Enhancement of the Wear Resistance and Corrosion Resistance of Electroplated Ni-W-B Coatings Using PDA-Functionalized VC.

In this study, vanadium carbide (VC) was used as the raw material to synthesize PDA-functionalized VC (P-VC). VC and P-VC were added as nanoreinforced materials to the Ni-W-B coating. The effects of the two nanomaterials on the morphology, wear resistance, and corrosion resistance of the Ni-W-B coatings were investigated and compared. The experimental results show that the surface of the Ni-W-B/P-VC coating is denser and more uniform than that of the Ni-W-B and Ni-W-B/VC coatings, and there are no obvious defects on the surface. According to the hardness test, the Ni-W-B/P-VC coating reaches the highest microhardness of 887.1 HV. According to the friction and wear tests, the Ni-W-B/P-VC coating has the shallowest scratches, the lowest average friction coefficient (COF = 0.274), and the lowest wear rate (9.578 × 10-8 mm2/N). The corrosion resistance is the best, the corrosion rate is 0.0456 mm/y, and the impedance value Rt reaches 14,501 Ω·cm2.

In silico study of androgen receptor N-terminal domain and exploration of its modulators.

The androgen receptor (AR, Uniprot: P10275) signaling plays a key role in the progression of prostate cancer, various AR-related ligands have been reported to treat prostate cancer. However, some resistance mechanisms limited the treating effect of these ligands. Since DBD binding or the allosteric binding sites in LBD of AR may allow the circumvention of some drug resistance mechanisms, anti-resistance is expected especially through the NTD (N-terminal domain) targeting. What's more, studies have shown that compounds including EPI-001 and its derivatives which bind to the Tau-5 region on NTD could be promising molecules for AR-based therapeutics. Herein, we employed aMD (accelerated molecular dynamics) simulation to fold Tau-5 unit proteins into native structure correctly. Subsequently, based on the predicted structural features of Tau-5, the virtual screening was conducted to discover new compounds targeting AR-NTD. We picked up 8 compounds (according to their docking scores and partly similar structural consists as known AR ligands) and analyzed their interaction with Tau-5, compared with the positive control EPI-001, four of the pick-up compounds showed better glide scores. Interestingly, although compound 8 had a lower docking score, it consisted of a similar component as the ligand EIQPN and the amide derivatives, this predicts that compound 8 has also the potential to be modified into an excellent AR-NTD binding molecule. These 8 compounds were all commercially available and could be tested to check whether there was a hit compound to bind the AR-NTD and to regulate its bio-activities. Together, this study described an in silico VLS approach to discover AR-NTD ligands and provided more choices for developing AR-targeted therapies.Communicated by Ramaswamy H. Sarma.

Effectiveness of a WHO self-help psychological intervention to alleviate stress among healthcare workers in the context of COVID-19 in China: a randomised controlled trial.

AIMS: To examine the effectiveness of Self-Help Plus (SH+) as an intervention for alleviating stress levels and mental health problems among healthcare workers. METHODS: This was a prospective, two-arm, unblinded, parallel-designed randomised controlled trial. Participants were recruited at all levels of medical facilities within all municipal districts of Guangzhou. Eligible participants were adult healthcare workers experiencing psychological stress (10-item Perceived Stress Scale scores of ≥15) but without serious mental health problems or active suicidal ideation. A self-help psychological intervention developed by the World Health Organization in alleviating psychological stress and preventing the development of mental health problems. The primary outcome was psychological stress, assessed at the 3-month follow-up. Secondary outcomes were depression symptoms, anxiety symptoms, insomnia, positive affect (PA) and self-kindness assessed at the 3-month follow-up. RESULTS: Between November 2021 and April 2022, 270 participants were enrolled and randomly assigned to either SH+ (n = 135) or the control group (n = 135). The SH+ group had significantly lower stress at the 3-month follow-up (b = -1.23, 95% CI = -2.36, -0.10, p = 0.033) compared to the control group. The interaction effect indicated that the intervention effect in reducing stress differed over time (b = -0.89, 95% CI = -1.50, -0.27, p = 0.005). Analysis of the secondary outcomes suggested that SH+ led to statistically significant improvements in most of the secondary outcomes, including depression, insomnia, PA and self-kindness. CONCLUSIONS: This is the first known randomised controlled trial ever conducted to improve stress and mental health problems among healthcare workers experiencing psychological stress in a low-resource setting. SH+ was found to be an effective strategy for alleviating psychological stress and reducing symptoms of common mental problems. SH+ has the potential to be scaled-up as a public health strategy to reduce the burden of mental health problems in healthcare workers exposed to high levels of stress.

