Occurrence and Exposure Assessment of Nickel in Zhejiang Province, China.

Nickel (Ni) is a silver-white metal with high antioxidative properties, often existing in a bivalent form in the environment. Despite being the fifth most abundant metal on Earth, anthropogenic activities, including industrial processes, have elevated Ni levels in environmental media. This study investigated Ni contamination in various food groups in Zhejiang Province, China, mainly focusing on Ni levels in beans, vegetables, aquatic foods, meat products, cereal products, and fruits. A total of 2628 samples were collected and analyzed. Beans exhibited the highest Ni content in all samples. The overall detection rate of Ni was 86.5%, with variation among food categories. For plant-origin foods, legumes had the highest Ni concentration while for animal-origin foods, shellfish showed the highest median Ni concentration. The results indicate generally acceptable Ni exposure levels among Zhejiang residents, except for children aged 0-6. Beans were identified as the primary contributor to high Ni exposure risk. The paper suggests monitoring Ni contamination in food, especially for vulnerable populations, and provides insights into exposure risks in different age groups.

Industrial agglomeration, FDI, and carbon emissions: new evidence from China's service industry.

In the context of economic servitization and low carbonization, the problem of carbon emissions in the service industry is worthy of attention. An essential channel for restraining carbon emissions from the service industry is industrial agglomeration. Based on provincial panel data from 2004 to 2021 in China, this study empirically analyzes the influence of the service industry's agglomeration on its CO2 emissions. The findings indicate that agglomeration significantly reduces the industry's carbon emissions. Next, producer services agglomeration has a significant carbon-reduction effect, whereas non-producer services agglomeration does not. Moreover, service industry agglomeration helps to restrain carbon emissions from the service industry in East China. However, it does not significantly affect carbon emissions in Central or West China. Regarding the moderating effect, foreign direct investment can enhance service industry agglomeration's carbon-reduction effect. Based on the results, relevant policy implications are provided.

An Occurrence and Exposure Assessment of Paralytic Shellfish Toxins from Shellfish in Zhejiang Province, China.

The intake of paralytic shellfish toxins (PSTs) may adversely affect human health. Therefore, this study aimed to show the prevalence of PSTs from commercially available shellfish in Zhejiang Province, China, during the period of frequent red tides, investigate the factors affecting the distribution of PSTs, and assess the risk of PST intake following the consumption of bivalve shellfish among the Zhejiang population. A total of 546 shellfish samples were collected, 7.0% of which had detectable PSTs at concentrations below the regulatory limit. Temporal, spatial, and interspecific variations in the occurrence of PSTs were observed in some cases. The dietary exposure to PSTs among the general population of consumers only was low. However, young children in the extreme scenario (the 95th percentile of daily shellfish consumption combined with the maximum PST concentration), defined as 89-194% of the recommended acute reference doses, were possibly at risk of exposure. Notably, Arcidae and mussels were the major sources of exposure to toxins. From the public health perspective, PSTs from commercially available shellfish do not pose a serious health risk; however, more attention should be paid to acute health risks, especially for young children, during periods of frequent red tides.

The impact of the digital economy on low-carbon innovation in the Yangtze River Delta region.

This study narrows its focus to the Yangtze River Delta, an important region in China known for its advancements in both digital economy and low-carbon technology. In contrast to previous studies, we also examine the heterogeneous effects between central and non-central cities, as well as the role of local financial development, when analyzing the impact of the digital economy on low-carbon innovation. Based on the data of 41 cities from 2011 to 2019, we find a significant direct promoting effect of the digital economy on low-carbon innovation. Furthermore, the development of the digital economy indirectly enhances low-carbon innovation through local financial development. The heterogeneous analysis reveals a positive impact of the digital economy on low-carbon innovation in both central and non-central cities, with a stronger effect observed in non-central cities. These findings suggest several policy recommendations, including promoting digital economy and finance, green finance, and fostering regional integration in the Yangtze River Delta.

[Occurrence and exposure assessment of fumonisins from grains and grain products in Zhejiang Province in 2018-2019].

