Revisiting the relationships between energy consumption, economic development and urban size: A global perspective using remote sensing data.

Existing methods of measuring energy consumption require complex statistics and computing. A real-time and globally applicable approach for comparing energy consumption across different cities is still lacking. Additionally, the nonlinear relationships and varying thresholds of energy consumption in relation to economic activities and urbanization remain unconfirmed. This study aims to fill these gaps by utilizing Suomi National Polar-orbiting Partnership Visible Infrared Imaging Radiometer Suite (NPP-VIIRS) nighttime light data in 2015 and a top-down approach based on a multiple regression model to examine energy consumption in global cities employing a redefined urban boundary. It also explores the accurate relationship between energy consumption, population density (as a proxy of urbanization), and per capita gross domestic product (GDP) across different regions and urban sizes using generalized additive models and regression models. High-resolution gridded population and GDP datasets covering the entire planet are utilized for this purpose. The study also estimates the development potentiality. The study yields followings outcomes: Firstly, the top 30 cities with the highest per capita energy consumption account for over 0.66% of the total per capita energy consumption of all cities. Secondly, in East Asia (EA) and Southeast Asia (SEA), the per capita energy consumption decreases when per capita GDP reaches $40,000 and $75,000, respectively, while it remains stable in cities located in Western Europe (WE) and North America (NA) as per capita GDP increases. Thirdly, the per capita energy consumption declines with increasing urban population density until reaching 10,000 person/km2, 22,000 person/km2, and 4000 person/km2 in EA, SEA, and NA, respectively. Fourthly, in Central Asia (CA), megacities can save over 100 Mbtu/population when per capita GDP increases by $1000 compared to big cities. This pioneering study provides a comparable investigation of energy consumption at the global city level, exploring its relationship with urbanization and economy by employing a unified calculation standard. It will facilitate long-term energy-saving policies and urban planning strategies.

Invasiveness assessment by artificial intelligence against intraoperative frozen section for pulmonary nodules ≤ 3 cm.

PURPOSE: To investigate the performance of an artificial intelligence (AI) algorithm for assessing the malignancy and invasiveness of pulmonary nodules in a multicenter cohort. METHODS: A previously developed deep learning system based on a 3D convolutional neural network was used to predict tumor malignancy and invasiveness. Dataset of pulmonary nodules no more than 3 cm was integrated with CT images and pathologic information. Receiver operating characteristic curve analysis was used to evaluate the performance of the system. RESULTS: A total of 466 resected pulmonary nodules were included in this study. The areas under the curves (AUCs) of the deep learning system in the prediction of malignancy as compared with pathological reports were 0.80, 0.80, and 0.75 for all, subcentimeter, and solid nodules, respectively. Additionally, the AUC in the AI-assisted prediction of invasive adenocarcinoma (IA) among subsolid lesions (n = 184) was 0.88. Most malignancies that were misdiagnosed by the AI system as benign diseases with a diameter measuring greater than 1 cm (26/250, 10.4%) presented as solid nodules (19/26, 73.1%) on CT. In an exploratory analysis involving nodules underwent intraoperative pathologic examination, the concordance rate in identifying IA between the AI model and frozen section examination was 0.69, with a sensitivity of 0.50 and specificity of 0.97. CONCLUSION: The deep learning system can discriminate malignant diseases for pulmonary nodules measuring no more than 3 cm. The AI model has a high positive predictive value for invasive adenocarcinoma with respect to intraoperative frozen section examination, which might help determine the individualized surgical strategy.

Study on dietary intake, risk assessment, and molecular toxicity mechanism of benzo[α]pyrene in college students in China Bashu area.