Platelet-derived drug delivery systems: Pioneering treatment for cancer, cardiovascular diseases, infectious diseases, and beyond.

Platelets play a critical role as circulating cells in the human body and contribute to essential physiological processes such as blood clotting, hemostasis, vascular repair, and thrombus formation. Currently, platelets are extensively employed in the development of innovative biomimetic drug delivery systems, offering significant enhancements in circulation time, biocompatibility, and targeted delivery efficiency compared to conventional drug delivery approaches. Leveraging the unique physiological functions of platelets, these platelet-derived drug delivery systems (DDSs) hold great promise for the treatment of diverse diseases, including cancer, cardiovascular diseases, infectious diseases, wound healing and other diseases. This review primarily focuses on the design and characteristics of existing platelet-derived DDSs, including their preparation and characterization methods. Furthermore, this review comprehensively outlines the applications of these materials across various diseases, offering a holistic understanding of their therapeutic potential. This study aimed to provide a comprehensive overview of the potential value of these materials in clinical treatment, serving as a valuable reference for the advancement of novel platelet-derived DDSs and their broader utilization in the field of disease treatment.

Magnetic resonance imaging of knees: a novel approach to predict recombinant human growth hormone therapy response in short-stature children in late puberty.

BACKGROUND: There is no appropriate tool to predict recombinant human growth hormone (rhGH) response before therapy initiation in short-stature children in late puberty. The current study aimed to explore the associations between magnetic resonance imaging (MRI) stages of the knee growth plates and rhGH response in short-stature children in late puberty. METHODS: In this prospective cohort study, short-stature children in late puberty were treated with rhGH and followed up for 6 months. We proposed a novel knee MRI staging system according to the growth plate states of distal femurs or proximal tibias and divided the participants into three groups: unclosed growth plate group, marginally closed growth plate group, and nearly closed growth plate group. The primary outcomes were height gain and growth velocity (GV), which were assessed three months later. RESULTS: Fifty participants were enrolled, including 23 boys and 27 girls. GV and height gain after 6 months of rhGH therapy decreased successively in the three groups with an increased degree of growth plate fusion, especially when grouped by proximal tibias (GV1-3 mon from 9.38 to 6.08 to 4.56 cm/year, GV4-6 mon from 6.75 to 4.92 to 3.25 cm/year, and height gain from 4.03 to 2.75 to 1.95 cm, all P < 0.001). Moreover, the MRI stages of growth plates independently served as a significant variable for GV and height gain after therapy, especially when grouped by proximal tibias (all P < 0.01). CONCLUSION: The MRI staging method is expected to be an effective tool for predicting rhGH response before therapy initiation in short-stature children in late puberty.

Genetically Engineered-Cell-Membrane Nanovesicles for Cancer Immunotherapy.

The advent of immunotherapy has marked a new era in cancer treatment, offering significant clinical benefits. Cell membrane as drug delivery materials has played a crucial role in enhancing cancer therapy because of their inherent biocompatibility and negligible immunogenicity. Different cell membranes are prepared into cell membrane nanovesicles (CMNs), but CMNs have limitations such as inefficient targeting ability, low efficacy, and unpredictable side effects. Genetic engineering has deepened the critical role of CMNs in cancer immunotherapy, enabling genetically engineered-CMN (GCMN)-based therapeutics. To date, CMNs that are surface modified by various functional proteins have been developed through genetic engineering. Herein, a brief overview of surface engineering strategies for CMNs and the features of various membrane sources is discussed, followed by a description of GCMN preparation methods. The application of GCMNs in cancer immunotherapy directed at different immune targets is addressed as are the challenges and prospects of GCMNs in clinical translation.

