Cotton Ball Aspiration Leading to Pulmonary Complications in a Child.

BACKGROUND Foreign body aspiration (FBA) is a common and serious problem in childhood that requires early recognition and treatment. Common complications include asphyxia, hemorrhage, infection, and pneumothorax. In severe cases of foreign body obstruction, death can result from asphyxia. We report an interesting case in which a forgotten cotton ball was inhaled into the lungs. CASE REPORT A 5-year-old boy presented to the local hospital with coughing for 6 days and fever for 4 days, without any information of foreign body aspiration upon admission. Laboratory findings indicated an elevated white blood cell; therefore, cefprozil was given as anti-infective treatment. However, the child's condition did not improve. A computed tomography scan showed left pulmonary atelectasis. Considering that the child's condition was serious, he was referred to our hospital for diagnosis and treatment. After referral, auscultation revealed decreased breath sounds over the left lung. After multidisciplinary discussion, combined with the results of auxiliary examination, the possibility of a foreign body was considered. He underwent rigid bronchoscopy, which confirmed a yellow-white foreign body in the left main bronchus that was later verified as a cotton ball. The operation was very successful. Eventually, his condition improved and he was discharged, without additional complications. CONCLUSIONS For children with unclear history of foreign body aspiration, bronchoscopy is recommended if there is recurrent pulmonary infection, low auscultation breath sounds, or abnormal imaging. The choice of surgical method depends on the location and type of foreign body and the experience of the surgeon, which is also very important.

[Characteristics of Ozone Concentration in Shanghai and Its Associated Atmospheric Circulation Background During Summer Half-years from 2006 to 2021].

It is of great importance to scientifically evaluate the impact of weather and climate conditions on the occurrence of O3 pollution in order to improve the accuracy of O3 pollution forecasts， as well as to reasonably control and reduce the adverse effects of O3 pollution. The characteristics of O3 concentration and climate background were analyzed based on daily O3 concentration data， meteorological factors， and NCEP/NCER reanalysis data from 2006 to 2021 in Shanghai. In addition， the differences in atmospheric circulation situations during years with anomalous O3 concentrations were compared and diagnosed from the perspective of climatology. Additionally， the monthly O3 concentration prediction model （seasonal autoregressive integrated moving average with exogenous regressors， SARIMAX） was further established by adding the key meteorological factors. The results indicated that both the whole-year average and summer half-year average O3 concentrations in Shanghai were increasing with fluctuation， and the summer half-year average was much higher than the annual average， up to 36.2%. Furthermore， there was a significant negative correlation between O3 concentration and wind speed （correlation coefficient of -0.826） and a significant positive correlation with the frequency of static wind and the number of days in which the low cloud cover was less than 20% （correlation coefficients of 0.836 and 0.724， respectively）. The monthly mean O3 concentration had a clear periodicity， showing a pattern with a high concentration in the middle period （April to September） and a low concentration at the beginning and end of the periods. High O3 concentration years （2013-2021） were accompanied by more polluted days， lower average wind speed， more small wind （≤1.5 m·s-1） days， more days of low cloud cover of less than 20%， more days of high temperature， higher direct solar radiation， and more sunshine hours. When the location of the stronger West Pacific subtropical high was westward and southward in the summer half-year， Shanghai was influenced by an anomalous westerly wind， which was not conducive to the transportation of clean air from the sea to Shanghai and thus led to the high concentration of O3 pollution. When the long wave radiation emitted from the ground was low in the summer half-year， it was favorable for the increase in ground temperature and caused a high concentration of O3 pollution. Adding direct solar radiation， maximum temperature， and wind speed as exogenous variables to the monthly O3 forecast model could significantly improve the effectiveness of the monthly forecast， with the root mean square error decreasing by 47.7% （from 22 to 11.5） and the correlation coefficient increasing by 11.2% （from 0.819 to 0.911）， which could be applied to the practical prediction of monthly O3 concentration.

Evolution and trends of new energy vehicle policy research hotspots: an analysis based on a Citespace knowledge graph.

