Comprehensive evaluation of antibiotics pollution the Yangtze River basin, China: Emission, multimedia fate and risk assessment.

Antibiotics have attracted global attention because of their potential ecological and health risks. The emission, multimedia fate and risk of 18 selected antibiotics in the entire Yangtze River basin were evaluated by using a level Ⅳ fugacity model. High antibiotic emissions were found in the middle and lower reaches of the Yangtze River basin. The total antibiotic emissions in the Yangtze River basin exceeded 1600 tons per year between 2013 and 2021. The spatial distribution of antibiotics concentration was the upper Yangtze River > middle Yangtze River > lower Yangtze River, which is positively correlated with animal husbandry size in the basin. Temperature and precipitation increases may decrease the antibiotic concentrations in the environment. Transfer fluxes showed that source emission inputs, advection processes, and degradation fluxes contributed more to the total input and output. High ecological risks in the water environment were found in 2018, 2019, 2020, and 2021. The comprehensive health risk assessment through drinking water and fish consumption routes showed that a small part of the Yangtze River basin is at medium risk, and children have a relatively high degree of health risk. This study provides a scientific basis for the pollution control of antibiotics at the basin scale.

[Seasonal Variation Characteristics and Pollution Assessment of Heavy Metals in Water and Sediment of Taipu River].

Taipu River is a river spanning two provinces and one city in a demonstration area in the Yangtze River Delta on an ecologically friendly developmentand an important water source in the upper reaches of the Huangpu River in Shanghai. To understand the multi-media distribution characteristics, pollution status, and ecological risk of heavy metals in the Taipu River, the contents of heavy metals (As, Cd, Co, Cr, Cu, Mn, Ni, Pb, Sb, and Zn) in the sediments of Taipu River were analyzed, and the pollution status and potential ecological risk were evaluated using the Nemerow comprehensive pollution index, geo-accumulation index, and potential ecological risk index methods. In addition, the health risk assessment model was used to assess the health risk of heavy metals in surface water of Taipu River. The results showed that the concentrations of Cd, Cr, Mn, and Ni in the surface water of Taipu River exceeded the class Ⅲ water limit at the upstream point in spring; the concentrations of Sb exceeded the class Ⅲ water limit at all points in winter; the average value of As exceeded the class Ⅲ water limit in overlying water during the wet season; and the average values of As and Cd exceeded the class Ⅲ water limit in pore water during the wet season. The health risk assessment of surface water implied that both adults and children had higher health risk in spring and lower health risk in other seasons. The health risk of children was significantly higher than that of adults, and it mainly came from chemical carcinogenic heavy metal elements As, Cd, and Cr. The average contents of Co, Mn, Sb, and Zn in Taipu River sediments in the four seasons all exceeded the Shanghai soil baseline; the average contents of As, Cr, and Cu in summer, autumn, and winter exceeded the Shanghai soil baseline; and the average contents of Cd, Ni, and Pb in summer and winter exceeded the Shanghai soil baseline. The evaluation results of the Nemerow comprehensive pollution index and geo-accumulation index showed that the pollution degree of the middle reaches of Taipu River was higher than that of the upper and lower reaches, and the Sb pollution was more serious. The potential ecological risk index method revealed that the Taipu River sediment was at a low risk. Cd had a high contribution in both the wet and dry seasons and could be regarded as the main heavy metal of potential ecological risk in the Taipu River sediment.

Seasonal heavy metal speciation in sediment and source tracking via Cu isotopic composition in Huangpu River, Shanghai, China.

The present study systematically analyzed and evaluated the variations in chemical speciation, pollution assessment, and source identification of heavy metals in sediments of Huangpu River. The methods employed included heavy metal concentration, chemical speciation and Cu isotopic compositions analysis. Results showed that the chemical speciation of sediment-bound heavy metals, characterized by significant seasonal variation, shifted from non-residual fractions dominating in spring and summer to residual fractions dominating in autumn and winter. Precipitation was identified as an important factor influencing the chemical speciation of sediment-bound heavy metals. Furthermore, ratio of the secondary phase to the primary phase, RSP (=Cnon-residual/Cresidual) values in Huangpu River sediments were higher than 1 in spring and summer, indicating that sediment-bound heavy metals in Huangpu River were mainly composed of non-residual fractions and could potentially be released into the river water. Principal component analysis (PCA) revealed that navigation, traffic, agricultural, and industrial activities could be the potential sources of heavy metal pollution. Notably, the δ65Cu values in Huangpu River sediments were observed to be isotopically lighter (from -0.37 to +0.18 ‰), suggesting that navigation might be the primary pollution source. These results will not only provide guidance in reducing heavy metal concentrations, but also serve as a crucial basis for policy making regarding heavy metal control.

