Influencing factors of hospitalization cost of hypertension patients in traditional Chinese medicine hospitals.

Objectives: This study aimed to analyze the influencing factors of hospitalization cost of hypertensive patients in TCM (traditional Chinese medicine, TCM) hospitals, which can provide a scientific basis for hospitals to control the hospitalization cost of hypertension. Methods: In this study, 3,595 hospitalized patients with a primary diagnosis of tertiary hypertension in Tianshui City Hospital of TCM, Gansu Province, China, from January 2017 to June 2022, were used as research subjects. Using univariate analysis to identify the relevant variables of hospitalization cost, followed by incorporating the statistically significant variables of univariate analysis as independent variables in multiple linear regression analysis, and establishing the path model based on the results of the multiple linear regression finally, to explore the factors influencing hospitalization cost comprehensively. Results: The results showed that hospitalization cost of hypertension patients were mainly influenced by length of stay, age, admission pathways, payment methods of medical insurance, and visit times, with length of stay being the most critical factor. Conclusion: The Chinese government should actively exert the characteristics and advantages of TCM in the treatment of chronic diseases such as hypertension, consistently optimize the treatment plans of TCM, effectively reduce the length of stay and steadily improve the health literacy level of patients, to alleviate the illnesses pain and reduce the economic burden of patients.

Mobile Health System for Meeting Health Information Needs in Patients With Head and Neck Cancer Undergoing Radiotherapy: Development and Feasibility Study.

Patients with head and neck cancer undergoing radiotherapy encounter physical and psychosocial challenges, indicating unmet needs. Mobile health technology can potentially support patients. This single-armed feasibility study included 30 patients with head and neck cancer undergoing radiotherapy. Patients were asked to use the Health Enjoy System, a mobile health support system that provides a disease-related resource for 1 week. We assessed the usability of the system and its limited efficacy in meeting patients' health information needs. The result showed that the system was well received by patients and effectively met their health information needs. They also reported free comments on the system's content, backend maintenance, and user engagement. This study supplies a foundation for further research to explore the potential benefits of the Health Enjoy System in supporting patients with head and neck cancer.

Evolution and interaction relationship of "eco-economy" dual grid pattern in Lingwu City, Ningxia, China.

Strengthening ecological network construction is an important measure to improve urban ecological environment and protect biodiversity. With Lingwu City of Ningxia as an example, based on remote sensing and social and economic data, we comprehensively analyzed the "double network" (ecological network and social and economic landscape) pattern and their relationship by using morphological spatial pattern analysis, Linkage Mapper, and improved gravity model. The results showed that land use/cover changed dramatically from 2000 to 2020 in Lingwu City. The area of sandy land and grassland decreased sharply, that of forest and construction land increased, and industrial zones expanded rapidly. The connectivity and stability of "dual network" were improved. The intensive areas of human activities were distributed in urban area, oasis agricultural areas, and Ningdong energy industrial zone. The ecological source areas and ecological corridors were mainly distributed in the middle of the nature reserve, while some extended to the other three functional areas. The transportation corridor presented an "H" pattern that was dense in oasis agricultural area and Ningdong energy industrial zone, and connected between the two regions. The "double network" were centered around their respective functional area spaces and had interwoven distributions. The trend of the "double network" changed from conflict to coordinated situation, with obvious zoning and interaction in space. The oasis agricultural area and Ningdong energy industrial area destroyed the eco-logy in the early stage and improved that in the later stage. In the future, it is necessary to strengthen the coordination between ecological protection and social and economic development, which could improve ecological quality by combining measures such as improving the quality of ecological sources and corridors, constructing ecological nodes, and repairing ecological disturbance points.

Assessment of anxiety and depression in patients with Posner-Schlossman syndrome.