New energy vehicle (NEV) policies involve extensive and complex aspects. NEV policies have been an important issue of academic interest in the academic research community. The current research of the NEV policy has the key significance of inducing experience and guiding the future. This study conducts a comprehensive bibliometric analysis through quantitative research methods to summarize the development and evolution of NEV policy in recent years. Using Citespace visualization tools, we reviewed 2919 papers collected from the Web of Science, identified three stages in the development of the research field, and summarized features relevant to the policy in history. The most influential countries, institutions, authors, keywords, and references have been examined. Through burst detection and cluster analysis, we analyzed historical trends and trajectories in this area of research. In the data we collected, a number of indicators are related to China, indicating that China's NEV policy has a representative significance in the field of NEV policy research. Consequently, we further collected the relevant research from China, in order to summarize the policy reasons behind the rapid development of NEVs in China, and help researchers to have a better understanding of the frontiers of NEVs.

Relationship between light absorption properties of black carbon and aerosol origin at a background coastal site.

As a potent climate forcer, black carbon (BC) optical properties can have significant impacts on the regional meteorology and climate. To unveil the seasonal differences of BC and its contribution by various emission sources, a one-year continuous monitoring of atmospheric aerosols was conducted at a background coastal site in Eastern China. By comparing the seasonal and diurnal patterns between BC and elemental carbon, we observed that BC were evidently aged with varying extents among all four seasons. The light absorption enhancement of BC (Eabs) was calculated as 1.89 ± 0.46, 2.40 ± 0.69, 1.91 ± 0.60, and 1.34 ± 0.28, from spring to winter, respectively, indicating that BC was more aged in summer. Contrary to the negligible impact of pollution levels on Eabs, the patterns of air masses arriving to the sampling site had a significant impact on the seasonal optical characteristics of BC. Sea breezes evidently exhibited higher Eabs than land-sourced breezes, and BC was more aged and light-absorbing with an increased contribution of marine airflows. By applying a receptor model, we resolved six emission sources as ship emission, traffic emission, secondary pollution, coal combustion, sea salt, and mineral dust. The mass absorption efficiency of BC for each source was estimated, showing the highest from the ship emission sector. This explained the highest Eabs observed in summer and sea breezes. Our study highlights that curbing emission from shipping activities is beneficial for reducing the warming effect of BC in coastal areas, particularly in the context of future rapid development of international shipping.

Effects of subcutaneous immunotherapy in allergic rhinitis children sensitive to dust mites.

BACKGROUND: Subcutaneous immunotherapy (SCIT) is now the only treatment that can modify the natural course of allergic rhinitis (AR). However, not all children with AR benefit from SCIT. OBJECTIVE: To evaluate the efficacy of SCIT in dust-mites-induced AR children and explore correlative factors predicting treatment response to SCIT. METHODS: 225 children aged 4-17 years old with AR were recruited from January 2016 to September 2019, and monitored at baseline, 4, 12, and 24 months after the start of SCIT treatment. The visual-analogue-score (VAS) was used to assess the clinical symptoms. Multivariate binary logistic regression analyses and receiver operating characteristic curves were used to explore correlative factors in predicting the efficacy of SCIT. RESULTS: The significant declines in VAS started after 4 months of SCIT and continued to improve throughout the study compared with baseline. An increase in children's age (OR=0.688, 95%CI: 0.479-0.988) and those with allergic history (OR=0.097, 95%CI: 0.009-1.095) were negatively associated with the risk of poor efficacy. Polysensitized children were more likely to suffer poor efficacy (OR=15.511 95%CI: 1.319-182.355). The clinical response at month 4 (r=0.707) and month 12 (r=0.925) was related to that at month 24. The area under the curve (AUC) for improvement at month 4 and month 12 was 0.746 and 0.860, respectively. CONCLUSION: Our study confirmed the clinical efficacy of SCIT in AR children. Children with younger age, negative allergic history, and multiple allergens may predict a worse efficacy. The onset of action and the clinical response to SCIT in the second year can be predicted as early as by month 4.

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.

