Machine learning reveals the selection pressure exerted by nonantibiotic pharmaceuticals at environmentally relevant concentrations on antibiotic resistance genotypes.

The emergence and increasing prevalence of antibiotic resistance pose a global public risk for human health, and nonantimicrobial pharmaceuticals play an important role in this process. Herein, five nonantimicrobial pharmaceuticals, including acetaminophen (ACT), clofibric acid (CA), carbamazepine (CBZ), caffeine (CF) and nicotine (NCT), tetracycline-resistant strains, five ARGs (sul1, sul2, tetG, tetM and tetW) and one integrase gene (intI1), were detected in 101 wastewater samples during two typical sewage treatment processes including anaerobic-oxic (A/O) and biological aerated filter (BAF) in Harbin, China. The impact of nonantibiotic pharmaceuticals at environmentally relevant concentrations on both the resistance genotypes and resistance phenotypes were explored. The results showed that a significant impact of nonantibiotic pharmaceuticals at environmentally relevant concentrations on tetracycline resistance genes encoding ribosomal protection proteins (RPPs) was found, while no changes in antibiotic phenotypes, such as minimal inhibitory concentrations (MICs), were observed. Machine learning was applied to further sort out the contribution of nonantibiotic pharmaceuticals at environmentally relevant concentrations to different ARG subtypes. The highest contribution and correlation were found at concentrations of 1400-1800 ng/L for NCT, 900-1500 ng/L for ACT and 7000-10,000 ng/L for CF for tetracycline resistance genes encoding RPPs, while no significant correlation was found between the target compounds and ARGs when their concentrations were lower than 500 ng/L for NCT, 100 ng/L for ACT and 1000 ng/L for CF, which were higher than the concentrations detected in effluent samples. Therefore, the removal of nonantibiotic pharmaceuticals in WWTPs can reduce their selection pressure for resistance genes in wastewater.

High-risk antibiotics positively correlated with antibiotic resistance genes in five typical urban wastewater.

Antibiotic resistance genes (ARGs) and antibiotic amount increased within close proximity to human dominated ecosystems. However, few studies assessed the distribution of antibiotics and ARGs in multiple ecosystems especially the different urban wastewater. In this study, the spatial distribution of ARGs and antibiotics across the urban wastewater included domestic, livestock, hospital, pharmaceutical wastewater, influent of the wastewater treatment plant (WWTP) in Northeast China. The q-PCR results showed that ARGs were most abundant in community wastewater and followed by WWTP influent, livestock wastewater, pharmaceutical wastewater and hospital wastewater. The ARG composition differed among the five ecotypes with qnrS was the dominant ARG subtypes in WWTP influent and community wastewater, while sul2 dominant in livestock, hospital, pharmaceutical wastewater. The concentration of antibiotics was closely related to the antibiotic usage and consumption data. In addition to the high concentration of azithromycin at all sampling points, more than half of the antibiotics in livestock wastewater were veterinary antibiotics. However, antibiotics that closely related to humankind such as roxithromycin and sulfamethoxazole accounted for a higher proportion in hospital wastewater (13.6%) and domestic sewage (33.6%), respectively. The ambiguous correlation between ARGs and their corresponding antibiotics was detected. However, antibiotics that exhibited high ecotoxic effects were closely and positively correlated with ARGs and the class 1 integrons (intI1), which indicated that high ecotoxic compounds might affect antimicrobial resistance of bacteria by mediating horizontal gene transfer of ARGs. The coupling mechanism between the ecological risk of antibiotics and bacterial resistance needed to be further studied, and thereby provided a new insight to study the impact of environmental pollutants on ARGs in various ecotypes.

Land-derived wastewater facilitates antibiotic resistance contamination in marine sediment of semi-closed bay: A case study in Jiaozhou Bay, China.