Efficient photocatalytic remediation of typical antibiotics in water via Mn3O4 decorated carbon nitride nanotube.

Antibiotic abuse will seriously affect the ecology and environment. Photocatalytic oxidation technology based on carbon nitride (g-C3N4) has been widely adopted to treat wastewater containing antibiotics. Here, a novel composite photocatalyst MCNT was prepared by loading manganese oxide (Mn3O4) on the surface of g-C3N4 nanotubes (CNT). Three typical antibiotics, trimethoprim (TMP), norfloxacin (NOR), and tetracycline (TC) were used as model contaminants to evaluate the oxidative properties of prepared materials. Compared with bulk g-C3N4, the degradation rates of TMP, NOR, and TC catalyzed by MCNT-5 were increased by 2, 3, and 1.4 times, respectively, mainly due to 1) the larger specific surface area of the nanotube structure of CNT, which provides abundant active sites for antibiotic adsorption and catalytic oxidation, and 2) the loading of Mn3O4, which promotes the directional migration of photogenerated charges and improves the separation efficiency of photogenerated electrons and holes. The free radical capture and quenching experiments confirmed that MCNT degraded the target organic pollutants with hydroxyl radical (·OH) and singlet oxygen (1O2) as the main active oxidants. This catalyst maintained 80% photocatalytic oxidation performance after five cyclic experiments. This study provides new insights into developing efficient, stable, and environmentally-friendly photocatalysts and provides a new dimension to mitigate the antibiotic pollution problem.

An overview on the exploring the interaction of inorganic nanoparticles with microtubules for the advancement of cancer therapeutics.

Targeting microtubules (MTs), dynamic and stable proteins in cells, by different ligands have been reported to be a potential strategy to combat cancer cells. Inorganic nanoparticles (NPs) have been widely used as anticancer, antibacterial and free radical scavenging agents, where they come in contact with biological macromolecules. The interaction between the NPs and biological macromolecules like MTs frequently occurs through different mechanisms. A prerequisite for a detailed exploration of MT structures and functions for biomedical applications like cancer therapy is to investigate profoundly the mechanisms involved in MT-NP interactions, for which the full explanation and characterization of the parameters that are responsible for the formation of a NP-protein complex are crucial. Therefore, in view of the fact that the goal of the rational NP-based future drug design and new therapies is to rely on the information of the structural details and protein-NPs binding mechanisms to manipulate the process of developing new potential drugs, a comprehensive investigation of the essence of the molecular recognition/interaction is also of considerable importance. In the present review, first, the microtubule (MT) structure and its binding sites upon interaction with MT stabilizing agents (MSAs) and MT destabilizing agents (MDAs) are introduced and rationalized. Next, MT targeting in cancer therapy and interaction of NPs with MTs are discussed. Furthermore, interaction of NPs with proteins and the manipulation of protein corona (PC), experimental techniques and direct interaction of NPs with MTs, are discussed, and finally the challenges and future perspective of the field are introduced. We envision this review can provide useful information on the manipulation of the MT lattice for the progress of cancer nanomedicine.

Psychological stress self-help interventions for healthcare workers in the context of COVID-19 in China: A randomized controlled trial protocol.