Airborne black carbon variations during the COVID-19 lockdown in the Yangtze River Delta megacities suggest actions to curb global warming.

Airborne black carbon is a strong warming component of the atmosphere. Therefore, curbing black carbon emissions should slow down global warming. The 2019 coronavirus pandemic (COVID-19) is a unique opportunity for studying the response of black carbon to the varied human activities, in particular due to lockdown policies. Actually, there is few knowledge on the variations of black carbon in China during lockdowns. Here, we studied the concentrations of particulate matter (PM2.5) and black carbon before, during, and after the lockdown in nine sites of the Yangtze River Delta in Eastern China. Results show 40-60% reduction of PM2.5 and 40-50% reduction of black carbon during the lockdown. The classical bimodal peaks of black carbon in the morning and evening rush hours were highly weakened, indicating the substantial decrease of traffic activities. Contributions from fossil fuels combustion to black carbon decreased about 5-10% during the lockdown. Spatial correlation analysis indicated the clustering of the multi-site black carbon concentrations in the Yangtze River Delta during the lockdown. Overall, control of emissions from traffic and industrial activities should be efficient to curb black carbon levels in the frame of a 'green public transit system' for mega-city clusters such as the Yangtze River Delta. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10311-021-01327-3.

Vertically-resolved sources and secondary formation of fine particles: A high resolution tethered mega-balloon study over Shanghai.

Numerous studies have focused on air pollution near the surface in China, yet we still have little knowledge on the characteristics, formation mechanisms, and sources of air pollutants aloft. Based on a tethered mega-balloon platform, the vertical profiles of PM2.5, black carbon (BC), SO2, O3, and meteorological parameters were measured within the lower troposphere of 1000 m over Shanghai. One clean and slightly polluted period (CP) and one heavily polluted period (HP) with continuously measured profiles were compared. The potential source areas of PM2.5 at different altitudes during HP were determined based on the time-lag spatial correlation analysis, indicating the surrounding regions were the main sources of low-altitude particles in Shanghai and farther regions of northern China significantly affected the upper atmosphere. By apportioning the sources of vertical BC profiles, fossil fuel combustion contributed >80% to BC below 600 m during HP, exhibiting a higher contribution than CP. An indicator (i.e. SA/SO2, SA represents secondary aerosols) was established to investigate the vertical evolution of secondary aerosol formation. During CP, relatively low SA/SO2 ratios were observed within the boundary layer due to the weak atmospheric processing. SA/SO2 profiles showed the opposite vertical trend of higher ratios below about 600 m while lower values at high altitudes during HP. Regional and long-range transport regulated the extents of secondary aerosol formation. Northeasterlies transported abundant aged aerosols from northern China while sea breezes suppressed the columnar secondary aerosol formation. This study provided insights into the vertical structures of typical air pollutants in a Chinese megacity and implied that high-resolution measurements of atmospheric vertical profiles were valuable for diagnosing sources and potential secondary formation of fine particles.

Atmospheric black carbon in urban and traffic areas in Shanghai: Temporal variations, source characteristics, and population exposure.

Black carbon (BC) measurements were performed at Pudong (PD) urban supersite and Gonghexin (GH) roadside station from December 1, 2017 to August 10, 2020 to investigate the variations, source characteristics, and population exposure levels of BC in traffic and urban areas in Shanghai, China. The BC median concentration at GH was more than two-fold that at PD. Absorption Ångström exponent (AAE) values were 1.27 ± 0.17 and 1.31 ± 0.17 at PD and GH, respectively, suggesting the dominance of liquid fossil fuel combustion sources (i.e., traffic exhaust) at these stations. The higher BC and AAE values in winter at PD indicated the relatively increasing contribution of solid fuels (i.e., biomass burning) to BC concentration in urban Shanghai. The diurnal variation in BC showed similar twin-peak patterns at PD and GH, implying that traffic emission mainly contributed to ambient BC concentration in urban Shanghai. The estimated daily intakes (EDIs) of BC were generally higher in males than in females at both PD and GH. The highest BC EDIs at PD were found in age subgroups 1-<2 and 2-<3 years. In contrast, the BC EDIs at GH were observed in age subgroups 6-<9, 12-<15, and 15-<18 years, which were higher than those determined at PD, indicating that more attention must be paid to BC exposure of the population in these age subgroups. These results provide scientific insights into variations, source characteristics, and population exposure levels of BC in urban and traffic areas and could help in the development of BC control strategies in Shanghai.