BACKGROUND: To assess the anxiety and depression levels in patients with Posner-Schlossman syndrome (PSS) and to determine the potential risk factors. METHODS: In this cross-sectional study, a total of 195 participants, including 93 PSS patients and 102 healthy controls were recruited. Sociodemographic and clinical information were collected for all participants. Hospital Anxiety and Depression scale (HADS) was administered to evaluate the anxiety and depression levels. Visual function (VF) and quality-of-life (QOL) questionnaires were administered to assess variables potentially associated with anxiety and depression. RESULTS: Increased anxiety level was observed in 22 (23.7%) PSS patients as compared to 10 (9.8%) of controls (P = 0.009). While the frequency of depression between the two groups was not significantly different (P = 0.349). The mean anxiety and depression scores were 6.98 ± 4.20 and 6.44 ± 3.66 in PSS patients as compared to 6.67 ± 3.21 (P = 0.564) and 5.96 ± 2.93 (P = 0.311) in controls. Logistic regression analysis showed mental well-being was significantly associated with anxiety (odds ratio [OR] = 0.920, 95% confidence interval [CI] = 0.881-0.962, P < 0.001) and depression (OR = 0.959, CI = 0.926-0.994, P = 0.023) in PSS patients. CONCLUSION: More patients with PSS may experience anxiety as compared to healthy controls. Mental well-being is an independent risk factor for anxiety and depression. It is important for ophthalmologists to be aware of these factors and should pay more attention on mental health when PSS is managed in clinic.

[Spatial Distribution and Risk Assessment of Heavy Metals in Surface Sediments from the Middle and Upper Reaches of the Yangtze River].

The hydrological regime of rivers significantly changes after dam impoundment, which in turn affects the particle composition and heavy metal fractions of the river sediments. From June to July 2019, the sediments from 26 sampling sections were collected along the main stream of the Yangtze River from Panzhihua City in the upper reaches of the Yangtze River to Hukou City in the middle reaches of the Yangtze River. The concentrations and fractions of As, Cd, Co, Cr, Cu, Ni, Pb, and Zn were measured using the BCR three-step extraction procedure. The pollution status and potential ecological risk of heavy metals in sediments were evaluated using the geo-accumulation index, the sediment quality guideline, and the risk assessment coding method (RAC). The results showed that the average particle size of sediments in the upper reaches of the Yangtze River (Jinsha River cascade reservoir section and the Three Gorges reservoir section) decreased from upstream to downstream, the total concentrations of As and Zn increased, and the variation trend in the middle reaches was not obvious. The content of clay particles was significantly positively correlated with the acid-soluble fraction concentrations of Cd and Ni. Cd was mainly in the residual fraction (59.26%) and acid-soluble fraction (24.67%). Large parts of Cr and Ni were residual fractions accounting for 92.41% and 83.41%, respectively. As, Co, Cu, Pb, and Zn were mainly in the residual fraction and the reducible fraction. The order of decrease for the pollution degree (Igeo) of As, Cd, Co, Cr, Ni, and Zn was the Jinsha River, the middle reaches of the Yangtze River, and the Three Gorges Reservoir. The decrease order of bioavailability (RAC) of Cd, Co, Cr, Cu, Ni, and Zn was the Three Gorges Reservoir, the Jinsha River, and the middle reaches of the Yangtze River. The bioavailability of As and Pb decreased in the order of the middle reaches of the Yangtze River, the Three Gorges, and the Jinsha River. According to the classification of the RAC, Cd in the Three Gorges Reservoir area exhibited a high risk with the RAC accounting for 48.44%. Cu, Ni, and Zn showed a low or medium risk.

Comparative assessment of nutritional composition, polyphenol profile and antioxidative properties of wild edible ferns from northeastern China.

Ferns are one of the prevalent species of wild edible plants but one of the least explored terrestrial plants. Therefore, the aim of this study was to assess the nutrient composition, polyphenol profile and antioxidative properties of four wild edible ferns commonly utilized in northeastern China. We studied the content of ash, polysaccharide, protein, fat and mineral elements of the samples. Furthermore, the samples were found to have good total phenolic and total flavonoid contents and some level of antioxidant capacity as determined by 1,1-diphenyl-2-picrylhydrazyl (DPPH), 2,2'-azino-bis(3-ethylbenzothiazoline) 6-sufonic acid (ABTS) and ferric reducing antioxidant power (FRAP). They also exhibited different specific accumulation of polyphenol profiles, estimated by liquid chromatography/mass spectrometry (LC/MS). Significance analysis revealed a significant correlation between individual phenolic compounds and the antioxidant activity of the ferns. The results of the study suggest that wild edible ferns are rich in nutritional value and have potential as a natural source of antioxidants.