[Association between Gestational Diabetes Mellitus and Postpartum Depressive Episode].

Objective To explore the association between gestational diabetes mellitus (GDM) and postpartum depressive (PPD) episode and the influencing factors of PPD episode. Methods The clinical data of pregnant women who filed in the Department of Obstetrics,Peking Union Medical College Hospital from March 1,2020 to February 28,2021 were collected.Oral glucose tolerance test (OGTT,75 g) and determination of glycosylated hemoglobin (HbA1c) were carried out in the second trimester,and fasting blood glucose and glycosylated albumin (GA) were determined in the third trimester.Mini-International Neuropsychiatric Interview (MINI,5.0 Chinese version) was used to diagnose depressive episode and anxiety disorder within (42±7) days after delivery.We analyzed the influencing factors of PPD episode by multiple Logistic regression to explore the relationship between GDM and PPD episode.Fasting glucose and GA in the third trimester,as well as the incidence of PPD episode,between women with and without GDM were compared. Results The GDM,75 g OGTT,and HbA1c in the second trimester,as well as fasting blood glucose and GA in the third trimester,showed no significant differences between the PPD group and the non-PPD group (all P>0.05).Postpartum generalized anxiety disorder (OR=4.656,95%CI=1.130-19.184, P=0.033),obsessive-compulsive disorder (OR=11.989,95%CI=1.004-143.113, P=0.049),and the history of mental disorder before pregnancy (OR=13.567,95%CI=2.191-83.991, P=0.005) were the risk factors of PPD episode.The fasting blood glucose and GA in the third trimester,the incidence of PPD episode,and the PPD episode comorbidities of generalized anxiety disorder and obsessive-compulsive disorder had no significant differences between pregnant women with and without GDM (all P>0.05).Conclusions There is no association between GDM and PPD episode under routine blood glucose management. Special attention should be paid to pregnant women with a history of mental disorder before pregnancy.

[Distribution Characteristics, Source Analysis, and Pollution Evaluation of Organic Matter in Surface Sediments of Qingpu District, Yangtze River Delta Integration Demonstration Area].

The surface sediments were collected from 25 sampling points in the Qingpu District of the Yangtze River Delta integration demonstration area, and the total organic carbon (TOC), total nitrogen (TN), organic carbon isotope (δ13C), and nitrogen isotope (δ15N) content in the samples were analyzed. The distribution characteristics and potential sources of organic matter in the surface sediments were discussed in detail, and the organic pollution index was also evaluated. The results showed that the ω(TOC) in the surface sediments of 31 sampling points in Qingpu District was 0.21%-3.55%, with an average value of 1.18%; ω(TN) ranged from 0.02% to 0.23%, with an average value of 0.09%. The δ13C ranged from -28.04‰ to -10.80 ‰, with an average of -22.28‰, and the δ15N ranged from 2.28‰ to 11.19‰, with an average of 5.76‰. The TOC content was significantly correlated with the TN content. Source analysis showed that the organic matter in the surface sediments of the study area was mainly affected by soil organic matter, sewage organic matter, and terrestrial plants. The calculation results of the contribution rate based on IsoSource software showed that the relative contribution rate of soil organic matter was relatively high (0.3%-96.8%), and domestic sewage had a certain contribution to the organic matter source of most sampling points. In addition, the selected end-member substances had certain differences in the contribution of organic matter sources in samples of different land use types. The evaluation index of organic pollution in the surface sediments of the study area ranged from 0.006-0.745, with an average value of 0.163, indicating that the organic pollution of the study area was considered lightly polluted. Among them, the pollution of sampling points around the Jinze Reservoir was more serious than that in other areas, indicating that there was a potential risk of eutrophication in this area, which requires certain attention.

Adsorptive behavior of thallium using Fe3O4-kaolin composite synthesized by a room temperature ferrite process.