Atmospheric characteristics and population exposure assessment of black carbon at a regional representative site in the Yangtze River Delta region, China based on the five-year monitoring.

To investigate the multi-year atmospheric characteristic and population exposure level of black carbon (BC) in the Yangtze River Delta (YRD) region, China, about five years of ambient BC measurement was performed at Dianshan Lake (DSL) regional Supersite from February 2014 to February 2019. BC concentration at DSL was 1.39 ± 1.15 µg m-3, which was at low to medium level compared to other areas in the world, and annual BC level was decreased by an average of 45.4% from 2014 to 2018. The absorption Ångström exponent (AAE) value was 1.30 ± 0.173, indicating the predominant contribution of liquid fuel sources such as traffic exhaust to BC. Meanwhile, AAE and BC values both showed the winter-high and summer-low temporal patterns, which highlighted the increasing contribution from solid fuels to BC in winter. Moreover, diurnal characteristics of BC, AAE, carbon monoxide and nitrogen oxide demonstrated the dominance of traffic sources for BC. The average estimated daily intakes (EDIs) of BC through inhalation for 17 population age subgroups were 0.0177-0.0811 µg kg-1 day-1, which the highest EDIs for male and female were both observed in infants (9 months ~ < 1 year). Male generally taken higher exposure level of BC compared to female. This work could improve the insights for atmospheric characteristic and population exposure level of BC, and potentially facilitate the development of abatement policies of BC in YRD region, China.

Insights into chemical composition, abatement mechanisms and regional transport of atmospheric pollutants in the Yangtze River Delta region, China during the COVID-19 outbreak control period.

To investigate chemical characteristics, abatement mechanisms and regional transport of atmospheric pollutants during the COVID-19 outbreak control period in the Yangtze River Delta (YRD) region, China, the measurements of air pollutants including fine particulate matter (PM2.5) and volatile organic compounds (VOCs) on non-control period (NCP, 24 December 2019-23 January 2020) and control period (CP, 24 January-23 February 2020) were analyzed at the urban Pudong Supersite (PD) and the regional Dianshan Lake Supersite (DSL). Due to the stricter outbreak control, the levels of PM2.5 and VOCs, and the occurrence frequencies of haze-fog episodes decreased substantially from NCP to CP, with average reduction rates of 31.6%, 38.9% and 35.1% at PD, and 34.5%, 50.7% and 37.9% at DSL, respectively. The major source for PM2.5 was secondary sulfate & nitrate in both periods, and the emission control of primary sources such as coal burning and vehicle exhaust decreased the levels of precursors gas sulfur dioxide and nitrogen oxide, which highly contributed to the abatement of PM2.5 from NCP to CP. The higher levels of ozone at both PD and DSL on CP might be due to the weak nitrogen monoxide titration, low relative humidity and high visibility compared with NCP. Vehicle exhaust and fugitive emission from petrochemical industry were the major contributors of ambient VOCs and their decreasing activities mainly accounted for VOCs abatement. Moreover, the high frequency of haze-fog events was closely impacted by medium-scale regional transport within Anhui and Jiangsu provinces. Therefore, the decreasing regional transported air pollutants coincided with the emission control of local sources to cause the abatement of haze-fog events in YRD region on CP. This study could improve the understanding of the change of atmospheric pollutants during the outbreak control period, and provide scientific base for haze-fog pollution control in YRD region, China.

[Characteristics of Aerosol Particulate Concentrations and Their Climate Background in Shanghai During 2007-2016].

