ2 = 81.143, P < 0.05). These cases included Plasmodium falciparum (97, 86.61%), Plasmodium vivax (4, 3.57%), Plasmodium ovale (8, 7.14%) and Plasmodium malariae (3, 2.68%). The median age of patients with malaria was 38.0 years, the majority of these individuals were males (109, 97.32%), and most of them were labour personnel (93, 83.04%). Of the reported cases, 8 of these individuals (7.14%) reported experiencing malaria symptoms before their arrival in China after their stay overseas; 97 of these individuals (86.61%) reported experiencing symptoms within 14 days after their initial arrival from overseas; 15 of these individuals (13.39%) were diagnosed with 'severe malaria'; and 4 of these individuals (3.57%) were also diagnosed with COVID-19. All cases were imported from Africa, and there were no indigenous cases and deaths. CONCLUSION: Due to the impact of COVID-19, the number of imported malaria cases in Shanghai had greatly increased; however, prevention and control measures for imported malaria could be implemented to prevent re-transmission of this condition. Considering that the number of individuals returning from overseas labour is likely to increase in the next few years, it is necessary to strengthen the surveillance of imported malaria and to review the protocol for potential epidemic situations. Together, these measures could support the maintation of free-malaria status in Shanghai.

Environmental and Resource Impacts from an Aggressive Regionalized Carbon Peak Policy.

When and how to achieve a carbon peak is a concern for provincial regions within China under the context of achieving carbon neutrality in 2060. This study investigates the overall carbon peak environmental and resource impacts under current national targets and Shanghai's latest more aggressive carbon peak policy by using a dynamic multiple-region computable general equilibrium (CGE) model for the year 2030. Results show that (1) the national carbon peak and the more aggressive regional policy in Shanghai will result in energy consumption and carbon emissions decreases when compared to the business-as-usual scenario in most provinces; (2) although some cobenefits in water use reduction may occur in most provinces under the carbon policy scenarios, the results show positive and negative variations; (3) provincial level environmental and resources in transport, electricity, metal smelting and pressing, and agricultural production sectors are most influenced by Shanghai's aggressive carbon peak policy; and (4) the outsourced environmental and resource impacts from Shanghai to other provinces are very significant under Shanghai's aggressive carbon policy. These relevant results provide insights to facilitate broader governance decision-making for environmental resource nexuses while seeking an improved understanding of global sustainable development and climate governance.

Hemoperfusion in Maintenance Hemodialysis Patients.

The accumulation of protein-bound uremic toxins and medium-large molecule toxins in maintenance hemodialysis (MHD) patients is one of the causes of long-term dialysis-related complications. Hemoperfusion can remove these uremic toxins and reduce the complications of MHD patients. Upon a review of the Chinese and international literature, combined with practical experience of clinical diagnosis and treatment, the Shanghai Medical Association Society of Nephrology reached a consensus on the clinical applications of hemoperfusion in MHD patients. This consensus included four aspects: selection of appropriate patients, treatment frequency, treatment methods, and adverse reactions and precautions and provided guidelines for the rational and standardized treatment of hemoperfusion in MHD patients.

Association of childhood rhinitis with phthalate acid esters in household dust in Shanghai residences.

OBJECTIVE: Phthalate acid esters (PAEs) have been identified to be associated with children's health. Present study was conducted to assess associations between PAEs in household dust and childhood rhinitis. METHODS: Based on phase II of CCHH study (China, Children, Home, Health) conducted in Shanghai, China, 266 indoor dust samples were collected from participants' families. Concentrations of PAEs in dust samples were measured by chemical treatment and gas chromatograph-mass spectrometer. Information about individuals and residences was surveyed by questionnaires. Logistic regression models were applied to obtain the associations between PAEs and childhood rhinitis. RESULTS: Higher concentrations of benzyl butyl phthalate (BBP) were found in those families with children who had diagnosed rhinitis. Significantly higher concentrations of bis(2-ethylhexyl) phthalate (DEHP) and PAEs with high molecular weight (HMW-PAEs) were found in the positive group of lifetime rhinitis. Using the multiple and ordinal logistic regression models adjusted by covariates, dibutyl phthalate (DBP), DEHP, and HMW-PAEs were found to be significantly associated with diagnosed rhinitis. Boys who exposure to higher concentrations of DBP, DEHP, HMW-PAEs, and total PAEs have significant associations with diagnosed rhinitis compared with girls who exposure to lower concentration of PAEs. CONCLUSIONS: Present observational study indicated that exposure to high concentrations of DBP, DEHP, and HMW-PAEs in house settled dust was a risk factor for rhinitis for children, especially for boys.