Background: Public health emergencies may lead to severe psychological stress, especially for healthcare workers, including frontline healthcare workers and public health workers. However, few stress management interventions have been implemented for healthcare workers even though they require more comprehensive interventions than the general public. Self-Help Plus (SH+) is a novel psychological self-help intervention developed by the World Health Organization. It is accessible, scalable, and cost-effective and has the potential to be quickly applied to help people cope with stress and adversity. The major objective of this study is to evaluate the effectiveness of SH+ interventions on the alleviation of stress levels and mental health problems among healthcare workers. Methods: A randomized controlled trial of SH+ will be conducted to investigate the stress level and mental health status of Chinese healthcare workers and control subjects in Guangzhou. Assessments will be performed before (baseline), at the end of (1 month), and 2 months after (3 months) the intervention. After completing the baseline screening questionnaire, eligible participants will be randomly assigned to one of the two groups in a 1:1 ratio by block randomization. During the 1-month intervention period, the intervention group will receive the SH+ intervention and the control group will receive information about mental health promotion. The intervention will be delivered by the research assistant via social media platforms. The primary outcome is the level of stress, which will be measured by a 10-item Perceived Stress Scale. Secondary outcomes including mental health symptoms will also be collected. Discussion: Given the potential for multiple COVID-19 waves and other infectious disease pandemics in the future, we expect that SH+ will be an effective stress management intervention for healthcare workers. The findings from this study will facilitate the application of SH+, and the trial is expected to be extended to a larger population in the future.

Temperature-sensitive morbidity indicator: consequence from the increased ambulance dispatches associated with heat and cold exposure.

Current development of temperature-related health early warning systems mainly arises from knowledge of temperature-related mortality or hospital-based morbidity. However, due to the delay in data reporting and limits in hospital capacity, these indicators cannot be used in health risk assessments timely. In this study, we examine temperature impacts on emergency ambulance and discuss the benefits of using this near real-time indicator for risk assessment and early warning. We collected ambulance dispatch data recording individual characteristics and preliminary diagnoses between 2015 and 2016 in Shenzhen, China. Distributed lag nonlinear model was used to examine the effects of high and low temperatures on ambulance dispatches during warm and cold seasons. Lag effects were also assessed to evaluate the sensitivity of ambulance dispatches in reflecting immediate health reactions. Stratified analyses by gender, age, and a wide range of diagnoses were performed to identify vulnerable subgroups. Disease-specific numbers of ambulance dispatches attributable to non-optimal temperature were calculated to determine the related medical burdens. Effects of temperature on ambulance dispatches appeared to be acute on the current day. Males, people aged 18-44 years, were more susceptible to non-optimal temperatures. Highest RR during heat exposure by far was for urinary disease, alcohol intoxication, and traumatic injury, while alcohol intoxication and cardiovascular disease were especially sensitive to cold exposure, causing the main part of health burden. The development of local health surveillance systems by utilizing ambulance dispatch data are important for temperature impact assessments and medical resource reallocation.

Associations between ambient air pollution and hospitalizations for acute exacerbation of chronic obstructive pulmonary disease in Jinhua, 2019.

Most cities in China are experiencing severe air pollution due to rapid economic development and accelerated industrialization. Exposure to various air pollutants has been related to acute exacerbations of chronic obstructive pulmonary disease (AECOPD). However, less is known about the spatial association between air pollution and AECOPD hospitalizations in the Yangtze River delta (YRD) economic and industrial region. Jinhua city is located in the YRD region of East China, in the middle of Zhejiang province. For the first time, 1563 AECOPD hospitalization cases in Jinhua during 2019 were enrolled in our analysis. The spatial distribution of six pollutants (SO2, CO, PM10, PM2.5, O3, NO2) and the population temporal-spatial specific air pollutant exposure levels were estimated using the ordinary Kriging model through geographic information system (GIS). Global Moran's I was used to explore the spatial association between ambient air pollutants and AECOPD hospitalizations. The Z-scores of residential SO2, CO, PM10, PM2.5, O3, and NO2 levels were 31.88, 42.95, 45.90, 32.29, 52.18, and 34.59, respectively. The concentrations of six monitored pollutants and AECOPD hospitalizations showed statistically significant spatial clustering. A generalized linear model (GLM) using a Poisson distribution with the log-link function was used to construct a core model. After adjusting for potential confounders in the model, residential SO2, NO2 and O3 concentrations were significantly associated with increased AECOPD hospitalizations.

Memory Retrieval-Extinction Combined With Virtual Reality Reducing Drug Craving for Methamphetamine: Study Protocol for a Randomized Controlled Trial.