Thallium (Tl) contaminants pose serious threats to the ecological environment and human health due to its acute/chronic poisoning on the health of most organisms even at low concentrations. To find a rapid and efficient technology in removing Tl from waters thus becomes a crucial issue. A magnetic Fe3O4-kaolin composite (denoted by FKC) with high specific surface area (133.7 m2/g) was successfully synthesized via a simple and low-cost technique for Tl(I) removing from various water media. The HRTEM images confirmed the existence of lattice fingers Fe3O4 and displayed that a large number of Fe3O4 nanoparticles dispersed on the surface of kaolin sheets. Compared with kaolin or Fe3O4 alone, FKC enhanced obviously the adsorption rate and capacity of Tl(I) over a wide pH range (4.5-9.0). The maximum adsorption capacity of FKC for Tl(I) was 19,347 mg/kg (calculated by Langmuir model), which was almost one hundred times and two times higher than those of kaolin and Fe3O4, respectively. Importantly, FKC was observed to have a great potential in removing Tl(I) from surface water, groundwater, and tap water in more alkaline conditions. By applying the external magnetic field, FKC could be recovered efficiently (99%) and rapidly (20 s). Moreover, Tl L3-edge XANES spectra revealed that Tl(I) was adsorbed on the FKC and would not be converted to more toxic Tl(III). The cations (CaCl2, NaCl, and KCl) and the ionic strength with concentrations of 0.001-1.0 mol/L showed a great influence on the adsorption of Tl(I) by FKC, implying that this adsorption was dominated by outer-sphere surface complexation at investigated pH values. The information provided is essential for designing a rapid and effective scavenger for removing Tl in various natural waters.

[Multimedia Distribution Characteristics and Risk Assessment of 22 PPCPs in the Water Environment of Qingpu District, Yangtze River Delta Demonstration Area].

In this study, 50 surface water and sediment samples were collected from 25 sampling points in Qingpu District (including Taipu River basin, Jinze Reservoir, and Qingxi country park) in the Yangtze River Delta integration demonstration area, and 22 pharmaceuticals and personal care products (PPCPs) in the samples were analyzed using high-performance liquid chromatography tandem mass spectrometry (HPLC/MS-MS). The distribution characteristics, sources, and influencing factors of targeted PPCPs in the study area were studied in detail. The ecological and health risks of the target PPCPs were evaluated using the quotients method. The results showed that a total of 19 PPCPs were detected in the surface water and sediment samples from 25 sampling points in Qingpu District, with total concentrations ranging from 0.06 to 178.67 ng·L-1 and 0.07 to 37.68 ng·g-1, respectively. The average value of sulfachloropyridazine (SCP) in the surface water was the highest with a concentration of 129.54 ng·L-1, whereas the average value of sulfamethoxazole (SMX) in the sediment was the highest with a concentration of 70.62 ng·g-1. The spatial distribution of the total amount of PPCPs showed a trend of Qingxi country park > Jinze Reservoir > Taipu River basin. Principal component analysis showed that the main sources of pollution were animal antibiotics used in aquaculture and the discharge of domestic sewage. There was a significant correlation between lg Koc and lg Kd (P<0.05), indicating that the organic carbon plays an important role in the distribution of the target PPCPs in water and sediments. The ecological risk assessment results revealed that the fungicides (TCC and TCS) in the surface waters showed a moderate risk to aquatic organisms of different trophic levels. The Qingxi country park and Jinze Reservoir were the regions with the highest ecological risks of PPCPs in surface water and sediment. The health risk entropy (HQ) of people of all age groups exposed through drinking was less than 1; however, with the continuous emission and accumulation of PPCPs, the pollution control of PPCPs in the environment still requires further attention.

Multimedia fate model and risk assessment of typical antibiotics in the integrated demonstration zone of the Yangtze River Delta, China.

Due to the widespread consumption of antibiotics by humans and animals, antibiotic residues from human and animal excrements are released into the environment through domestic sewage and breeding wastewater, which ultimately affect the ecological environment and human health. In this study, the concentrations of 10 antibiotics in the air, water, soil, and sediment from 2013 to 2019 in Qingpu District of the integrated demonstration zone of the Yangtze River Delta were predicated by developing a dynamic Level IV fugacity model. The influence of seasonal environmental factors (e.g., temperature, rainfall) on the distribution and migration of antibiotics in multi-media was also explored. The simulation results show that the 10 antibiotics mainly existed in water and sediment. The concentrations of antibiotics in air, water, soil, and sediment were 0-7.629 × 10-14 ng/L, 1.187 × 10-10-16.793 ng/L, 1.042 × 10-14-3.500 × 10-11 ng/g and 8.015 × 10-12-14.188 ng/g, respectively. It was also found that the increase in temperature and rainfall can reduce the migration rate of some antibiotics into the water and sediment phases. The flux analysis of the cross-media migration and transformation of antibiotics in Qingpu District shows that advection was the prime input and output paths of antibiotics in the water. Moreover, the prime input and output paths of antibiotics in sediment were sedimentation from water to sediment and degradation. Sensitivity analysis shows that the characteristics of antibiotic emission, degradation rate, and Koc were the most influential parameters for target chemicals. The results of risk assessment based on Monte Carlo method reveal that the overall risk level of antibiotics in sediment was relatively risk-free, and the risk of antibiotics in water decreased in the order of tetracyclines > ß-lactams > fluoroquinolones > macrolides > sulfonamides.