Jiangnan dietary pattern actively prevents muscle mass loss: Based on a cohort study.

BACKGROUND: The proportion of sarcopenia in the elderly is very high, although muscle mass loss before sarcopenia covers a wider population. The present study aimed to analyse the effects of different dietary patterns on muscle mass. METHODS: In both 2015 and 2018, using multilayer random sampling, the same participants were selected, and the same questionnaires and machines were used. RESULTS: In total, 502 participants were selected. The >65-year-old group showed maximum muscle mass loss in males and females (-1.53 kg ± 4.42 and -1.14 kg ± 2.6 on average, respectively). The cumulative variance of four dietary patterns reached 52.28%. Logistical regression revealed significant differences between 'Jiangnan Dietary' groups: Q2 vs. Q1 [odds ratio (OR) = 0.356, 95% confidence interval (CI) = 0.202-0.629]; Q3 vs. Q1 (OR = 0.457, 95% CI = 0.262-0.797). Relative influence factors for muscle mass loss were age (>65 vs. <45, OR = 2.027, 95% CI = 1.117-3.680), physical activity (OR = 0.550, 95% CI = 0.315-0.960), income (high vs. low, OR = 0.413, 95% CI = 0.210 -0.810), sex (female vs. male, OR = 0.379, 95% CI = 0.235-0.519). CONCLUSIONS: After 3 years of follow-up, participants' muscle mass declined significantly. The 'Jiangnan Dietary' pattern prevented muscle mass loss and is recommended to the wider population.

High Resolution On-Road Air Pollution Using a Large Taxi-Based Mobile Sensor Network.

Traffic-related air pollution (TRAP) was monitored using a mobile sensor network on 125 urban taxis in Shanghai (November 2019/December 2020), which provide real-time patterns of air pollution at high spatial resolution. Each device determined concentrations of carbon monoxide (CO), nitrogen dioxide (NO2), and PM2.5, which characterised spatial and temporal patterns of on-road pollutants. A total of 80% road coverage (motorways, trunk, primary, and secondary roads) required 80-100 taxis, but only 25 on trunk roads. Higher CO concentrations were observed in the urban centre, NO2 higher in motorway concentrations, and PM2.5 lower in the west away from the city centre. During the COVID-19 lockdown, concentrations of CO, NO2, and PM2.5 in Shanghai decreased by 32, 31 and 41%, compared with the previous period. Local contribution related to traffic emissions changed slightly before and after COVID-19 restrictions, while changing background contributions relate to seasonal variation. Mobile networks are a real-time tool for air quality monitoring, with high spatial resolution (~200 m) and robust against the loss of individual devices.

Multiple accounting and driving factors of water resources use: A case study of Shanghai.

Previous research papers on urban water resources accounting were confined to the perspectives of production and consumption, ignoring the perspective of income. This paper proposes a systems framework to analyze the income, production, and consumption-based water uses and underlying driving forces of a city based on the methods of multi-scale input-output analysis and structural decomposition analysis. A case study is performed for Shanghai as a megacity. The results show that the income, production and consumption-based water uses of Shanghai had decreased from 5.70 billion m3, 10.85 billion m3 and 28.45 billion m3 in 2007 to 2.80 billion m3, 6.20 billion m3 and 24.10 billion m3 in 2017, respectively. Domestic imported primary inputs had emerged as an important virtual water supplier of Shanghai and its share of total supply-side water use had increased from 23.92% in 2007 to 42.95% in 2017. Meanwhile, about 46% and 40% of Shanghai's total consumption-based water use had been imported from other Chinese regions and foreign countries in 2017, respectively. It is revealed that trade played an important role in relieving water use pressure in Shanghai. The factors that had increased the uses of water resources in Shanghai include population, per capita value-added, per capita output, final consumption structure, and per capita final consumption. The factors that had reduced the water uses in Shanghai include technology, value added mix, output structure, value added structure, domestic import, commodity mix, and foreign import. It is suggested that in addition to curbing urban water use from the production side, more targeted water-saving measures should be devised from the supply (e.g., restricting loan to heavy water-consuming enterprises) and consumption sides (e.g., encouraging residents to buy low-water products).