As an extremely strong polycyclic aromatic hydrocarbon carcinogen, benzo[α]pyrene (BaP) is often produced during food processing at high temperatures. Recently, food safety, as well as toxicity mechanism and risk assessment of BaP, has received extensive attention. We first constructed the database of BaP pollution concentration in Chinese daily food with over 104 data items; collected dietary intake data using online survey; then assessed dietary exposure risk; and finally revealed the possible toxicity mechanism through four comparative molecular dynamics (MD) simulations. The statistical results showed that the concentration of BaP in olive oil was the highest, followed by that in fried meat products. The margins of exposure and incremental lifetime cancer risk both indicated that the dietary exposure to BaP of the participants was generally safe, but there were still some people with certain carcinogenic risks. Specifically, the health risk of the core district population was higher than that of the noncore district in Bashu area, and the female postgraduate group was higher than the male group with bachelor degree or below. From MD trajectories, BaP binding does not affect the global motion of individual nucleic acid sequences, but local weak noncovalent interactions changed greatly; it also weakens molecular interactions of nucleic acid with Bacillus stearothermophilus DNA polymerase I large fragment (BF), and significantly changes the cavity structure of recognition interface. This work not only reveals the possible toxicity mechanism of BaP, but also provides theoretical guidance for the subsequent optimization of food safety standards and reference of rational diet.

The role of individual service and team-based service price in the online environment: A view from the price difference.

Different from the traditional medical market, the online medical market allows physicians considerable discretion in setting prices of their services, which is beginning to be paid close attention to. Physicians face a challenge with the introduction of various service styles. Guided by transaction utility theory and price fairness, this study aims to investigate the influence of pricing strategy on service demands from the price difference perspective by focusing on two typical service models: individual service and team-based service. Moreover, team characteristics (response speed and team size) are also considered. The data collection was done in March 2018 and repeated in May 2018, and physicians who provide both individual service and team-based services are included in our study. Finally, a dataset consisting of 1,100 teams with 1,100 physician leaders from 14 departments such as obstetrics and gynecology department were collected from an online medical platform in China. Empirical results support most of our hypotheses. A negative influence of team-based price was observed. As a substitute service, a higher individual service price will make patients turn to team-based service. Moreover, individual service prices negatively moderated the relationship between team-based service prices and demands. By calculating the price difference between the individual service price and the team-based service price, we found a negative role of the price difference affecting patient purchase decisions. Although we did not find a significant effect of team size, a quick response can attract more patients. Price fairness provides a proper framework for understanding pricing strategy in individual and team-based service in an online environment. Understanding the effects of prices from a price difference perspective has both theoretical and practical contributions. Specifically, this study contributes to knowledge on price fairness, online medical platforms, and virtual teams, and provides management suggestions.

Characterization, source apportionment, and risk assessment of polycyclic aromatic hydrocarbons (PAHs) in urban soils from 23 cities in China.

Concentrations, composition profiles, sources, and health risks of 16 USEPA priority polycyclic aromatic hydrocarbons (PAHs) in urban soils from 23 cities across China based on metadata collected from previous studies between 2005 and 2021 were investigated. ΣPAH concentrations in urban soils from 23 cities across China ranged from 0.1231 to 17.2000 mg/kg (mean = 2.7171 ± 3.8276 mg/kg). Overall PAH contamination in urban soils across China was moderate compared to that in global cities. Based on energy consumption and climate conditions, the spatial distributions of mean ΣPAH concentrations in Northeast China were highest, followed by those in North China, West China, East China, and South China. Individual PAH composition profiles decreased in the order: 4-ring PAHs (41.36%) > 5-ring PAHs (21.77%) > 3-ring PAHs (18.53%) > 6-ring PAHs (14.00%) > 2-ring PAHs (2.27%). Diagnostic ratios and positive matrix factorization (PMF) revealed that PAHs in urban soils were mainly derived from fossil fuel combustion (from coal, natural gas, and biomass), especially in North, Northeast, and East China, with smaller contributions from petrogenic sources. Health risk assessment results suggest that although there are potential cancer risks from PAHs, risks were acceptable. Toxic equivalent concentration (TEQ) and the corresponding oral cancer slope factor (CFS0) contributed most to the uncertainty of total risks. This study will help develop strategies to reduce PAH risk management in urban soils in China.

Occurrence characteristics and health risk assessment of per- and polyfluoroalkyl substances from water in residential areas around fluorine chemical industrial areas, China.