Pharmaceuticals and personal care products in a drinking water resource of Yangtze River Delta Ecology and Greenery Integration Development Demonstration Zone in China: Occurrence and human health risk assessment.

The occurrence, partition, and human health risk of thirteen pharmaceuticals and personal care products (PPCPs) have been investigated in surface water, overlying water, pore water and sediment samples from Dianshan Lake of Yangtze River Delta Ecology and Greenery Integration Development Demonstration Zone in China. PPCPs were ubiquitous in aqueous phase and sediments from Dianshan Lake. Sulfamethazine (SMZ) was dominated in surface water and overlying water, while ketoprofen (KPF) was rich in sediment. The total concentration of PPCPs ranged from 0.38-85.27 ng/L, 24.26-130.03 ng/L and 5.39-149.84 µg/kg in surface water, overlying water and sediment, respectively, which were in middle levels compared with these reported in other aquatic environment in China. Naproxen (NPX), sulfadimethoxine (SDM), sulfamethoxazole (SMX) and sulfamethazine (SMZ) in surface water showed a relatively higher level in lake side than those in lake center suggesting that a mixed containment source of human- and animal-derived from the areas around lake. The significant season variations of most PPCPs were mainly attributed to their usage, water temperature and dilution effect. The partition behaviors of PPCPs in sediment-overlying water and sediment-pore water system were mainly affected by their logKow values, and showed weak correlation with total organic carbon (TOC) content in sediment and molecular weights of PPCPs. Preliminary results indicated that PPCPs in Dianshan Lake have not posed a high risk to human health by exposure to drinking water for all age groups. Nevertheless, their potential to cause the mixture toxicity and resistance genes cannot be neglected. This work will contribute to the clear picture of PPCPs contamination in drinking water source in the Demonstration Zone, and provide reliable and simple-to-use information to regulators on the exposure and risk levels of PPCPs, as well as recommendations for future research.

Anxiety symptoms in patients with Mayer-Rokitansky-Küster-Hauser syndrome: a cross-sectional study.

BACKGROUND: As a congenital malformation that results in infertility and an inability to have vaginal intercourse, Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome places a considerable psychological burden on patients, which results in anxiety symptoms. However, only single case studies or a few small to medium-sized cross-sectional studies were identified to focus on anxiety symptoms in MRKH patients. Thus, the aim of this study was to explore the status of anxiety symptoms and the related factors in patients with MRKH syndrome. METHODS: This cross-sectional study involving 141 patients with MRKH syndrome and 178 healthy women was conducted from January 2018 to December 2018. All participants were required to complete a demographic questionnaire and the Generalized Anxiety Disorder 7-item scale (GAD-7), Patient Health Questionnaire-9, Eysenck Personality Questionnaire-Revised, Short Scale for Chinese, and Chinese Version of the Female Sexual Function Index. The main outcome was the anxiety symptoms measured by the GAD-7. Main outcome was compared between the MRKH syndrome group and the healthy control group. Then, we explored the related factors by comparing patients with and without anxiety symptoms. RESULTS: Of the respondents, 24.1% experienced moderate to severe anxiety symptoms. Patients with MRKH syndrome manifested more severe anxiety symptoms than healthy women. Negative self-evaluation of femininity (odds ratio [OR] 2.706, 95% confidence interval [CI] 1.010-7.247), neurotic personality traits (OR 1.100, 95% CI 1.029-1.175), and coexisting depressive symptoms (OR 4.422, 95% CI 1.498-13.049) were more prevalent in anxious patients. CONCLUSION: The findings stress the importance of anxiety symptom screening in MRKH patients and identify patients at risk of anxiety symptoms, providing a possible basis for future intervention.

Association of psychosocial and perceived environmental factors with park-based physical activity among elderly in two cities in China and Germany.