BACKGROUND: Relapse, often precipitated by drug-associated cues that evoke craving, is a key problem in the treatment of methamphetamine use disorder (MUD). Drug-associated memories play a major role in the maintenance of relapse. Extinction training is a common method for decreasing drug craving by suppressing drug-associated memories. However, the effects are often not permanent, which is evident in form of spontaneous recovery or renewal of cue-elicited responses. Based on memory reconsolidation theory, the retrieval-extinction (R-E) paradigm may be more effective in decreasing spontaneous recovery or renewal responses than extinction. After the original memory reactivated to a labile state, extinction will be introduced within the reconsolidation window, thereby updating drug-associated memories. However, there are still some controversial results, which suggest that the reactivation of drug-associated memories and the 10 min-6 h of limited time window are two main elements in the R-E protocol. Virtual reality (VR) is supposed to promote memory reactivation by providing vivid drug-related stimuli when compared with movies. OBJECTIVE: The aim of this study is to examine the effectiveness of R-E training combined with VR on reducing spontaneous recovery or renewal of cue-elicited responses, in comparison to extinction, R-E training provided outside the time window of 6 h and R-E training retrieved using videos, in methamphetamine abusers. METHODS: The study is a parallel matched controlled study including 95 participants with MUD. Participants will be randomly assigned to either a R-10 min-E group (methamphetamine-related cues retrieval in VR followed by extinction after 10 min) or a NR-10 min-E group (neutral cues retrieval in VR followed by extinction after 10 min) or a R-6 h-E group (methamphetamine-related cues retrieval in VR followed by extinction after 6 h) or a RV-10 min-E group (methamphetamine-related cues retrieval in videos followed by extinction after 10 min). Cue-evoked craving and reactivity will be assessed at pre-test and at 1 day, 1 week, 1 month, and 6-month post-tests. DISCUSSION: To our knowledge, this study will probably be the first study to examine the efficacy of R-E training combined with VR to reduce cue-evoked responses in people with MUD. This innovative non-pharmacological intervention targeting drug-associated memories may provide significant clinical implications for reducing relapse, providing the study confirms its efficacy. CLINICAL TRIAL REGISTRATION: The trial is registered with Chinese Clinical Trial Registry at 17 October 2018, number: ChiCTR1800018899, URL: http://www.chictr.org.cn/showproj.aspx?proj=30854.

Geographical disparities in the impacts of heat on diabetes mortality and the protective role of greenness in Thailand: A nationwide case-crossover analysis.

Diabetes is a major public health problem globally, and heat exposure may be a potential risk factor for death among diabetes. This study examines the association between heat and diabetes mortality in different regions of Thailand and investigates whether heat effects are modified by regional greenness. Daily temperature and daily diabetes deaths data were obtained for 60 provinces of Thailand during 2000-2008. A case-crossover analysis was conducted to quantify the odds of heat-related death among diabetes. Meta-regression was then used to examine potential modification effects of regional greenness (as represented by the Normalized Difference Vegetation Index) on heat-related mortality. A strong association between heat and diabetes mortality was found in Thailand, with important regional variations. Nationally, the pooled odds ratio of diabetes mortality was 1.10 (95% confidence interval (CI): 1.06-1.14) for heat (90th percentile of temperature) and 1.20 (95% CI: 1.10-1.30) for extreme heat (99th percentile of temperature) compared with the minimum mortality temperature, across lag 0-1 days. Central and northeast Thailand were the most vulnerable regions. Regional greenness modified the effects of heat, with lower mortality impacts in areas of higher levels of greenness. In conclusion, heat exposure increases mortality risk in diabetes, with large geographical variations in risk suggesting the need for region-specific public health strategies. Increasing greenness levels may help to reduce the burden of heat on diabetes in Thailand against the backdrop of a warming climate.

Fibroblast Growth Factor-1 Improves Insulin Resistance via Repression of JNK-Mediated Inflammation.