Recently, identifying the contamination status and assessing the health risk of per- and polyfluoroalkyl substances (PFASs) in surface water and groundwater have been of great significance. Eighteen individual PFASs were analyzed in thirty-three surface/groundwater samples during one period in a fluorine chemical park (Park A) and during two periods in Park B. The mean total concentration of 18 PFASs (∑PFASs) in Park A (9104.63 ng·L-1) was significantly higher than that in the wet season (WS) (801.68 ng·L-1) or DS (714.64 ng·L-1) in Park B. The perfluorobutane sulfonate (PFBS) was the predominant substance in the two parks, and the maximum concentration in groundwater exceeded 10,000 ng·L-1. The contamination status in the wet season (WS) was higher than that in the dry season (DS) in Park B. The ∑PFASs in Park A presented an increasing tendency following the groundwater flow direction, whereas this rule was limited to all periods in Park B. Two relative source contributions (RSCs) of 20% or 100% allowed assessing the PFASs risk to different age groups, and the results revealed that some PFASs (4 ≤ C ≤ 7 or 9 ≤ C ≤ 12) were identified as having a low risk quotient (RQ), except for perfluorooctane sulfonate (PFOS) and PFOA (C = 8). The RQmix value mainly relies on PFOA and PFOS, with a larger contribution rate of 80-90%. All assessed cases (case 1, case 2, case 3, and case 4) in all age groups revealed that infants were vulnerable to PFASs influence, followed by children, teenagers, and adults.

Characterization, source apportionment and risk assessment of PAHs in urban surface dust in Shenyang city, China.

Characteristics, profile composition, ecological and human health risk of polycyclic aromatic hydrocarbons in surface dust collected from Shenyang city, China, were investigated. Concentrations of 16 USEPA priority PAHs ranged between 371.57 and 3300.04 µg/kg (mean 1244.76 ± 715.25 µg/kg). Fluoranthene was the most abundant individual PAHs, followed by pyrene, and high molecular weight PAHs, more than three times of low molecular weight PAHs, were the predominant components. Profiles of PAHs showed that 4-ring PAHs were dominant, followed by 3-ring and 5-ring PAHs, and indicated that combustion sources accounted for the most PAHs. Results of diagnostic ratios and positive matrix factorization all suggested that pyrogenic sources were the most important source of PAHs in urban dust, followed by natural gas combustion and petrogenic sources, and traffic emissions would play an increasingly critical role with the increasing of vehicles. Health risk assessment suggested children were the most vulnerable to PAHs compared to adolescents and adults. Ingestion was the most important exposure pathway. The total lifetime cancer risk of 43.33% of sampling sites was higher than 10-6, but the TLCR at all sites was much lower than the highest acceptable risk established by USEPA (10-4).

Seasonal variation, source identification, and risk assessment of organophosphate ester flame retardants and plasticizers in surficial sediments from Liao River estuary wetland, China.

Organophosphate ester (OPE) flame retardants and plasticizers in surficial sediments were collected in Liao River estuarine wetland during the dry, flood, and level periods to understand the seasonal variation, potential sources, and environmental risks. The concentrations of ∑13OPEs ranged from 19.5 to 67.0 ng g-1 dry weight (dw), with an average concentration of 30.6 ng g-1 dw. OPEs pollution displayed a seasonal variation, the concentrations of OPEs in dry period > level period > flood period. Tributyl-n-phosphate was the predominant OPEs, which accounts for 29.7% of ∑13OPEs. Principal component analysis and positive matrix factorization suggested that the pollution sources of OPEs also varied seasonally. The ecological risk of OPEs to aquatic organisms was low, and the non-carcinogenic and carcinogenic risks to human beings were also far below the acceptable level. 2-Ethylhexyl diphenyl phosphate was the major compound causing ecological and non-carcinogenic risk, while tris-(2-chloroethyl) phosphate had the highest carcinogenic risk.

Human Methylmercury Exposure and Potential Impacts in Central Tibet: Food and Traditional Tibetan Medicine.

Methylmercury presents potent neurotoxicity to humans. Fish consumption is the leading source of human exposure to methylmercury worldwide. However, the exposure source in Tibet remains poorly understood because of the scarcity of observational data on most Tibetan foods, although high mercury levels were recently detected in some traditional Tibetan medicines. Here, the results of field investigations show that the joint consumption of traditional Tibetan medicines (TTMs), fish, and rice constitutes a primary exposure pathway to methylmercury in Tibetans and that the probable daily intake of methylmercury is close to that for many coastal regions. People who are young and high-income may have higher methylmercury exposure levels mainly because of economic development and cultural exchanges among regions. Our analysis indicates that a large proportion of the Tibetan population are likely to face a high methylmercury exposure risk and that mercury-susceptible populations in Tibet should be attentive to consuming TTMs with fish.