We use daily aerosol particulate matter<10 µm (PM10) concentration data from 2006 to 2016 in Shanghai along with meteorological elements (wind and temperature), atmospheric stability, temperature inversion, and upper atmosphere circulation data, to analyze the variation characteristics of the PM10 concentrations and differences of the winter climate background. We establish a multivariate linear stepwise regression equation, and also compare and analyze differences in the upper atmospheric circulation by selecting the years with the highest and lowest PM10 concentrations. The results showed an oscillating downward trend in the annual average concentrations of PM10 in Shanghai, whereas seasonally, PM10 concentrations were relatively high in winter and showed two peaks with a low in between. PM10 concentrations were negatively correlated with the daily average wind speed and the daily mixing layer height at 20:00, and positively correlated with the frequency of northwest wind, the mean daily temperature, and the frequency of stable weathers and thermal inversion at 20:00. When the 500 hPa height field in the northern part of China was a positive anomaly in winter, a warm winter prevailed and led to high PM10 concentrations. When the 500 hPa height field was a negative anomaly, cold air frequently moved southward to result in relatively low temperatures, which caused relatively low PM10 concentrations. When the wind field at 850 hPa was easterly, the wind speed was relatively large and resulted in relatively low PM10 concentrations.

Blood lead, bone lead and child attention-deficit-hyperactivity-disorder-like behavior.

BACKGROUND AND OBJECTIVE: Mounting evidence showed that lead exposure increased the risk of child attention-deficit-hyperactivity disorder (ADHD). Epidemiologic studies have typically used the blood-lead as a biomarker of lead exposure; blood-lead levels mostly reflect recent lead exposure. However, few studies have examined the relationship between bone-lead, a biomarker of cumulative exposure, and ADHD. Therefore, we aimed to compare the associations of bone-lead vs blood-lead levels with child ADHD symptoms and comorbidities. METHODS: A total of 164 children aged 3-15 years were enrolled during 2014-2015. The Vanderbilt-ADHD-Diagnostic-Parent-Rating Scale (VADPRS) was used to evaluate the children's ADHD symptoms and comorbidities. Children's blood and bone lead concentrations were assessed, the latter using a non-invasive K-X-ray-fluorescence technique. According to blood-lead levels, children were classified into high (blood-lead ≥ 10.0 µg/dL) and low (blood-lead < 10.0 µg/dL) blood-lead groups. According to bone-lead levels, children were classified into high (bone-lead ≥ 2.66 µg/g) and low (bone-lead < 2.66 µg/g) bone-lead groups. We associated blood/bone lead with VADPRS data using multi-variable binary logistic regression models. RESULTS: Children in the high blood-lead group had higher hyperactivity/impulsivity (P = 0.02) scores than the corresponding low blood-lead group. Children in the high bone-lead group had higher hyperactivity/impulsivity (P = 0.02) and oppositional-defiant-disorder (ODD) (P = 0.03) scores than the corresponding low bone-lead group. After adjusting for relevant confounders, children in the high bone-lead group were more likely to have ODD-behavior than the low group (OR = 6.7, 95%CI: 1.2-36.5). However, no adjusted association was observed between blood-lead and any ADHD-domain score. CONCLUSION: High levels of cumulative lead exposure in children may be an independent risk factor of ODD-behavior.

Bone lead levels in an environmentally exposed elderly population in shanghai, China.

This study looked at measurements of lead (Pb) in a pilot population of environmentally exposed elderly residents of Shanghai, China and presented the first set of bone Pb data on an elderly Chinese population. We found that with environmental exposures in this population using K-shell x-ray fluorescence (KXRF) bone Pb measurements 40% of the individuals had bone Pb levels above the nominal detection limit with an average bone lead level of 4.9 ±â€¯3.6 µg/g. This bone lead level is lower than comparable values from previous studies of community dwelling adults in US cities. This population had a slightly higher geometric mean blood Pb of 2.6 µg/dL than the adult US population. The main conclusion of this data is that in Shanghai there is environmental exposure to Pb, measured through blood and bone, which should be further investigated to assess the health impact of this exposure.

Measurements of Strontium Levels in Human Bone In Vivo Using Portable X-ray Fluorescence (XRF).