The emergence of antibiotic resistance is a severe threat to public health. There are few studies on the effects of sewage discharge on antibiotics and antibiotic resistance genes (ARGs) contamination in Jiaozhou Bay sediment. Herein, a total of 281 ARG subtypes, 10 mobile genetic elements (MGEs), 10 antibiotics and bacterial communities in marine sediments from Jiaozhou Bay were characterized. Similar bacterial community structures and ARG profiles were identified between the various sampling sites inside the bay, which were both dominated by multidrug and (fluoro)quinolone resistance genes and harbored lower relative abundances of ARGs than those in the sampling sites near the bay exit. Compared with antibiotics and MGEs, bacterial community composition was a more important driver of ARG diversity and geographic distribution. The abundance of pathogens carrying genetic information increased dramatically in southern Jiaozhou Bay is affected by sewage discharge, which indicating that wastewater discharge facilitated ARG contamination of marine sediments. This study highlights the risk of disseminating antibiotic resistance-influencing factors from treated wastewater discharge into marine environment there is an urgent need to optimize or improve wastewater treatment processes to enhance the removal of antibiotics and ARGs. This study has necessary implications for filling the gap in information on antibiotic resistance in Jiaozhou Bay and developing future pollution regulation and control measures.

Nonsmokers' Responses to Online E-Cigarette Commercials: Effects of Argument Quantity and Celebrity Endorsement Paper Resubmitted to Substance Use and Misuse.

Objectives: With mounting evidence on health risks caused by e-cigarette consumption, it is of great necessity to explore not only smokers' but also nonsmokers' responses to e-cigarette marketing messages, such as online commercials. Employing both psychophysiological and self-report measures, this study examined nonsmoking young adults' cognitive, emotional, and attitudinal reactions to two major message features used in e-cigarette commercials: argument quantity and endorsement type. Method: The experiment used a 2 (endorsement type: celebrity and average citizen) × 2 (argument quantity: low and high) × 2 (message repetition) within-subjects design. Continuous heart rate (indicative of attention) and skin conductance activity (indicative of emotional arousal) were measured during ads viewing. Self-reported ad liking and vaping urge were assessed immediately after participants finished watching each commercial. Results: Results showed that compared to high argument quantity, low argument quantity elicited more attention, evoked higher emotional arousal, and generated stronger ad liking and vaping urge. Additionally, compared to average-citizen endorsement, the presence of celebrity endorsement elicited higher attention and lower emotional arousal in nonsmoking young adults. There was a significant interaction effect of endorsement type and argument quantity on ad liking. Conclusions: For nonsmoking young adults, low argument quantity commercials might have the greatest impact in initiating vaping behavior, which has implications for regulatory policies regarding e-cigarette. Celebrity endorsement was effective in catching nonsmokers' attention but had limited effects on emotional involvement and product adoption. The implications of the findings were finally discussed in more details in the manuscript.

The landscape of eating disorders research: A 40-year bibliometric analysis.

OBJECTIVE: Employing bibliometric methods, the present study aimed to map out the general landscape of existing research on eating disorders (EDs) over the past decades. METHOD: Using the Web of Science database, we retrieved 41,917 research articles related to EDs published from 1981 to 2020. After removing those without an abstract, a total of 37,446 articles were retained. The study outlined the distribution of scholarship by time, languages, regions, and countries, and identified major research lines by applying latent topic modelling. RESULTS: Results revealed a general increasing trend in the number of publications on EDs research, and researchers from Western countries dominated the production of related scholarship. The distribution of published scholarship varied significantly by languages, regions, and countries. Seven main research topics emerged from past research (i.e., animal studies of food intake, risk factors and at-risk groups for eating disorders, body image in eating disorders, studies of cognition and brain in eating disorders, symptomatology and comorbidity of eating disorders, body weight and nutrition status in eating disorders, and treatment of eating disorders), with different topics showing unique research trends across the years. CONCLUSIONS: This bibliometric analysis presents the most complete up-to-date overview on published research on EDs. While there is an increasing trend for EDs research, the available research evidence is generally from Western countries; thus, it is suggested that cooperation on EDs research should be strengthened between Western countries and other countries in the future.

Validation of the 12-item Short Form of the Eating Disorder Examination Questionnaire in the Chinese context: confirmatory factor analysis and Rasch analysis.