Distribution, source apportionment, and health risk assessment of polycyclic aromatic hydrocarbons in urban soils from Shenyang, China.

A total of 74 urban topsoil samples were collected from the central area of Shenyang, China. The concentration, distribution, source, and health risk of 16 polycyclic aromatic hydrocarbons (PAHs) were analyzed. The 16 USEPA priority PAHs were detected in all soil samples. The total concentrations of PAHs ranged from 283 to 21,821 ng/g dry weight (dw), with a mean value of 2370 ng/g and median value of 1427 ng/g. The benzo[a]pyrene toxicity equivalent (BaPeq) concentrations ranged from 6.03 to 2403 ng/g dw, with a mean value of 308 ng/g and median value of 185 ng/g. High molecular weight PAHs were the predominant components. The spatial distribution revealed that soil PAH concentrations within the Two Ring Road were high, but low in the south of Hun River. Compared with other urban soils, the pollution of PAHs in urban soils of Shenyang was at a moderate level, but increased rapidly compared with previous years, especially fluoranthene. Diagnostic ratios of PAHs and positive matrix factorization model all suggested that PAHs in urban soils of Shenyang were dominantly from pyrogenic origins. The health risk assessment indicated that children had the highest total carcinogenic risk, followed by adolescents and adults. The differences between gender groups for the same age group were insignificant. Ingestion was the dominant exposure pathway, followed by dermal contact and inhalation. The total lifetime carcinogenic risks at all sampling sites were lower than the highest acceptable risk (10-4), and those of Eastern, Central, and Western Shenyang were higher than those of Northern and Southern Shenyang.

[Application of a technology based on JavaEE in National Rural Environmental Health Monitoring Information Management System].

OBJECTIVE: To establish a national rural environmental health monitoring information management system supporting the application and management of four levels of data at the county, municipal, provincial and national levels, to realize the inter-departmental and cross-platform interconnection service of the national environmental health monitoring information management system. METHODS: JavaEE and BS architecture platform, Web Service, XML and other data application and exchange service technologies were used to set data entry and audit functions, such as logic verification, extreme value verification and inter-table relationship verification for key variables, and also used to make the computer interface automatically configured. RESULTS: The functions of data entry, audit, exchange, historical data query and download, system management and maintenance, monitoring system feedback, data reporting progress of the national rural environmental health monitoring information management system across different departments and platforms can be realized by the JavaEE technology. CONCLUSION: The national rural environmental health monitoring information management system was simple in operation and friendly in interface, and had a good application prospect in the field of public health monitoring data management.

A Spatio-Temporal Pattern and Socio-Economic Factors Analysis of Improved Sanitation in China, 2006⁻2015.

Ensuring an adequate and safe access to sanitation is essential to prevent diseases. Using provincial spatial panel data reported in the China Health Statistical Yearbook and the China Statistical Yearbook, this paper analyzed the spatio-temporal characteristics of improved rural sanitation in 30 Chinese provinces during the period 2006⁻2015, and analyzed factors that may affect improved sanitation rates in rural China. Spatial autocorrelations of improved sanitation rates were computed via Global and Local Moran's I firstly, and then, inter-provincial disparities of improved sanitation were assessed by using the Theil index estimator; finally, the spatial panel model was employed to examine the potential socio-economic factors. Spatial autocorrelations results suggested that the provincial improved sanitation rates changes affect both the provinces themselves and the adjacent regions; Analysis of the spatial panel model revealed that factors such as GDP per capita, investment proportion ratio, centralized water supply, rural residents' expenditure were positively associated with improved sanitation rates, and illiteracy rate of people older than 15 was negatively related with improved sanitation rates. Socio-economic factors had affected the improved sanitation rates in 30 provinces in rural China. Thus, a series of policies, socio-economic measures and personal latrine literacy education should be given to improve the status of improved sanitation rates in rural China.