Measurement of bone strontium (Sr) is vital to determining the effectiveness of Sr supplementation, which is commonly used for the treatment of osteoporosis. Previous technology uses radioisotope sources and bulky equipment to measure bone Sr. This study demonstrates the effectiveness of portable X-ray fluorescence (XRF) for bone Sr measurement and validates it using data from a population of 238 children. We identified correlations between bone Sr and age in our participants.

Association between temperature and maternal stress during pregnancy.

BACKGROUND: Maternal psychological stress during pregnancy has essentially been conceptualized as a teratogen. However, little is known about the effect of temperature on maternal stress during pregnancy. The aim of this study is to investigate the relationship between temperature and maternal stress during pregnancy. METHODS: In 2010, a total of 1931 eligible pregnant women were enrolled across Shanghai from four prenatal-care clinics during their mid-to-late pregnancy. Maternal life-event stress and emotional stress levels during pregnancy were assessed by the "Life Event Scale for Pregnant Women" (LESPW) and "Symptom Checklist-90-Revised Scale" (SCL-90-R), respectively. Exposure to ambient temperature was evaluated based on daily regional average in different moving average and lag days. The generalized estimating equations were used to evaluate the relationship between daily average temperature/temperature difference and maternal stress. RESULTS: After adjusting for relevant confounders, an U-shaped relationship was observed between daily average temperature and maternal Global-Severity-Index (GSI) of the SCL-90-R. Cumulative exposures to extremely low temperatures (< P5, 1.4-10.5℃, lag 0-1 days, 0-2 days and 0-5 days) and extremely high temperatures (≥ P95, 31.2-34.1℃, lag 0-1 days and 0-2 days), and acute exposures to extremely low (lag day 0, 1, 2 and 3) and high (lag day 0, 1) temperatures, all induced higher risks of high GSI (the highest tertile), compared to the risk induced by exposed to an optimal temperature range (20-25℃) (P< 0.05). Increased temperature difference was associated with high maternal GSI (P< 0.05). However, non-significant associations were observed between daily average temperatures/temperature differences and maternal log-transferred LESPW scores. CONCLUSIONS: Cumulative and acute exposures to extremely low/high temperatures may both induce emotional stress during pregnancy.

Prenatal maternal stress in relation to the effects of prenatal lead exposure on toddler cognitive development.

OBJECTIVE: To evaluate the effects of maternal lead exposure during pregnancy on toddler cognitive development and the potential effect modification by maternal stress. METHODS: We conducted a prospective birth-cohort study in Shanghai from 2010 to 2012 and investigated 225 mother-infant pairs. The mothers were recruited in mid-to-late pregnancy and children were followed up until 24-36 months old. A self-administered Symptom Checklist-90-Revised Scale (SCL-90-R) was used to assess maternal emotional stress during pregnancy. Maternal whole blood lead levels were measured during gestational weeks 28-36. The toddlers' cognitive levels were assessed using the Gesell Development Scale. Multiple linear regression models were established to explore the main effects of prenatal lead exposure on toddlers' cognitive abilities and the modifying effects of maternal stress. Covariate information was collected through interviews, questionnaires and medical records. RESULTS: The mean maternal blood lead concentration was 3.30 (95%CI: 3.05, 3.57) µg/dL. After adjusting for relevant confounders, no significant associations of maternal blood lead concentrations with toddlers' cognitive levels were observed in all five domains of the Gesell scale (P>0.05). However, the interaction between prenatal maternal blood lead and stress was significant in the domains of adaptive behavior, language and social behavior. When stratified by maternal stress levels, compared with non-significant associations (P>0.05) among low (P1-P75) prenatal stress group, adverse associations between maternal blood lead concentrations (log10-transformed) and toddlers' cognitive levels were observed among high (P75-P100) prenatal stress group in the domains of language (ß=-33.82, 95%CI: -60.04, -7.59), social behavior (ß=-41.00, 95%CI: -63.11, -18.89) and adaptive behavior (ß=-17.93, 95%CI: -35.83, -0.03). CONCLUSION: Prenatal maternal stress may exacerbate the deleterious effects of prenatal exposure to lead on toddler cognitive development.