Insulin resistance is associated with a greatly increased risk of type 2 diabetes. Administration of fibroblast growth factor-1 (FGF-1) resulted in a marked improvement in insulin sensitivity. However, the underlying molecular mechanism whereby FGF-1 represses insulin resistance remains largely unknown. Here, we sought to delineate the role of FGF-1 in insulin resistance with respect to its anti-inflammatory capability. In this study, we found that FGF-1 had positive effects on glucose intolerance, hepatic lipid accumulation, and insulin resistance, while it markedly repressed cytokine secretion (TNF-α and IL-6) in serum and reduced liver inflammation in diet-induced obesity (DIO) mice. Further, FGF-1 treatment significantly represses TNF-α-induced insulin resistance in vitro and in vivo. These results indicate that FGF-1 likely ameliorates insulin resistance via a mechanism that is independent of its glucose-lowering activity. Subsequent experiments demonstrated that FGF-1 ameliorated insulin resistance, and inflammation was accompanied by decreased c-Jun N-terminal kinase (JNK) signaling. In addition, it is likely that FGF-1 impedes JNK phosphorylation via blocking the transforming growth factor-ß activated kinase 1 (TAK1) and TAK1 binding protein 1 (TAB1) interaction. These findings reveal that FGF-1 regulates insulin sensitivity and may represent an attractive therapeutic target for preventing the development of insulin resistance.

Left-turning vehicle-pedestrian conflicts at signalized intersections with traffic lights: Benefit or harm? A two-stage study.

PURPOSE: Vehicle-pedestrian conflicts are common at road intersections when traffic lights change. However, the impact of traffic light on transportation safety and efficiency remains poorly understood. METHODS: A two-stage study was used to survey the proportion of intersections with conflicting traffic lights and the related transportation efficiency and safety were evaluated as well. First, a cross-sectional study estimated the proportion of signalized intersections with conflicting left-turning vehicle-pedestrian traffic lights in Changsha city, China. Second, a natural experiment compared transportation efficiency and safety between intersections with and without conflicting left-turning vehicle-pedestrian traffic lights. Risky conflicts, where motor vehicles violated laws and failed to yield to pedestrians in crosswalk were used as a surrogate for transportation safety. The number of motor vehicles and pedestrians passing through the intersections per second and per meter were used to estimate transportation efficiency. Data were collected and analyzed in 2015 (from March to December). A search of online news from domestic media sources was also conducted to collect pedestrian injury data occurring at the intersections. RESULTS: About one-fourth (57/216) intersections had conflicting left-turning traffic lights (95% CI: 20.5%, 32.3%). Risky vehicle-pedestrian conflicts were more frequently observed at intersections with conflicting lights compared to those without (incidence rate ratio (IRR) = 3.13; pedestrians: IRR = 4.02), after adjusting for type of day (weekday vs. weekend), the time period of observation, and motor vehicles traffic flow. Intersections without conflicting vehicle-pedestrian traffic lights had similar transportation efficiency to those with conflicting lights after controlling for covariates (p > 0.05). The systematic review of news media reports yielded 10 left-turning vehicle-pedestrian crash events between 2011 and 2017, involving 11 moderate or severe pedestrian injuries and 3 fatal pedestrian injuries. CONCLUSION: Over one-fourth of road intersections in Changsha city, China have conflicting left-turning traffic lights. Conflicting traffic lights cannot improve transportation efficiency, but increase risky conflicts between vehicles and pedestrians.

Effects of heat on first-ever strokes and the effect modification of atmospheric pressure: A time-series study in Shenzhen, China.