Agro-environmental sustainability of using digestate fertilizer for solanaceous and leafy vegetables cultivation: Insights on fertilizer efficiency and risk assessment.

Digestate generated from anaerobic digestion (AD) has been widely used as digestate fertilizer (DF) for plant growth, but its application should be comprehensively investigated. This study evaluates the effects of different amounts of DF on crop growth, nutrient use efficiency (NUE), soil properties, and potential negative impacts of DF application (salinity and heavy metals (HMs)) with two different crops (Eggplant and Shanghai cabbage). In eggplant cultivation, the yield increased with the increase of DF amount, and the yield of the DF-680 group was the highest (65.4 t/ha) under the highest fertilizer amount. However, due to high ammonia volatilization loss and excessive application, the NUE of DF was only about half of that of chemical fertilizer (CF). Significantly different from eggplant, the high application amount of DF resulted in yield reduction in Shanghai cabbage cultivation. The yield and NUE of the DF-170 group were the highest, the yield was 46.5 t/ha, and the NUE was more than twice compared to CF. Moreover, DF can raise soil nitrogen storage and alleviate soil acidification caused by fertilization in both batches of cultivation. Nevertheless, the electrical conductivity (EC) value of the soil was increased by 2-3 times, and the long-term application may lead to soil salinization. On the other hand, the increase of DF application elevated the content of copper (Cu), zinc (Zn), and cadmium (Cd) in soil significantly but did not cause HMs contamination in crops and tillage soil. In summary, reasonable application amounts and methods should be considered when applying DF.

The future development and restructuring of the international shipping industry: Conference report.

With the worldwide spread of the global Coronavirus (COVID-19), the shipping industry has played an essential and irreplaceable role in combating the effects of the pandemic, promoting a trade-led economic recovery and maintaining the stability of industrial supply chains. The North Bund Forum advocated jointly promoting the continuous innovation and wide application of green low-carbon technologies and effectively implementing the reduction strategies of global greenhouse gas emission, thereby contributing to the creation of a safe, smooth and green global supply chain. With the epidemic under control worldwide, the international shipping industry has also ushered in a new development cycle and growth opportunities, which brings new strategic opportunities for the development of Shanghai International Shipping Center. Shanghai will accelerate the building of the world's first-class shipping center characterized as convenient and efficient, fully functional, open and integrated, green and intelligent. The forum is intended as a platform for exchanging ideas on major issues in global shipping, for incubating governance rules and norms of the international shipping industry, for releasing the latest policies and regulations in China and the world, and for showcasing the Shanghai International Shipping Center.

Response of PM2.5-bound elemental species to emission variations and associated health risk assessment during the COVID-19 pandemic in a coastal megacity.

The coronavirus (COVID-19) pandemic is disrupting the world from many aspects. In this study, the impact of emission variations on PM2.5-bound elemental species and health risks associated to inhalation exposure has been analyzed based on real-time measurements at a remote coastal site in Shanghai during the pandemic. Most trace elemental species decreased significantly and displayed almost no diel peaks during the lockdown. After the lockdown, they rebounded rapidly, of which V and Ni even exceeded the levels before the lockdown, suggesting the recovery of both inland and shipping activities. Five sources were identified based on receptor modeling. Coal combustion accounted for more than 70% of the measured elemental concentrations before and during the lockdown. Shipping emissions, fugitive/mineral dust, and waste incineration all showed elevated contributions after the lockdown. The total non-carcinogenic risk (HQ) for the target elements exceeded the risk threshold for both children and adults with chloride as the predominant species contributing to HQ. Whereas, the total carcinogenic risk (TR) for adults was above the acceptable level and much higher than that for children. Waste incineration was the largest contributor to HQ, while manufacture processing and coal combustion were the main sources of TR. Lockdown control measures were beneficial for lowering the carcinogenic risk while unexpectedly increased the non-carcinogenic risk. From the perspective of health effects, priorities of control measures should be given to waste incineration, manufacture processing, and coal combustion. A balanced way should be reached between both lowering the levels of air pollutants and their health risks.