Unintended consequences of COVID-19 public policy responses on renewable energy power: evidence from OECD countries in the EU.

Since 2020, governments around the world have implemented many types of public policies in response to the outbreak of COVID-19. These dramatic public policies have substantially changed production and consumption activities, thereby temporarily lowering electricity use and greenhouse gas emissions. This study argues that pandemic-induced public policies have unintentionally slowed the transition to renewable energy use in the EU since the decline in greenhouse gas emissions due to the lockdowns helped countries temporarily reduce their total emissions. We employ a fixed-effect model to investigate the effects of different types of COVID-19 public policy responses on electricity production, consumption, and net imports in 12 OECD countries in the EU, and we mainly focus on the share of electricity production from renewable energy sources. Among several public policy responses, stringent lockdown policies, such as workplace closures, stay-at-home requirements, and restrictions on gathering size, have negative and statistically significant impacts on electricity generation and consumption. Furthermore, countries with stringent lockdown policies are more likely to import electricity from other countries to mitigate the electricity shortages in their domestic markets. Importantly, we find that lockdown events have negative and statistically significant effects on the share of renewables in electricity production while increasing the share of fossil fuels in electricity production. In contrast, economic support policies such as income support, debt relief, and economic stimulus programs help reduce the share of fossil fuels in electricity production and decrease the net import of electricity from other countries. Our results indicate that the public policies implemented in response to the outbreak of COVID-19 have mixed effects on the transition to renewable energy sources in the EU, suggesting that the current decline in greenhouse gas emissions comes from the reduction in electricity use due to lockdown events instead of the adoption of renewable energy use and discouraging the transition to renewable energy sources.

A Decade of Scientific and Technological Innovation at Chinese Academy of Medical Sciences & Peking Union Medical College: Retrospect and Prospect.

Focusing on the reform initiatives of Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC) in medical scientific and technological innovation from perspectives of deepening the reform and optimizing the ecosystem of science and technology innovation, this article summarizes the highlights of CAMS & PUMC's efforts in safeguarding people's health and promoting the Healthy China 2030 strategy through scientific and technological innovation in the fields including basic research, disease prevention and treatment, and medical technology in the past ten years. These achievements embody the endeavors and responsibility of CAMS & PUMC in realizing self-reliance and self-improvement of Chinese medical science and technology and highlight its contributions to the development of medical science and technology of China.

The Disease Burden of Primary Intracerebral Hemorrhage in Hunan Province, China in 2018.

BACKGROUND: Hunan Province is a region in China with a high prevalence of intracerebral hemorrhage, especially primary intracerebral hemorrhage (PICH). The objective of this observational study was to assess the disease burden of PICH. METHODS: We searched the Hunan Provincial Health Statistics Direct Reporting and Decision Analysis System to retrieve PICH inpatient and outpatient data and all-population all-cause deaths in Hunan Province in 2018. DisMod II was used to estimate the disability-adjusted life years (DALYs) due to PICH in 2018. RESULTS: In 2018, 30,400 new PICH cases were recorded in Hunan Province. The incidence was higher among men (51.6 per 100,000) than women (29.3 per 100,000). The DALYs due to PICH were 478,000 patient-years, the years of life lost (YLLs) were 452,000 patient-years and the years lived with disability (YLDs) were 27,000 patient-years. In 2018, the rate of DALYs due to PICH was 6.4 patient-years per 1000 individuals, the rate of YLLs was 6.1 patient-years per 1000 individuals, and the rate of YLDs was 0.3 patient-years per 1000 individuals. CONCLUSION: We estimated the DALYs due to PICH in Hunan Province in 2018, thereby providing relevant data for the development of policies and measures for the management of PICH disease burden.

Equivalent efficacy assessment of QL1101 and bevacizumab in nonsquamous non-small cell lung cancer patients: A two-year follow-up data update.