Predictors of Drinking Water Boiling and Bottled Water Consumption in Rural China: A Hierarchical Modeling Approach.

Approximately two billion people drink unsafe water. Boiling is the most commonly used household water treatment (HWT) method globally and in China. HWT can make water safer, but sustained adoption is rare and bottled water consumption is growing. To successfully promote HWT, an understanding of associated socioeconomic factors is critical. We collected survey data and water samples from 450 rural households in Guangxi Province, China. Covariates were grouped into blocks to hierarchically construct modified Poisson models and estimate risk ratios (RR) associated with boiling methods, bottled water, and untreated water. Female-headed households were most likely to boil (RR = 1.36, p < 0.01), and among boilers those using electric kettles rather than pots had higher income proxies (e.g., per capita TV ownership RR = 1.42, p < 0.01). Higher-income households with younger, literate, and male heads were more likely to purchase (frequently contaminated) bottled water, or use electric kettles if they boiled. Our findings show that boiling is not an undifferentiated practice, but one with different methods of varying effectiveness, environmental impact, and adoption across socioeconomic strata. Our results can inform programs to promote safer and more efficient boiling using electric kettles, and suggest that if rural China's economy continues to grow then bottled water use will increase.

A multicenter point-prevalence survey of antibiotic use in 13 Chinese hospitals.

BACKGROUND: The use of antibiotics is considered a major determinant of the development of resistance in organisms. This study assessed current patterns of antibiotic prescription and provides background for quality improvement in general hospitals in Hubei, China. METHODS: A point-prevalence study was performed in November 2008. All inpatients on the day of the survey were included in the analysis. RESULTS: On the day of the study, 6904 patients (56%) were receiving antibiotic therapy; the highest rate occurred in the ICU (90%), and the lowest occurred in the medical wards (39%). The most commonly used antibiotics were ß-lactam antibiotics, including cephalosporins (40%) and piperacillin (19%), followed by fluoroquinolones (14%). CONCLUSIONS: Our data indicated a high rate of antibiotic use in Chinese hospitals. These findings suggest important areas for intervention and the implementation of antibiotic stewardship policies in Chinese hospitals. A multi-faceted strategy should be implemented at the national level in China and should include education, regulation, and greater financial support from the government.

Role of the new rural cooperative medical system in alleviating catastrophic medical payments for hypertension, stroke and coronary heart disease in poor rural areas of China.

BACKGROUND: Hypertension, stroke and coronary heart disease (CHD) are common diseases that impose a heavy burden on patients and their families, particularly on those living in poor areas. This study examined catastrophic medical payments faced by patients with these diseases and the effectiveness of the new rural cooperative medical system (NRCMS) at alleviating the impact of the said diseases in fourth-class rural areas (i.e. those with annual income of less than RMB 1500/$240.2 per capita) of China. METHODS: Data on medical payments, including out-of-pocket and NRCMS-reimbursed expenses were collected through self-administered questionnaires. The pre- and post-reimbursement (via the NRCMS) prevalence of household poverty, catastrophic medical payment (CMP) incidence (H cat), mean CMP gap (Gcat), mean positive CMP gap (MPG cat) and other determinants of CMP incidence were identified. RESULTS: Out-of-pocket payments for treatment of hypertension, stroke and CHD averaged RMB 580.1/$92.9, RMB 3028.4/$484.8 and RMB 1561.4/$250.0 per capita, respectively, in 2008. H cat, Gcat and MPG cat due to the three diseases were 17.0%, 16.6% and 97.6%, respectively, and reimbursement through the NRCMS reduced them to 13.5%, 11.8% and 87.4%, respectively. The difference between pre- and post-reimbursement H cat was not statistically significant. After adjusting the covariates for age [OR = 1.87, 95% confidence interval (CI) = 1.19-2.95], education (OR = 1.56, 95% CI = 1.07-2.27), marital status (OR = 1.67, 95% CI = 1.11-2.51), occupation (OR = 1.96, 95% CI = 1.34-2.85), annual income (OR = 4.95, 95% CI = 3.28-7.48), the multiple logistic regression analysis revealed that patients with stroke (OR = 3.94, 95% CI = 2.38-6.51) or CHD (OR = 2.25, 95% CI = 1.38-3.65) were more susceptible to CMP compared with patients with hypertension only. CONCLUSIONS: Out-of-pocket medical spending on hypertension, stroke and CHD imposes a heavy financial burden on the residents of fourth-class rural areas of China. The NRCMS has some impact on reducing catastrophic medical payments associated with these diseases, but improvement of the reimbursement rate is necessary to further improve its effectiveness.