PURPOSE: As a 12-item Short Form of the Eating Disorder Examination Questionnaire (EDE-QS), the EDE-QS was developed based on Rasch modeling to address certain weaknesses of the EDE-Q, and it has been demonstrated to be a psychometrically sound measure. Thus, the current study aimed to obtain a Chinese version of the EDE-QS and validate its psychometric properties in the Chinese context. METHODS: According to standard procedures, the Chinese version of the EDE-QS (C-EDE-QS) was obtained. A total of 1068 Chinese college students finished the survey. The psychometric properties of the C-EDE-QS were examined under the frameworks of both classic test theory and Rasch modeling. RESULTS: The one-factor structure of the C-EDE-QS was confirmed in confirmatory factor analysis; the C-EDE-QS showed good reliability with a Cronbach's α of 0.89; and the total scores of the C-EDE-QS were significantly correlated with eating disturbances and psychological distress in expected magnitudes and directions. Rasch analysis supported the unidimensional construct of the C-EDE-QS and the four-point rating scale structure. However, results revealed differential item functioning (DIF) across gender groups. CONCLUSIONS: The findings suggest that the C-EDE-QS could be a useful tool to assess key attitudes and behavioral features of eating disorder psychopathologies in the Chinese context. LEVEL OF EVIDENCE: V, descriptive (cross-sectional) study.

Obesity as a "self-regulated epidemic": coverage of obesity in Chinese newspapers.

OBJECTIVE: The aim of this study was to investigate how obesity was covered in Chinese newspapers from 1999 to 2018, demonstrating the trends and the characteristics of obesity-related news. METHODS: Content analysis was conducted to analyze a total of 358 news articles spanning two decades (1999-2018). We explored how Chinese newspapers portrayed obesity in terms of the evidence/sources cited in articles, its impacts, drivers/causes, and solutions; and how such portrayals have evolved over time. We further compared the articles across different types of newspapers (government-sponsored vs. commercial), two subpopulations (children vs. adults), and periods of time (1999-2008 vs. 2009-2018). RESULTS: Results showed that medical experts' interviews and statistics were the two most cited types of evidence in the articles. When discussing causes and solutions of obesity, factors pertaining to personal lifestyles were mentioned most frequently. Compared to psychological and social impacts, physical health risk was stressed more often. Compared with commercial newspapers, government-funded newspapers mentioned societal drivers of obesity and suggested reforming schools more frequently. Such differences were also found between coverage of child obesity and adult obesity. Our research, furthermore, revealed significant differences of media coverage of obesity across the two decades. CONCLUSIONS: Our findings indicate that obesity was generally depicted as a "self-regulated epidemic" in Chinese newspapers. Although the revealed causes and consequences of obesity are evidently related to individual factors, more attention should be directed to the roles that the government, media, and the society can play in preventing obesity and mitigating related social/economic burden. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Psychological distress after the Great East Japan Earthquake: two multilevel 6-year prospective analyses.

BACKGROUND: The Great East Japan Earthquake of 11 March 2011 led to the relocation of 300 000 survivors. Studies following disasters focus primarily on data collected in the immediate aftermath and neglect the influence of wider community factors. AIMS: A three-level prospective study examining associations between survivors' psychological distress and individual- and social-level factors in the 6 years following a complex disaster. METHOD: We drew on two multi-wave data collections in the 6 years after the earthquake, using residents from different forms of housing. Sample 1 included six waves of private-housing residents from 2011 to 2016 (n = 1084 per wave), sample 2 five waves of residents living in prefabricated housing from 2012 to 2016 (n = 1515 per wave). We analysed prospective associations between distress and time (level 1), pre-existing disorders and disaster experiences and behaviours (level 2) and city-wide measures of support and physical activity (level 3). RESULTS: Multilevel models with random coefficients demonstrated greater distress in earlier waves (samples 1 and 2 respectively, adjusted ß = -15 and ß = -0.16, P < 0.001), among female respondents (ß = 0.58, P = 0.01 and ß = 1.74, P = 0.001), in those with a previous psychiatric history (ß = 2.76, ß = 2.06, P < 0.001) with diminished levels of activity post-earthquake (ß = 1.40, ß = 1.51, P < 0.001) and those lacking in social support (ß = 1.95, ß = 1.51, P < 0.001). Support from spouses and friends was most protective of psychological health. City-level support was negatively associated with distress, but only among those in prefabricated housing. CONCLUSIONS: Psychological distress diminished with time, but varied across gender, psychiatric history, housing, levels of activity and availability of social support. Practitioners should consider individual- and city-level factors when devising effective interventions.

Occurrence, distribution and human exposure of phthalic esters in road dust samples across China.