OBJECTIVE: To monitor fumonisins(FBs) in grains and grain products in Zhejiang and assess the exposure risks of FBs to local residents. METHODS: Liquid chromatography coupled with tandem mass spectrometry method was used to determine the occurrence of FBs in rice, millet, dried noodles, instant noodles, and maize grains, and food frequency questionnaires were used to collect the food consumption data of Zhejiang population. Then, the simple probability distribution model was used to assess the exposure risk. RESULTS: The levels of FBs in rice, millet, dried noodles and instant noodles were relatively low. The occurrence of FB_1, FB_2 and FB_3 in these foods was 0-23.7%, 0-16.7% and 0-5.4%, respectively, and the mean levels were not detected(ND)-22.36, ND-20.63 and ND-7.19 µg/kg correspondingly. However, the levels of FBs in maize grains were relatively high. The occurrence of FB_1, FB_2, and FB_3 in maize grains was 100%, 93.6% and 90.3%, respectively, and the mean levels were 638.99, 103.54 and 59.69 µg/kg correspondingly. In 12.9% of the maize grain samples, the levels of FBs were higher than the standard reference. The residents were at low exposure risk overall. The mean estimated daily intake(EDI) of FBs was far lower than the provisional maximum tolerable daily intake of 2 µg/(kg·BW·d). However, 0.30% of the residents were at high risk. Among people of different ages, the mean EDI of children, adults, and elderly were 0.43, 0.28 and 0.29 µg/(kg·BW·d) respectively, and children were in the highest exposure levels of FBs. Among the tested five foodstuffs, rice and maize grains were the main sources of FBs exposure. CONCLUSION: Except for maize grains, the levels of FBs in grains and grain products were relatively low, and Zhejiang residents were at low FBs exposure risk generally.

Vaccine inequity-induced COVID-19 dilemma: Time to sober up.

UNSTRUCTURED: The ongoing coronavirus disease 2019 pandemic has not only posed a serious threat to public health but has also imposed a heavy burden on medical systems and global economies. To combat this challenge, unprecedented efforts have been made by governments and the scientific community in the development and production of vaccines. As a result, less than a year elapsed between identification of a novel pathogen sequence and large-scale vaccine rollout. However, much of the focus and debate has increasingly shifted to the looming risk of global vaccine inequity and whether we could do more to modify this risk. In this paper, we first outline the scope of inequitable vaccine distribution and identify its truly catastrophic consequences. Then, from the perspectives of political will, free markets and profit-driven enterprises based on patent and intellectual property protection, we analyze in-depth the root causes why this phenomenon is so difficult to combat. Apart from these, some specific and crucial solutions that should be undertaken in the long term were also put forward, in order to provide a useful reference for the authorities, stakeholders and researchers involved in addressing this global crisis and the next one.

Trace heavy metals and harmful elements in roots and rhizomes of herbs: Screening level analysis and health risk assessment.

Objective: Heavy metal and harmful element contamination are frequently reported in Chinese herbal medicines (CHMs), and roots and rhizomes parts showed a higher content than other parts. To investigate the residue level and assess the potential human health risk of heavy metals and harmful elements in roots and rhizomes, 720 batches of the sample representing 20 species of herbs from different sources were collected. Methods: The content of Pb, Cd, As, Hg, and Cu in the digests was determined using ICP-MS. The chronic hazard index estimate based on non-cancer hazard quotient (HQ) was applied for potential health risk assessment of Pb, Cd, As, Hg, and Cu via consumption of CHMs. Results: Compared with the Chinese limit standard (Chinese Pharmacopoeia Commission, 2020 edition) of Pb, Cd, As, Hg, and Cu in Ginseng Radix et Rhizoma, the exceedance percentage of Pb in total samples was 14.1%, which were generally far higher than Cd, As, Hg, and Cu. Health risk assessment results based on hazard quotient calculating showed that total HQ of Cu, Pb, As, Cd, and Hg in Pulsatillae Radix and Clematidis Radix et Rhizoma exceeded 1, with the value of 1.543 and 1.235. Besides, Arsenic had the highest HQ value (0.957) in Pulsatillae Radix . Conclusion: Consuming raw materials of Pulsatillae Radix and Clematidis Radix et Rhizoma may pose a potential risk and Arsenic residues in Pulsatillae Radix deserved special attention.

Occurrence and Exposure Assessment of Deoxynivalenol and Its Acetylated Derivatives from Grains and Grain Products in Zhejiang Province, China (2017-2020).

Deoxynivalenol (DON) together with its acetylated derivatives cause detrimental effects on human health, and the purpose of this study was to assess the prevalence of DON and its acetylated derivatives from grains and grain products in Zhejiang province, China, and to assess the risk of DON and its acetylated derivatives due to multiple consumptions of grains and grain products among the Zhejiang population. Food samples numbering 713 were collected, and the LC-MS/MS method was used to determine the toxins. The levels of toxins from grains and grain products were relatively low: DON was the toxin at the highest levels. The food frequency questionnaire was used to collect food consumption data. The result of exposure assessments showed that the population was overall at low levels of toxin exposure. The probable mean group daily intake of toxins was 0.21 µg/kg bw/day, which was far from the group provisional maximum tolerable daily intake of 1 µg/kg bw/day, but 0.71% of participants were at high exposure levels. Rice and dried noodles (wheat-based food) were the main sources of toxin exposure, and reducing the consumption of rice and dried noodles while consuming more of other foods with lower levels of toxins is recommended.