[Assessment of schistosomiasis transmission interruption in Beichuan County, Sichuan Province].

OBJECTIVE: To assess whether Beichuan County reaches the national standard of schistosomiasis transmission interruption. METHODS: Three villages in Beichuan County were sampled as assessment spots, and the schistosomiasis infections of residents and domestic animals, the status of Oncomelania snails and the past records were assessed according to the Criteria for Control and Elimination of Schistosomiasis in China. RESULTS: No local schistosome infections were found in residents and cattle for successive 5 years and no snails were found for 2 successive years in the 3 villages. The files were documented completely. All the indices reached the national standard of schistosomiasis transmission being interrupted. CONCLUSION: Beichuan County has reached the national standard of schistosomiasis transmission interruption. However, the endemic surveillance of schistosomiasis still needs to continue.

Evaluation of responsiveness of community health services in urban China: a quantitative study in Wuhan City.

BACKGROUND: With the objective of the national health services systems reform to move care to the community, community health services (CHS) are becoming the gateways of the health system in China. This study aims to evaluate the levels and distributions of the responsiveness of CHS in urban China and identify the relevant features to provide the government with policy advice on the improvement of CHS responsiveness. METHODS: A total of 872 face-to-face interviews were conducted in community health centers (CHCs) from 2007 to 2009. Indicators of responsiveness that were recommended by the World Health Organization were adopted, and non-conditional logistic regression analysis was performed to explore the factors associated with the levels and distributions of the responsiveness of CHS. RESULTS: The responsiveness scored at a fairly 'good' level of 7.45, 7.45, and 7.46 for CHS in years 2007, 2008, and 2009, respectively. The representative responsiveness inequality indexes were 0.097, 0.101, and 0.109, respectively, indicating the moderately balanced distributions of responsiveness in these three years. During this period, the scores of responsiveness elements were highest at 7.44 to 8.34 in "dignity", "communication", and "social support", while lowest at 6.76 to 7.54 in "autonomy", "confidentiality", and "basic amenities". The results of the logistic regression analysis suggested that five elements (OR value), namely, "dignity" (1.414-3.345), "communication" (1.218-3.655), "basic amenities" (1.251-2.362), "prompt attention" (1.098-1.590), and "autonomy" (1.416-2.173), had significant associations with CHS responsiveness. CONCLUSIONS: The responsiveness of CHS in Wuhan City was fairly good but still requires further improvement, particularly on the working conditions of CHCs and communication skills trainings among CHS workers.

Random field assessment of nanoscopic inhomogeneity of bone.

Bone quality is significantly correlated with the inhomogeneous distribution of material and ultrastructural properties (e.g., modulus and mineralization) of the tissue. Current techniques for quantifying inhomogeneity consist of descriptive statistics such as mean, standard deviation and coefficient of variation. However, these parameters do not describe the spatial variations of bone properties. The objective of this study was to develop a novel statistical method to characterize and quantitatively describe the spatial variation of bone properties at ultrastructural levels. To do so, a random field defined by an exponential covariance function was used to represent the spatial uncertainty of elastic modulus by delineating the correlation of the modulus at different locations in bone lamellae. The correlation length, a characteristic parameter of the covariance function, was employed to estimate the fluctuation of the elastic modulus in the random field. Using this approach, two distribution maps of the elastic modulus within bone lamellae were generated using simulation and compared with those obtained experimentally by a combination of atomic force microscopy and nanoindentation techniques. The simulation-generated maps of elastic modulus were in close agreement with the experimental ones, thus validating the random field approach in defining the inhomogeneity of elastic modulus in lamellae of bone. Indeed, generation of such random fields will facilitate multi-scale modeling of bone in more pragmatic details.