Objective: Anti-vascular endothelial growth factor (VEGF) monoclonal antibodies are an effective means of treating non-small cell lung cancer (NSCLC). Here, we aim to update the equivalent efficacy assessment between QL1101 and bevacizumab based on two-year follow-up data. Methods: In total, 535 eligible NSCLC patients were enrolled in this randomized controlled trial. Patients were randomly assigned 1:1 to the QL1101 group and the bevacizumab group. The full end time of this study was defined as 24 months after the last enrolled patient was randomized. The primary endpoint was the objective response rate (ORR); equivalence was confirmed if the two-sided 90% confidence interval (90% CI) of the relative risk was within the range of 0.75-1.33. The secondary endpoints were progression-free survival (PFS) and overall survival (OS). Results: The two-year updated data showed similar ORR (QL1101 vs. bevacizumab: 53.1% vs. 54.3%; relative risk=0.977; 90% CI: 0.838-1.144), PFS (235 d vs. 254 d, log-rank P=0.311), and OS (577 d vs. 641 d, log-rank P=0.099) results between the QL1101 group and the bevacizumab group. The mean shrinkage ratio of targeted lesions was also similar between the QL1101 group and the bevacizumab group (22.5% vs. 23.5%). For patients who received QL1101 maintenance therapy, similar results were shown between the QL1101 group (n=157) and the bevacizumab group (n=148) (PFS: 253 d vs. 272 d, log-rank P=0.387; OS: 673 d vs. 790 d, log-rank P=0.101; mean tumor shrinkage rate: 26.6% vs. 27.5%). Conclusions: This study reported that QL1101 had similar efficacy in treating nonsquamous NSCLC in terms of ORR, PFS and OS based on two-year updated data, providing a basis for the clinical application of QL1101.

Healthcare utilization and economic burden of myopia in urban China: A nationwide cost-of-illness study.

Background: China contributes to a significant proportion of the myopia in the world. The study aims to investigate the utilization of various correction methods and health service in urban China, and to estimate the cost of myopia treatment and prevention. In addition, we aimed to estimate the cost of productivity loss due to myopia. Methods: The study was a cross-sectional investigation carried out in urban areas in three provinces located in the east (Shanghai), middle (Anhui) and west part (Yunnan) of China, in 2016. A total of 23819 people aged between 5 to 50 years were included. Health utilization and the cost of myopia were analyzed from patients' perspective. Results: The total number of people with myopia in the urban China was estimated to be 143.6 million. The correction rate was 89.5%, 92.1%, and 92.7% for Anhui, Shanghai, and Yunnan (χ2 = 19.5, P < 0.01). Over the recent year, 20.6%, 16.8%, and 28.8% of myopic subjects visited hospital due to myopia, in Anhui, Shanghai and Yunnan. The annual cost of treatment and prevention of myopia was 10.1 billion US dollar (US$, floating from 9.2 to 11.2 billion US$), and the cost per person was 69US$. The annual cost of loss of productivity was estimated to be 6.7 billion US$ for those with mild to moderate visual impairment (floating from 6.1 to 7.4 billion US$), and 9.4 billion US$ (floating from 8.5 to 10.4 billion US$) for those with severe visual impairment to blindness. Therefore, the total economic burden of myopia was estimated as 173.6 billion CNY (26.3 billion US$). Conclusions: The present study shows that myopia leads to substantial economic burden in China. The loss of productivity caused by myopia is an important part of the disease burden compared to the cost of correction and treatment paid by individuals. Therefore, the focus of myopia prevention and control should be to decrease the myopia prevalence, and prevent the uncorrected refractive errors and the irreversible damage of visual acuity by high myopia.

[Historical Changes and Responses to Human Activities of Polycyclic Aromatic Hydrocarbons in Lake Sediments from Northern China During the Past 100 Years].