BACKGROUND: Urban parks play an important role in promoting physical activity (PA) among adults and especially among older city residents. According to the socioecological approach the association of physical environments and psychosocial factors in the context of park-based PA of elderly have not been systematically examined until now, let alone the relevance of the city (urban area) on a cross-cultural level. This study investigated selected aspects of (1) the association of psychosocial and park environmental factors with park-based physical activity (PBPA) of older people; and (2) the moderating effect of city on the association of these factors with PBPA. METHODS: A face-to-face survey was conducted of a mixed-culture sample from different urban surroundings in Hong Kong (HK) and Leipzig (L). In six parks of each city physically active elderly (> = 60 years; HK: n = 306; L: n = 311) were recruited. Multiple linear regressions were used to analyse the association between psychosocial factors and perceived environmental factors with PBPA and the moderating effect of city. RESULTS: Controlled for demographic variables, all other psychosocial factors were significantly related to PBPA, except social support. In terms of environmental factors, PBPA was positively associated with safety, attractiveness, features and negatively associated with park time distance. Controlled for demographic variables, psychosocial and environmental factors, the moderating effect of city on the associations of park features and park time distance with PBPA was not significant in HK. In contrast, there was a significant positive relationship for park features and a negative relationship for park time distance with PBPA in L. CONCLUSIONS: Psychosocial and perceived environmental factors significantly influence PBPA of older people. City moderates the associations of these factors and independently contributes to park-based PA of the elderly. The different interactions of environmental factors and urban area for PBPA of elderly can support policy makers on the municipal level in choosing adequate strategies for promoting PA of older people in parks.

[Psychometric Evaluation of the Union Physio-Psycho-Social Assessment Questionnaire].

Objective To validate the Union Physio-Psycho-Social Assessment Questionnaire(UPPSAQ-70)and test its validity and reliability.Methods From April,2013 to July,2018,patients were asked to finish the computer evaluation of UPPSAQ-70 and Symptom Checklist 90(SCL-90)in Peking Union Medical College Hospital(PUMCH).Confirmatory factor analysis(CFA)was conducted on the SPSS 17.0,and the number of fixed factors was 8 factors and 3 factors.Amos 23.0 was used to verify the original 8-factor model,8-factor revision model,3-factor model,3-factor revision model,and single-factor model.Each factor of SCL-90 was used as the calibration standard to calculate the correlation coefficient between factors.The retest reliability was tested by the outpatients in PUMCH in July,2018.Results Exploratory factor analysis indicated that the 8-factor revised model included:depression,anxiety and fatigue,sleep,physical discomfort,sexual function,happiness and satisfaction,hypochondria,and social anxiety.The 3 factors revised model included that:psychological,physiological and social dimension.Confirmatory factor analysis indicated that the 8-factor modified model was superior to the 3-factor model and the single-factor model: χ 2=10 410.4,df=1862,RMSEA=0.07,CFI=0.753,and NFI=0.715.With SCL-90 as the standard criteria,except the low correlation coefficient between emotional scale and depression(r=0.600)and anxiety(r=0.520),the correlation coefficients of other symptoms were below 0.5.The chronbach's α between each factor and total score of UPPSAQ-70 was between 0.823 and 0.904,and the Chronbach's α coefficient of the whole scale was between 0.954 and 0.956 after each item was deleted.The retest reliability of the scale of 32 participants Chronbach's α was 0.847.Each item of the scale measured between one week was significantly correlated(P<0.05). Conclusion UPPSAQ-70 is a good scale for evaluating overall health status and is especially feasible in general hospitals.

A web-based lifestyle intervention program for Chinese college students: study protocol and baseline characteristics of a randomized placebo-controlled trial.

BACKGROUND: This study aimed to describe the design and present the baseline characteristics of a web-based lifestyle intervention program, which comprises of sequentially and simultaneously delivered intervention modules targeting physical activity (PA) and fruit and vegetable consumption (FVC) in Chinese college students. METHODS: The study adopted a randomized placebo-controlled trial, using the Health Action Process Approach (HAPA) and the Compensatory Carry-Over Action Model (CCAM) as the theoretical backdrops. 556 Chinese college students participated in the 8-week web-based lifestyle intervention program. All eligible participants were randomly assigned to one of four groups: 1) the PA-first arm which received a 4-week intervention addressing PA followed by a 4-week intervention addressing FVC; 2) the FVC-first arm which received a 4-week intervention addressing FVC followed by a 4-week intervention addressing PA; 3) the PA + FVC simultaneous arm that received an 8-week intervention addressing both PA and FVC at the same time; and 4) the placebo-control arm that received 8 weeks of general health information, which is not relevant for changing actual PA and FVC behaviors. Data collection includes four time-points: at the beginning and end of the intervention, and a 3-month and 12-month follow-up after the intervention. RESULTS: At baseline, 41.7% of participants were male and 58.3% were female. 41.0% of the participants did not meet the standard PA-recommendations, while 69.6% did not adhere to the standard FVC-recommendations. In total, only 19.6% of participants met both PA and FVC recommendations. Baseline characteristics across the four groups had no significant differences (all P = .17-.99), indicating successful randomization. CONCLUSIONS: The preliminary results indicate a high prevalence of unhealthy lifestyles in college students in China, which further supports the need for web-based health intervention programs. This is also the first study that examines the comparative effectiveness of simultaneously and sequentially delivered lifestyle interventions in the Chinese population. These findings may contribute to the creation of future web-based health behavior change interventions. TRIAL REGISTRATION: ClinicalTrails.gov: NCT03627949 , 14 August, 2018.