The impacts of air pollution on maternal stress during pregnancy.

To investigate the association of air pollution with maternal stress during pregnancy, we enrolled 1,931 women during mid-to-late pregnancy in Shanghai in 2010. The "Life-Event Scale for Pregnant Women" and "Symptom-Checklist-90-Revised Scale" (SCL-90-R) were used to evaluate life event stress and emotional stress, respectively. Air pollution data were collected for each district where pregnant women lived during pregnancy. We associated ambient air pollution with stress scores using multivariable logistic regression models. After adjusting for relevant covariates, an interquartile-range (IQR) increase in sulphur-dioxide (SO2) (OR = 1.30, 95% CI: 1.11-1.52) and particulate-matter with an aerodynamic-diameter <10 µm (PM10) (OR = 1.16, 95% CI: 1.02-1.34) concentrations on the recruitment day, and in the 5-day moving average concentrations of nitrogen-dioxide (NO2) (OR = 1.34, 95% CI: 1.05-1.70) were associated with high Global-Severity-Indices (P75-P100) of the SCL-90-R. These associations were stronger among women bearing high levels (P25-P100) of air pollutants than among women experiencing low levels (P1-P25) of pollutants. The stronger associations and higher levels of pollutants were observed in the cool season than in the warm season. SO2 increases on the recruitment day were also associated with an increased risk of high depression scores (P75-P100). Our findings supported a dose-dependent association between air pollution and emotional stress during pregnancy.

Effects of prenatal and postnatal maternal emotional stress on toddlers' cognitive and temperamental development.

BACKGROUND: Maternal stress is associated with impairments in the neurodevelopment of offspring; however, the effects of the timing of exposure to maternal stress on a child's neurodevelopment are unclear. METHODS: In 2010, we studied 225 mother-child pairs in Shanghai, recruiting mothers in mid-to-late pregnancy and monitoring offspring from birth until 30 months of age. Maternal stress was assessed prenatally (at 28-36 weeks of gestation) and postnatally (at 24-30 months postpartum) using the Symptom-Checklist-90-Revised Scale (SCL-90-R) and Life-Event-Stress Scale to evaluate mothers' emotional stress and life event stress levels, respectively. Children's cognition and temperament were assessed at 24-30 months of age using the Gesell Development Scale and Toddler Temperament Scale, respectively. Multi-variable linear regression models were used to associate prenatal and postnatal stress with child cognitive and temperamental development. RESULTS: Maternal prenatal and postnatal Global Severity Index (GSI) of SCL-90-R were moderately correlated (ICC r=0.30, P<0.001). After adjusting for relevant covariates, the increase in prenatal GSI was associated with decreases in toddlers' gross motor, fine motor, adaptive and social behavior development independently of postnatal GSI, while the increase in postnatal GSI was associated with changes in multiple temperament dimensions independently of prenatal GSI. The effects of prenatal and postnatal depression scores of SCL-90-R were similar to those of GSI. LIMITATION: Relatively small sample size. CONCLUSIONS: Compared with postnatal exposure, children's cognitive development may be more susceptible to prenatal exposure to maternal emotional stress, whereas temperamental development may be more affected by postnatal exposure to maternal emotional stress compared with prenatal exposure.

XRF-measured bone lead (Pb) as a biomarker for Pb exposure and toxicity among children diagnosed with Pb poisoning.

Childhood lead (Pb) poisoning remains a global issue, especially in industrial areas. In this study, 115 children with average age 5.7 years were recruited as either patient diagnosed with Pb poisoning or controls at Xinhua Hospital in China. The subjects' bone Pb was measured with a K-shell X-ray fluorescence (KXRF) and a portable X-ray fluorescence (XRF) system. A significant correlation between KXRF bone Pb and blood Pb and portable XRF and KXRF measurements were observed. The half-life of blood-lead was calculated to be 9.96 ± 3.92 d. Our results indicate that bone is a useful biomarker for Pb in children.