BACKGROUND: Stroke is a leading cause of death globally. Extreme temperatures may induce stroke, but evidence on the effects of heat on first-ever strokes is not clear. Low air pressure can lead to depression and an increase in blood pressure, and it may exacerbate the health impact of heat. In this study, we aimed to evaluate the effects of heat on first-ever strokes, the possible sensitive populations, and the effect of modification of atmospheric pressure. METHODS: We collected data on 142,569 first-ever strokes during 2005-2016 in Shenzhen, a coastal city in southern China, with subtropical oceanic monsoon climate. We fitted a time-series Poisson model in our study, estimating the association between daily mean temperature and first-ever strokes in hot months, with a distributed lag non-linear model with 7 days of lag. We calculated strokes attributable to heat in various gender, age groups, household register types, stroke subtypes, and atmospheric pressure levels. RESULTS: Heat had a significant cumulative association with first-ever strokes, and the risk of strokes increased with the rise in temperature after it was higher than 30 °C (the 85th percentile). In total, 1.95% (95% empirical CI 0.63-3.20%) of first-ever strokes were attributable to high temperature. The attributable fraction and attributable number of heat were statistically significant in male, female, middle-aged and old patients, immigrant patients, and CBI patients. The fraction attributable to heat was 3.33% in the low atmospheric pressure group, and the number of estimated daily attributable strokes at low atmospheric pressure levels was higher than that of medium and high atmospheric pressure levels (p < 0.01). CONCLUSIONS: High temperatures in hot months may trigger first-ever strokes, and low atmospheric pressure may exacerbate the effect. We mainly found associations between heat and first-ever strokes for intracerebral hemorrhage, middle-aged and old patients, as well as immigrant patients.

Estimation of work-related injury and economic burden attributable to heat stress in Guangzhou, China.

BACKGROUND: Climate change has exacerbated the health effects of high ambient temperatures on occupational health and safety; however, to what extent heat stress can induce workplace injuries and economic costs is poorly studied. This study aimed to quantify the attributable fractions of injury claims and subsequent insurance payouts using data from work-related injury insurance system in Guangzhou, China. METHODS: Individual workers' injury claims data were collected for the period of 2011-2012, including demographic characteristics and work-related information. Daily maximum wet bulb globe temperature (WBGT, °C) was calculated from meteorological data. To examine the association between WBGT index and work-related injury, we fit a quasi-Poisson regression with distributed lag non-linear model. Then we calculated the numbers of injury claims and costs of insurance compensations attributable to days with WBGT above the heat stress limit according to the national occupational health standards. RESULTS: There were 9550 work-related injury claims, resulting in an insurance payout of 282.3 million Chinese Yuan. The risks of injury claims increased with rising WBGT. 4.8% (95% eCI: 2.9%-6.9%) of work-related injuries and 4.1% (95% eCI: 0.2%-7.7%) of work-related injury insurance payouts were attributed to heat exposure for WBGT threshold above the heat stress limit. Male workers, those in small enterprises and with low educational attainment were especially sensitive to the effects of heat exposure. CONCLUSIONS: Heat stress can contribute to higher risk of work-related injury and substantial economic costs. Quantified the impacts of injuries and related economic costs should be considered to develop targeted preventive measures in the context of climate change.

Identifying windows of susceptibility for maternal exposure to ambient air pollution and preterm birth.

Maternal exposure to ambient air pollution has been associated with preterm birth (PTB), however, entire pregnancy or trimester-specific associations were generally reported, which may not sufficiently identify windows of susceptibility. Using birth registry data from Guangzhou, a megacity of southern China (population ~14.5 million), including 469,975 singleton live births between January 2015 and July 2017, we assessed the association between weekly air pollution exposure and PTB in a retrospective cohort study. Daily average concentrations of PM2.5, PM10, NO2, SO2, and O3 from 11 monitoring stations were used to estimate district-specific exposures for each participant based on their district residency during pregnancy. Distributed lag models (DLMs) incorporating Cox proportional hazard models were applied to estimate the association between weekly maternal exposure to air pollutant and PTB risk (as a time-to-event outcome), after controlling for temperature, seasonality, and individual-level covariates. We also considered moderate PTB (32-36 gestational weeks) and very PTB (28-31 gestational weeks) as outcomes of interest. Hazard ratios (HRs) and 95% confidential intervals (95% CIs) were calculated for an interquartile range (IQR) increase in air pollutants during the study period. An IQR increase in PM2.5 exposure during the 20th to 28th gestational weeks (27.0 µg/m3) was significantly associated with PTB risk, with the strongest effect in the 25th week (HR = 1.034, 95% CI:1.010-1.059). The significant exposure windows were the 19th-28th weeks for PM10, the 18th-31st weeks for NO2, and the 23rd-31st weeks for O3, respectively. The strongest associations were observed in the 25th week for PM10 (IQR = 37.0 µg/m3; HR = 1.048, 95% CI:1.034-1.062), the 26th week for NO2 (IQR = 29.0 µg/m3; HR = 1.060, 95% CI:1.028-1.094), and in the 28th week for O3 (IQR = 90.0 µg/m3; HR = 1.063, 95% CI:1.046-1.081). Similar patterns were observed for moderate PTB (32-36 gestational weeks) and very PTB (28-31 gestational weeks) for PM2.5, PM10, NO2 exposure, but the effects were greater for very PTB. We did not observe any association between pregnancy SO2 exposure and the risk of PTB. Our results suggest that middle to late pregnancy is the most susceptible air pollution exposure window for air pollution and PTB among women in Guangzhou, China.