Evaluation of a Web-Based Intervention for Multiple Health Behavior Changes in Patients With Coronary Heart Disease in Home-Based Rehabilitation: Pilot Randomized Controlled Trial.

BACKGROUND: Web-based and theory-based interventions for multiple health behaviors appears to be a promising approach with respect to the adoption and maintenance of a healthy lifestyle in cardiac patients who have been discharged from the hospital. Until now, no randomized controlled trials have tested this assumption among Chinese rehabilitation patients with coronary heart disease using a Web-based intervention. OBJECTIVE: The study aim was to evaluate the effect of an 8-week Web-based intervention in terms of physical activity (PA), fruit and vegetable consumption (FVC), lifestyle changes, social-cognitive outcomes, and health outcomes compared with a waiting control group in Chinese cardiac patients. The intervention content was theory-based on the health action process approach. Self-reported data were evaluated, including PA, FVC, healthy lifestyle (the synthesis of PA and FVC), internal resources (combination of intention, self-efficacy, and planning), and an external resource (social support) of PA and FVC behaviors, as well as perceived health outcomes (body mass index, quality of life, and depression). METHODS: In a randomized controlled trial, 136 outpatients with coronary heart disease from the cardiac rehabilitation center of a hospital in China were recruited. After randomization and exclusion of unsuitable participants, 114 patients were assigned to 1 of the 2 groups: (1) the intervention group: first 4 weeks on PA and subsequent 4 weeks on FVC and (2) the waiting control group. A total of 2 Web-based assessments were conducted, including 1 at the beginning of the intervention (T1, N=114), and 1 at the end of the 8-week intervention (T2, N=83). The enrollment and follow-up took place from December 2015 to May 2016. RESULTS: The Web-based intervention outperformed the control condition for PA, FVC, internal resources of PA and FVC, and an external resource of FVC, with an eta-squared effect size ranging from 0.06 to 0.43. Furthermore, the intervention effect was seen in the improvement of quality of life (F1,79=16.36, P<.001, η2=.17). When predicting a healthy lifestyle at follow-up, baseline lifestyle (odds ratio, OR 145.60, 95% CI 11.24-1886; P<.001) and the intervention (OR 21.32, 95% CI 2.40-189.20; P=.006) were found to be significant predictors. Internal resources for FVC mediated the effect of the intervention on the adoption of a healthy lifestyle (R2adj=.29; P=.001), indicating that if the intervention increased the internal resource of behavior, the adoption of a healthy lifestyle was more likely. CONCLUSIONS: Patients' psychological resources such as motivation, self-efficacy, planning, and social support as well as lifestyle can be improved by a Web-based intervention that focuses on both PA and FVC. Such an intervention enriches extended rehabilitation approaches for cardiac patients to be active and remain healthy in daily life after hospital discharge. TRIAL REGISTRATION: ClinicalTrials.gov NCT01909349; https://clinicaltrials.gov/ct2/show/NCT01909349 (Archived by WebCite at http://www.webcitation.org/6pHV1A0G1).

Web-Based Intervention for Physical Activity and Fruit and Vegetable Intake Among Chinese University Students: A Randomized Controlled Trial.