Polycyclic aromatic hydrocarbons (PAHs) are of concern globally because of their carcinogenic, teratogenic, mutagenic, and bio-accumulative effects. Northern China is one of the regions in China with a high density of lakes; however, the lake aquatic environment is becoming seriously deteriorated, especially from PAH pollution due to the intensification of human activities during the past 100 years. Therefore, the spatial distribution and historical changes in PAHs in lake sediments from northern China were analyzed to indicate their response to anthropogenic emissions and pollution reduction actions. The ω(PAHs) in lake sediments ranged from 18.2 to 1205.0 ng·g-1, and low molecular weight PAHs were the dominant compounds. PAH concentrations increased from the 1950s to a peak level in the 2000s, which was induced mainly by increased energy consumption and rapid economy development, with PAH levels decreasing subsequently in the last 10 years due to craft improvement of wastewater treatment plants and the promotion of new energy policies. Spatially, PAHs pollution in Northeast and North China was more serious than that in Northwest China due to the higher level of economic development and energy consumption. Source apportionment results revealed that historical PAH emissions transferred from biomass combustion to a mixture of coal and petroleum combustion. In addition, the results of ecological risk assessment showed that the synthetic sediment quality index (SeQI) of northern China ranged from 36 to 75, and North and Northeast China posed higher ecological risk than that in Northwest China, with phenanthrene (Phe), acenaphthylene (Ace), acenaphthylene (Acy), and dibenzo(a,h)anthracene (DahA) as the main risk contributors.

Clinical and psychological assessment of patients with rheumatoid arthritis and fibromyalgia: a real-world study.

OBJECTIVES: To assess the clinical features and functional and psychological status of patients with rheumatoid arthritis (RA) and those with fibromyalgia (FM) in a real-world setting. METHOD: Between December 2018 and April 2019, 202 inpatients with RA were enrolled from the Rheumatology and Immunology Department at Peking University People's Hospital and assessed for the presence of FM using the 1990 American College of Rheumatology's classification criteria for FM. Disease activity and functional and psychological status were assessed using the Disease Activity Score in 28 joints (DAS-28), Short-Form 36 (SF-36), Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale, and Visual Analog Scale. RESULTS: Among the patients with RA, 42 (20.8%) had concurrent FM. Compared with patients without FM, patients with FM had higher DAS-28 (6.0 vs. 4.4, P = 0.011) and notably higher tender joint counts (16.5 vs. 4.5, P < 0.001). Patients with RA and FM had worse HAQ scores (1.24 vs. 0.66, P < 0.001) and lower SF-36 scores (28.6 vs. 58.2, P < 0.001). Patients with RA and FM experienced more fatigue (88.1% vs. 50.6%, P < 0.001) and had higher anxiety (10 vs. 4, P < 0.001) and depression scores (12 vs. 6, P < 0.001). No significant differences in erythrocyte sedimentation rate, C-reactive protein concentration, morning stiffness period, or swollen joint counts were found between the groups. CONCLUSIONS: Patients with RA and FM had higher disease activity, a worse functional and psychological status, and poorer quality of life. The DAS-28 may have been overestimated in these patients. When patients with RA do not reach remission, FM should be considered. Key Points • Patients with rheumatoid arthritis and fibromyalgia had a worse functional and psychological status compared with those with rheumatoid arthritis alone. • When patients with rheumatoid arthritis do not reach remission, fibromyalgia should be considered. • Physicians should avoid overtreatment and enable these patients to receive the treatment, such as non-drug interventions, that they need.

Burden and trends of multiple sclerosis in China from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019.

OBJECTIVE: To compare the burden of multiple sclerosis disease indicators in the Asia-Pacific countries, China and globally through the Global Burden of Disease 2019 (GBD2019) Database, and to analyse the changes of multiple sclerosis disease burden in China from 1990 to 2019. STUDY DESIGN: Observational study based on the Global Burden of Disease. SETTING: The relevant incidence, prevalence, death and disability-adjusted life year (DALY) rates and corresponding age-standardised rates (ASRs) and sociodemographic index (SDI) in China, globally and in Asia-Pacific countries were extracted from the GBD2019 Database to further study the age-standardised incidence, prevalence and mortality, and the relationship between DALY rate and SDI. RESULTS: Various disease burden indicators of multiple sclerosis in China are at low level in the world, and the prevalence, incidence and DALY rates have slowly increased from 1990 to 2019. During this period, the age-standardised prevalence rate (ASPR) of multiple sclerosis in China showed an upward trend, while the age-standardised death rate (ASDR), age-standardised DALY rate (ASR-DALY) and age-standardised incidence rate all decreased to varying degrees, which were roughly consistent with the global amplitude changes, and all indicators are similar to most countries in the Asia-Pacific region. As the value of the SDI increases, the ASPR of multiple sclerosis was trending upward, and the ASDR was trending downward. CONCLUSION: Compared with other countries in the Asia-Pacific region, China is in a low state of disease burden indicators. However, as a developing country and the most populous country in the world, the total number of patients is not small, and as a rare disease, the treatment cost is relatively expensive, and the treatment cost of the complications caused by the disease is not low. The construction of the medical security system should be strengthened to reduce its burden on individuals, families and society.