Analysis of the Implementation Effect of College Curriculum Ideological and Political under the Background of Ecological Sustainable Development.

Our country is paying more and more attention to ecological issues. How to put ecological sustainable development in real life is a key problem. This article discusses the significance of integrating ecological sustainable development and college ideological political courses. Therefore, an experiment was designed to analyse the model of ecology and other courses. The final experiment showed the following: (1) The ecological sustainable development model can be well integrated into the students in their courses. Students can freely choose to study some quality assurance thought courses and reinforce their spiritual level. The mentality of this model can also self-optimize to solve students' troubles in choosing courses and consider the level of students intimately. (2) According to the experimental data of the figures and tables, it is concluded that the form "other professional courses" at my country is still very serious, and the popularization of ideological and political courses is not common, so it is a little troublesome to carry out work, but our system model is very characteristic. With its help, we have obtained the effect of the integration of ecological sustainable development and students' curriculum. The state has vigorously provided economic support for their development. Under their influence, students have gradually maintained their awareness of protecting the environment. Socioeconomic and environmental conditions are also improving. However, in the future, the times will change, and we will continue to update the system model to adapt to more challenges.

Occurrence and exposure assessment of aflatoxins in Zhejiang province, China.

The purpose of this study was to assess the risk of aflatoxins due to multiple food consumption among the Zhejiang population. Ultra-high-performance liquid chromatography coupled with tandem mass spectrometry method was used to determine aflatoxins in 792 samples. Aflatoxins were detected in 27.1% of the samples at levels between 0.07 and 262.63 µg kg-1, and aflatoxins B1 was the most frequently detected among different types of samples. 0.8% of peanut oil, 3.39% of nut products as well as 1.1% of condiments contaminated with aflatoxins B1 exceeded China national tolerance limits. Peanut oil had the highest incidence of aflatoxin, with a range from 0.17 to 22.50 µg kg-1. Using bags conferred limited advantages in reducing aflatoxin contents. Moreover, peanut and rice were the main contributors to dietary exposure to aflatoxins among Zhejiang residents. Finally, the margin of exposure values obtained by rice consumption were far from the safe margin of 10,000, indicating a potential risk to public health. The results pointed out the need for further prioritization of aflatoxins B1 risk-management actions in Zhejiang.

IL-27 signalling promotes adipocyte thermogenesis and energy expenditure.

Thermogenesis in brown and beige adipose tissue has important roles in maintaining body temperature and countering the development of metabolic disorders such as obesity and type 2 diabetes1,2. Although much is known about commitment and activation of brown and beige adipose tissue, its multiple and abundant immunological factors have not been well characterized3-6. Here we define a critical role of IL-27-IL-27Rα signalling in improving thermogenesis, protecting against diet-induced obesity and ameliorating insulin resistance. Mechanistic studies demonstrate that IL-27 directly targets adipocytes, activating p38 MAPK-PGC-1α signalling and stimulating the production of UCP1. Notably, therapeutic administration of IL-27 ameliorated metabolic morbidities in well-established mouse models of obesity. Consistently, individuals with obesity show significantly decreased levels of serum IL-27, which can be restored after bariatric surgery. Collectively, these findings show that IL-27 has an important role in orchestrating metabolic programs, and is a highly promising target for anti-obesity immunotherapy.

Three-dimensional heterogeneity analysis of climate aid's carbon reduction effect.

Exploring the effectiveness of climate aid is crucial to distribute funds scientifically and maximize its impact. A body of related literature has estimated the impact of international climate aid on carbon emissions. However, these studies did not adequately consider the multi-dimensional heterogeneity of climate aid's carbon reduction effect. Based on national panel data of 77 recipients from 1980 to 2016, this study is the first to analyze the heterogeneous characteristics of climate aid's carbon reduction effect from three dimensions of emission level, aid level, and income level. Results show that, totally speaking, climate aid has a significant negative effect on carbon emissions in recipient countries. From the perspective of heterogeneity, climate aid has significant reduction effects for the recipient countries with middle-emission level. Meanwhile, climate aid also has significant negative effects on carbon emissions in recipient countries with high-aid level, i.e., only when the amount of aid reaches relatively high levels can climate aid play its role in reducing emissions. Furthermore, climate aid only conducts a significant reduction effect for middle-income recipients. This study recommends proposing a new collective quantified financial target, pursuing low-carbon economic development, optimizing the aid distribution, and enhancing capacity building to maximize the effectiveness of climate aid.

Human health risk assessment of pesticide residues in honeysuckle samples from different planting bases in China.