BACKGROUND: Ample evidence demonstrates that university students are at high risk for sedentary behaviors and inadequate fruit and vegetable intake (FVI). Internet-based interventions for multiple health behavior appear to be promising in changing such unhealthy habits. Limited randomized controlled trials have tested this assumption among Chinese university students. OBJECTIVE: Our objective was to test the efficacy of an 8-week Web-based intervention compared with a control group condition to improve physical activity (PA) and FVI in Chinese university students. The intervention content was based on the health action process approach, and developed on the basis of previous evidence from the Western hemisphere. We evaluated self-reported data including PA and FVI, stages of change for PA and FVI, and motivational (risk perception, outcome expectancies, self-efficacy), volitional (action planning, coping planning, social support), and distal (intention, habit) indicators for PA and FVI, as well as perceived mental health outcomes (quality of life, depression). METHODS: In a randomized controlled trial, we recruited 566 university students from one university in the central region of China during their general physical education class. After random allocation and exclusion of unsuitable participants, we assigned 493 students to 1 of 2 groups: (1) intervention group: first 4 weeks on PA and subsequent 4 weeks on FVI, (2) control group. We conducted 3 Web-based assessments: at the beginning of the intervention (T1, n=493), at the end of the 8-week intervention (T2, n=337), and at a 1-month follow-up after the intervention (T3, n=142). The entire study was conducted throughout the fall semester of 2015. RESULTS: Significant time ⨯ group interactions revealed superior intervention effects on FVI; motivational, volitional, and distal indicators of FVI; and PA behavior changes, with an effect size (η2) ranging from .08 to .20. In addition, the overall intervention effects were significant for stage progression to the action group from T1 to T2 in PA (χ21=11.75, P=.001) and FVI (χ21=15.64, P=.03). Furthermore, the intervention effect was seen in the improvement of quality of life (F3,492=1.23, η2=.03, P=.02). CONCLUSIONS: This study provides evidence for the efficacy of a Web-based multiple health behavior intervention among Chinese university students tested with different outcome variables. Future research should address the high dropout rate and optimize the most effective components of this intervention. TRIAL REGISTRATION: Clinicaltrials.gov NCT01909349; https://clinicaltrials.gov/ct2/show/NCT01909349 (Archived by WebCite at http://www.webcitation.org/6pHV1A0G1).

Polybrominated diphenyl ethers (PBDEs) in PM2.5, PM10, TSP and gas phase in office environment in Shanghai, China: occurrence and human exposure.

To evaluate risk via inhalation exposure of polybrominated diphenyl ethers (PBDEs) in office environment, thirty-six pairs air samples including PM2.5 (particles with aerodynamic diameter less than 2.5 µm), PM10 (particles with aerodynamic diameter less than 10 µm), total suspended particles (TSP) with matching gas phase were collected in office environment in Shanghai, China. The average concentrations of PM2.5, PM10 and TSP were 20.4, 27.2 and 50.3 µg/m3, respectively. Σ15PBDEs mean concentrations in PM2.5, PM10, TSP and gas phase were 51.8, 110.7, 148 and 59.6 pg/m3, respectively. Much more PBDEs distributed in fine fractions than coarse ones. PBDEs congener profiles found in PM2.5, PM10 and TSP (dominated by BDE-209) were different from that in gas phase (dominated by the tri- to penta-BDEs). Approximately 3.20 pg/kg/d PM2.5 bound PBDEs can be inhaled into the lung; 3.62 pg/kg/d PM10-PM2.5(particles with aerodynamic diameter of 2.5-10 µm) bound PBDEs tended to be deposited in the upper part of respiratory system, and the intake of PBDEs via gas-phase was 2.74 pg/kg/d. The exposure of PBDEs was far below the minimal risk levels (MRLs), indicating lower risk from PBDEs via inhalation in the studied office in Shanghai.

Characterizing distribution, sources, and potential health risk of polybrominated diphenyl ethers (PBDEs) in office environment.

This study evaluated the levels and spatial distribution of PBDEs in 9 typical offices in Shanghai, China through the sample analysis of air and settled dust (floor dust, desktop dust and dust in computer case). PBDEs in air ranged from 93 to 322 pg/m(3), while the PBDEs levels in dust varied from 247 to 3.3 × 10(4) ng/g. Spatial variability of PBDEs in office dust was evident and likely influenced by air exchange and the use of electronic devices. A significant positive linear correlation was observed between the power usage rate and PBDE levels in both office air (R(2) = 0.81) and settled dust (R(2) = 0.94). The PBDEs exposure via inhalation and dust ingestion were both analyzed to estimate the life-time cancer risk, which is 1.34 × 10(-22) to 7.16 × 10(-22), significantly lower than the threshold level (10(-6)). Non-cancer risk indicated by the hazard index (<1) is also low in current exposure conditions.

Occurrence and human health risk of wastewater-derived pharmaceuticals in a drinking water source for Shanghai, East China.