The Patterns of Complementary Feeding and Growth among 12 to 23 Month-Old Children in China.

OBJECTIVE: This study aimed to understand the characteristics of dietary patterns among children aged 12 to 23 months and discusses the relationship between dietary patterns and the growth of children. METHOD: Cross-sectional data were selected from the National Nutrition and Health Systematic Survey for 0 to 18 year-old children in China ( n = 2,449) to describe the patterns of complementary feeding and the growth of children. Cluster analysis was used to analyze complementary feeding patterns, and an analysis of variance and Bonferroni test were conducted to analyze the relationship between Z scores and complementary feeding patterns. RESULTS: Four dietary patterns were identified among the children via cluster analysis. In Pattern 4 ( n = 104, 4.2%), children still consumed milk as their staple food. They displayed the lowest grain, fruit, vegetable, egg, and flesh foods consumption, a medium frequency of breast milk consumption, and a high frequency of dairy product consumption. Pattern 4 had the lowest length-for-age Z scores and weight-for-age Z scores, with -0.10 ± 1.34 and 0.24 ± 1.00, respectively ( F = 7.940, P < 0.001; F = 5.317, P < 0.001). CONCLUSION: Although China is undergoing rapid urbanization and economic development, there is still a phenomenon of insufficient intake of protein-rich foods and dairy-based dietary patterns at the stage of complementary food introduced among children aged 12 to 23 months.

[Screening of Priority Pollutants and Risk Assessment for Surface Water from Shengjin Lake].

Shengjin Lake, which serves as an important National Nature Reserve, is suffering from chemical pollution due to rapid industrial and agricultural development in the circumjacent basin. Therefore, 168 anthropogenic toxic chemicals were determined to examine their spatial distribution and identify priority pollutants using a ranking system based on occurrence(O), persistence(P), bioaccumulation(B), ecological risk(E), and human health risk(H). Ecosystem and human health risks were also assessed. The spatial distribution of pollutants indicated that higher concentrations occur in the upper lake area compared to the middle and lower lake areas because of Jiang Dam. According to the derived priority pollutant list, phthalate esters(PAEs), organochlorine pesticides(OCPs), and heavy metals(HMs) are high-priority pollutants; polychlorinated biphenyls(PCBs), polycyclic aromatic hydrocarbons(PAHs), and volatile organic compounds(VOCs) are medium-priority pollutants; and antibiotics(ANTs) are low-priority pollutants. The ecology risk quotient(RQ) of the high-priority pollutants ranged from 4.3 to 15.9, indicating severe ecology risk to the aquatic organism, and higher risks were found in the upper lake areas. Additionally, the human health risk assessment revealed negligible carcinogenic risks associated with high-priority pollutants. The comprehensive ranking system established in this study can be applied to other lake basins by altering the measured concentrations to screen for priority pollutants, offering a scientific foundation for identifying priority control pollutants for watershed management.

Short-Term Ambient Particulate Air Pollution and Hospitalization Expenditures of Cause-Specific Cardiorespiratory Diseases in China: A Multicity Analysis.