The buds and initial flowers of honeysuckle (Lonicera japonica Thunb.) are most widely used in traditional Chinese medicines (TCMs). In recent years, the problem of pesticide residues in honeysuckle has attracted much attention. This research aimed to study pesticide residual situation of honeysuckle in China and estimate the potential health risks for consumers using the HQ (hazard quotient) and HI (hazard index) methods. A reliable and robust method was established to determine and quantify 137 pesticide residues simultaneously by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) for 151 honeysuckle samples from different planting bases in China in 2017 and 2018. Fifty-four pesticides were detected in total, including 10 unauthorized pesticides (chlorpyrifos, fipronil, carbofuran, omethoate, isofenphos-methyl, triazophos, methomyl, dimethoate, methidathion, and methamidophos). One hundred and fifty (99.3%) samples contained at least 1 and up to 31 pesticides and/or their metabolites, with concentrations ranging from 0.001 to 3.087 mg/kg. Carbendazim, chlorbenzuron, imidacloprid, chlorpyrifos, and acetamiprid were the most frequently detected pesticides in 2017 and 2018, and the corresponding detection rates were 95.31%, 64.06%, 65.63%, 53.13%, 57.81%, and 98.85%, 88.51%, 70.11%, 77.01%, 57.47%, respectively. The acute hazard quotient (HQa) of carbofuran was 1.54 for specific population (fetus, infants, and pregnant or nursing women), which indicated that it posed a potential acute health risk. In the cumulative risk assessment, the acute hazard index (HIa) of insecticides in honesuckle for children and the specific population were 1.34 and 3.36, respectively, suggesting that they posed potential acute cumulative health risks. These results were of theoretical and practical value for evaluating the safety of honeysuckle and improving its quality and safety.

Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?

BACKGROUND: Few studies have looked under the hood of practice redesign to understand whether and, if so, how staffing changed with the adoption of patient-centered medical home (PCMH), and whether these staffing changes impacted utilization. OBJECTIVES: To examine the workforce transformation occurring in community health centers that have achieved PCMH status, and to assess the relationship of those changes to utilization, as measured by the number of visits. RESEARCH DESIGN, SUBJECTS, MEASURES: Using a difference-in-differences approach, we compared staffing and utilization outcomes in 450 community health centers that had adopted a PCMH model between 2007 and 2013 to a matched sample of 243 nonadopters located in the 50 states and the District of Columbia. RESULTS: We found that adopting a PCMH model was significantly associated with a growth in use of advanced practice staff (nurse practitioners and physician assistants) [0.53 full-time equivalent (FTE), 8.77%; P<0.001], other medical staff (medical assistants, nurse aides, and quality assurance staff) (1.23 FTE, 7.46%; P=0.001), mental health/substance abuse staff (0.73 FTE, 17.63%; P=0.005), and enabling service staff (case managers and health educators) (0.36 FTE, 6.14%; P=0.079), but not primary care physicians or nurses. We did not observe a significant increase in utilization, as measured in total number of visits per year. However, the visits marginally attributed to advanced practice staff (539 FTE, 0.89%; P=0.037) and mental health/substance abuse staff (353 FTE, 0.59%; P=0.051) significantly increased. CONCLUSIONS: Our findings suggest that the implementation of PCMH actively reengineers staff composition and this, in turn, results in changes in marginal utilization by each staff type.

The 2015 Class of Hospice and Palliative Medicine Fellows-From Training to Practice: Implications for HPM Workforce Supply.

CONTEXT: A relatively new specialty, hospice and palliative medicine (HPM), is unusual in that physicians can enter from 10 different specialties. This study sought to understand where HPM physicians were coming from, where they were going to practice, and the job market for HPM physicians. OBJECTIVES: Describe characteristics of the incoming supply of HPM physicians, their practice plans, and experience finding initial jobs. METHODS: In October 2015, we conducted an online survey of physicians who completed accredited HPM fellowships the previous June. We had electronic mail addresses for 195 of the 243 graduating fellows. RESULTS: About 112 HPM fellows responded (58% of those invited). The most common prior training was internal medicine (45%), followed by family medicine (23%), pediatrics (12%), and emergency medicine (10%). More than 40% had practiced medicine before their HPM training. After graduation, 97% were providing 20 or more hours per week of patient care, with most hours in palliative care. About 72% devoted more than 20 hours per week to palliative care, whereas only 13% worked that much in hospice care. About 81% reported no difficulty finding a satisfactory practice position. About 98% said that they would recommend HPM to others, and 63% took the time to provide written comments that were highly positive about the specialty. CONCLUSION: New HPM physicians are finding satisfying jobs. They are enthusiastic in recommending the specialty to others. Most are going into palliative medicine, leaving questions about how the need for hospice physicians will be filled. Although jobs appear to be numerous, there are practice areas with more limited opportunities.