Pharmaceuticals are heavily used to improve human and animal health, resulting in the frequent contamination of aquatic environments with pharmaceutical residues, which has raised considerable concern in recent years. When inadequately removed from drinking water in water treatment plants, pharmaceuticals can have potential toxic effects on human health. This study investigated the spatial distributions and seasonal variations of five pharmaceuticals, including ibuprofen (IBP), ketoprofen (KEP), naproxen (NPX), diclofenac (DFC), and clofibric acid (CA), in the Huangpu River system (a drinking water source for Shanghai) over a period of almost two years as well as the associated risk to human health for different age groups. All of the targets were ubiquitous in the river water, with levels decreasing in the following order: KEP (mean: 28.6 ng/L)≈IBP (23.3 ng/L)>DFC (13.6 ng/L)≈NPX (12.3 ng/L)>CA (1.6ng/L). The concentrations of all of the investigated compounds were at the low or medium end of the global range. The upstream tributaries contained lower IBP but higher NPX than did the mainstream and downstream tributaries. However, no significant variations were found in the levels of KEP, DFC, or CA at the different sampling sites. Except for CA in the mainstream, significantly higher pharmaceutical levels were observed in the dry season than in the wet season. Overall, a very low risk of the selected pharmaceuticals for human health via drinking water was observed, but future studies are needed to examine the fate and chronic effects of all pharmaceuticals in aquatic environments. To our knowledge, this is the first report to investigate the human health risk of pharmaceuticals in raw drinking water in China.

Suicide risk in major affective disorder: results from a national survey in China.

BACKGROUND: This study investigated suicide risk and its correlates among major affective disorder patients in China and examined possible risk factors for future suicide among individuals with major affective disorder to inform appropriate interventions and management approaches to minimize and prevent suicide. METHODS: A total of 1478 major affective disorder patients were consecutively examined in 13 mental health centers in China. The patients' socio-demographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. DSM-IV diagnoses were established using the Mini International Neuropsychiatric Interview (MINI), and suicide risk was assessed by the suicide risk module of the MINI. RESULTS: Of the patients, 963 (65.2%) were in the nonsuicidal risk group and 515 (34.8%) were in the suicidal risk group. Compared to major depressive disorder patients, bipolar disorder patients had higher suicide risk levels (χ2=10.0, df=1, P=0.002); however, there were no statistically significant differences (χ2=2.6, df=1, P=0.1) between bipolar disorder-I and bipolar disorder-II patients. Suicide risk factors were associated with 6 variables in major affective disorder patients, as follows: male gender, unemployed, more frequent depressive episodes (>4 in the past year), depressive episodes with suicidal ideation and attempts, depressive episodes with psychotic symptoms, and no current antidepressant use. LIMITATIONS: Most of the data were retrospectively collected and, therefore, subject to recall bias. CONCLUSIONS: This study suggested that bipolar disorder patients have a higher suicide risk than major depressive disorder patients. The factors that were significantly associated with suicide risk may aid in identifying major affective disorder patients who are at risk for future suicidal behavior.

Polybrominated diphenyl ethers in e-waste: level and transfer in a typical e-waste recycling site in Shanghai, Eastern China.

Very few data for polybrominated diphenyl ethers (PBDEs) were available in the electronic waste (e-waste) as one of the most PBDEs emission source. This study reported concentrations of PBDEs in e-waste including printer, rice cooker, computer monitor, TV, electric iron and water dispenser, as well as dust from e-waste, e-waste dismantling workshop and surface soil from inside and outside of an e-waste recycling plant in Shanghai, Eastern China. The results showed that PBDEs were detected in the majority of e-waste, and the concentrations of ΣPBDEs ranged from not detected to 175 g/kg, with a mean value of 10.8 g/kg. PBDEs were found in TVs made in China after 1990. The mean concentrations of ΣPBDEs in e-waste made in Korea, Japan, Singapore and China were 1.84 g/kg, 20.5 g/kg, 0.91 g/kg, 4.48 g/kg, respectively. The levels of ΣPBDEs in e-waste made in Japan far exceed the threshold limit of RoHS (1.00 g/kg). BDE-209 dominated in e-waste, accounting for over 93%. The compositional patterns of PBDEs congeners resembled the profile of Saytex 102E, indicating the source of deca-BDE. Among the samples of dust and surface soil from a typical e-waste recycling site, the highest concentrations of Σ18PBDEs and BDE-209 were found in dust in e-waste, ranging from 1960 to 340,710 ng/g and from 910 to 320,400 ng/g, which were 1-2 orders of magnitude higher than other samples. It suggested that PBDEs released from e-waste via dust, and then transferred to surrounding environment.