BACKGROUND: Ambient air pollution is leading risk factor for health burden in China. Few studies in China have investigated the economic loss related to short-term exposure to ambient PM2.5, which could trigger acute onset of cardiorespiratory diseases within a few days. METHODS: Daily ambient air pollutants data are obtained for each city from the National Air Quality Monitoring System and daily hospitalization data are obtained from the urban employee-based basic medical insurance scheme database in 74 Chinese cities with an average coverage of 88.5 million urban employees during 2016-2017. A three-stage time-series analytic approach is used in this study to investigate the impact of short-term exposure to ambient fine particulate (PM2.5) air pollution on hospital admissions, expenses and hospital stays of three cause-specific cardiorespiratory diseases, including lower respiratory infections (LRI), coronary heart disease (CHD) and stroke in the included cities. FINDINGS: Based on the time-series analysis using daily hospitalization data, 28,560 LRI cases, 54,600 CHD cases, and 23,989 stroke cases are attributable to ambient PM2.5 in the 74 cities during the study period, and the related attributable expenses are 220 million CNY (US$ 32.9 million) for LRI, 458 million CNY (US$ 68.5 million) for CHD, and 410 million CNY (US$ 65.8 million) for stroke, respectively. These attributable numbers account for 1.45% to 2.05% of total hospital admissions and 1.10% to 1.51% of total expenses for the three diseases during 2016-2017, respectively. The attributable numbers for the three cause-specific cardiorespiratory diseases would increase to 362,007 hospital admission cases and 3.68 billion CNY expenses ($US550 million) in the entire urban employee population (299 million) in China during 2016-2017, and the related direct economic loss of absence from work would be 798 million CNY (US$ 119.3 million). INTERPRETATION: Our results support that short-term exposure to ambient PM2.5 pollution could lead to significant health and economic impacts in China. Reducing levels of ambient PM2.5 can avoid substantial health damage and expenditures, and generate appreciable economic benefits from decreasing absence from work. FUNDING: Natural Science Foundation of China (82073509, 71903010, 71903011), and the National Key Research and Development Program of China (2017YFC0211600, 2017YFC0211601).

[Changes in Water Chemistry and Driving Factors in the Middle and Lower Reaches of the Beijing-Hangzhou Grand Canal].

To reveal the Beijing-Hangzhou Grand Canal natural water chemistry characteristics and the influence of human activities, river samples from Xuzhou to Jiaxing were collected in 2019-2020. Simultaneously, the water chemistry data of the canal from 1959 to 1962 and 1975 to 1977 in the Suzhou, Wuxi, and Changzhou sections and the recent social and economic data of the major cities along the canal were collected and analyzed. The results showed that the type of hydrochemistry in the study area was mainly influenced by the weathering of carbonate rocks in the basin, but K++Na+ accounted for 40.39% of the cation equivalent concentration, which was higher than that in ordinary surface water, thereby indicating that the natural hydrochemistry of the canal had been significantly affected by human factors. Spatially, the major ion mass concentrations, total hardness, and total alkalinity of the Grand Canal from Xuzhou station to the downstream area tended to decrease overall, but the parameters at Wuxi and Suzhou stations increased significantly. It was found that Na+ and SO42- were increased by approximately 16 and 12 times and total dissolved solids was increased by nearly 3 times by analyzing the 60 years of water chemistry of the Suzhou, Wuxi, and Changzhou sections. The current (Ca2++Mg2+)/HCO3- ratio in the Suzhou, Wuxi, and Changzhou sections is generally greater than 1, which is significantly higher than that from 1959 to 1962, thereby reflecting the results of human activities. According to the analysis of the social and economic development of the Grand Canal, this change was the result of the accelerated weathering of carbonate rocks in the basin caused by the sulfur oxides discharged by human activities. Further statistical analysis showed that urban domestic sewage and industrial wastewater discharge were the main driving factors causing chemical salinization of natural water in the Grand Canal. This study can provide a scientific basis for coordinating urban development and protecting the water ecological environment of the Grand Canal Basin.

Family Socioeconomic Status and Social Media Addiction in Female College Students: The Mediating Role of Impulsiveness and Inhibitory Control.

There is increasing evidence that low family socioeconomic status (SES) not only is a social issue, but also is a precursor to addiction to social media and other technologies. The authors investigated the relationship between family SES, stress, impulsiveness and inhibitory control, and social media addiction among Chinese female college students. The findings revealed that in lower-SES families, increased social media addiction was associated with reduced inhibitory control and increased stress and impulsiveness. A structural equation model was used to examine the mediation model hypothesis, and the results confirmed the mediating role of no-planning impulsiveness and inhibitory control between family educational level and social media addiction among Chinese female college students. These findings demonstrate the importance of reducing impulsiveness and improving inhibitory control for preventing social media addiction in female college students of low SES. Future studies are required to confirm precursors to social media addiction, elucidate causal mechanisms, and support the explanatory model of social media addiction.