Assessing Effect Modification of Excess Winter Death by Causes of Death and Individual Characteristics in Zhejiang Province, China: A Multi-Community Case-Only Analysis.

Mortality in many parts of the world has a seasonal pattern, with a marked excess of deaths during winter. To date, however, there is very little published evidence on the nature of this wintertime excess in low- and middle-income countries. In this study, we aimed to quantify the extent of the death peak in winter and to assess effect modification on excess winter death (EWD) by individual characteristics and cause of deaths in China. We used a Cosinor model to examine seasonal patterns for specific causes of deaths and a case-only analysis of deaths in winter compared with other seasons to assess effect modification by individual characteristics. A total of 398,529 deaths were investigated between January 2010 and December 2013 in Zhejiang Province, China. Deaths peaked in winter, and overall mortality was around 30% higher in winter than in summer. Although diseases of the respiratory and circulatory systems were highly seasonal, surprisingly we observed that deaths from mental and behavioral disorders exhibited greater fluctuation. Males, the elderly and illiterate individuals suffered high EWD. EWDs were also particularly common in emergency rooms, at home, on the way to hospitals, and in nursing homes/family wards. This study highlighted the high EWD in some previously unreported groups, indicating new information to facilitate the targeting of necessary preventive measures to those at greatest risk in order to mitigate wintertime death burdens.

Effects of prenatal exposure to air pollution on preeclampsia in Shenzhen, China.

The impact of ambient air pollution on pregnant women is a concern in China. However, little is known about the association between air pollution and preeclampsia and the potential modifying effects of meteorological conditions have not been assessed. This study aimed to assess the effects of prenatal exposure to air pollution on preeclampsia, and to explore whether temperature and humidity modify the effects. We performed a retrospective cohort study based on 1.21 million singleton births from the birth registration system in Shenzhen, China, between 2005 and 2012. Daily average measurements of particulate matter <10 µm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), air temperature (T), and dew point (Td) were collected. Logistic regression models were performed to estimate associations between air pollution and preeclampsia during the first and second trimesters, and during the entire pregnancy. In each time window, we observed a positive gradient of increasing preeclampsia risk with increasing quartiles of PM10 and SO2 exposure. When stratified by T and Td in three categories (<5th, 5th -95th, and >95th percentile), we found a significant interaction between PM10 and Td on preeclampsia; the adverse effects of PM10 increased with Td. During the entire pregnancy, there was a null association between PM10 and preeclampsia under Td < 5th percentile. Preeclampsia risk increased by 23% (95% CI: 19-26%) when 5th < Td < 95th percentile, and by 34% (16-55%) when Td > 95th percentile. We also found that air pollution effects on preeclampsia in autumn/winter seasons were stronger than those in the spring/summer. This is the first study to address modifying effects of meteorological factors on the association between air pollution and preeclampsia. Findings indicate that prenatal exposure to PM10 and SO2 increase preeclampsia risk in Shenzhen, China, and the effects could be modified by humidity. Pregnant women should limit air pollution exposure, particularly during humid periods.