203 road dust samples were conducted across China covering 28 provinces from January to February，2016 to comprehensively investigates the occurrence, distribution and human exposure of 21 phthalic esters (PAEs). The concentration of Σ21PAEs in road dust ranged from 2.3 to 531 mg/kg, with a mean concentration of 64.1 ± 57.2 mg/kg. DEHP, DnBP and DiBP were the dominant components accounting for 63.3-97.9% (mean: 92.1%) of the Σ21PAEs. Significant Pearson correlation (r = 0.51, p < 0.0001) between Σ21PAEs concentrations and longitude demonstrated a distinguished geographical trend. Higher concentration of PAEs in sidewalk (SW) and trunk road (TR) may reflect influence of human activities such as shoe wear and traffic load. Significant differences were found among different human activities area (urban commercial, urban residential, and suburbs/rural). For total daily intake of Æ©21PAEs via street dust, children had the highest exposure risk followed by teenagers and adults with the median values of 160.8, 43.6, and 37.7 ng/kg-bw/day, respectively. The maximum exposure risk of PAEs calculated based on measurement and simulation were all far below reference values. The sensitivity analysis results demonstrated that concentrations, ingestion rate (IR) and fraction of PAEs absorbed in the skin (AF) were most important parameters on the assessment of exposure risk of PAEs via street dust. Specific parameters based on China and Chinses population is needed to obtain more reliable exposure risk via street dust.

Chinese media coverage of eating disorders: Disorder representations and patient profiles.

OBJECTIVE: Eating disorders (EDs) are becoming more prevalent in China; however, no studies have been conducted to explore how Chinese media represented EDs, and how media representation of ED impacted public understanding of EDs. The aim of this study was to analyze articles about EDs in Chinese newspapers, and to identify any potential inaccuracies about EDs as represented in the media. METHOD: Content analysis was employed to analyze a total number of 292 news articles over the span of two decades (1998-2019). Intercoder reliability was satisfactory for all the coded categories. The analysis was conducted on two different dimensions: for individual news article and for individual patient profile. RESULTS: The bulk of news reporting on EDs was about anorexia nervosa and bulimia nervosa. A majority of individual patient profiles focused on young women. Anorexia nervosa was mentioned and discussed more frequently than bulimia nervosa. Chinese newspapers generally presented correct information concerning anorexia nervosa and bulimia nervosa, but conveyed shallow information about the etiology and treatment. There were also misconceptions of EDs as reported in Chinese media. DISCUSSION: EDs have not received sufficient attention in Chinese media, as shown by the media coverage on EDs over the last two decades. Considering the increasing prevalence of EDs in China with its large population base, effective communication strategies are needed to call public attention to this health issue, and to galvanize the medical community and the society to devote more resources to improve the prevention and treatment of EDs in China.

The Impact of Generativity Awareness on Mid- to Old-Age Smokers in China.

Smoking remains a serious health threat to many mid- to old-age Chinese people. Many smoking interventions have been implemented in public areas, but smoking occurring in a private setting, such as at home, has largely been neglected. Generativity is based on evaluating the worth of one's life experience that can be passed on to others. This study evaluated whether generativity awareness can have an impact on smoking reduction. Five hundred and eight Chinese smokers were recruited and demonstrated their strong awareness of generativity, specifically general generativity (e.g., moral ethics), health-related generativity (e.g., living a healthy life), and smoke-free family generativity. The study showed support for a three-dimensional model for generativity, namely general, health, and smoke-free generativity. The three types of generativity varied in their effects on behavioral intention to reduce smoking and to encourage younger family members not to smoke. Family communication patterns also influenced behavioral intention to reduce smoking and to encourage younger family members not to smoke. Theoretical and practical implications are discussed.

Representations of electronic cigarettes in Chinese media.

BACKGROUND: Electronic cigarettes (E-cigarettes) have become a debated issue for tobacco control over recent years. In this study we investigate how Chinese newspapers have covered E-cigarettes over the past ten years. METHODS: The study analyses the salience, patterns and content of news articles pertaining to E-cigarettes in regional and national Chinese outlets. A total of 476 articles are examined via content analysis and supervised automatic text analysis. The manual content analysis generates a coding scheme, which is then validated and applied to machine learning. The whole research methodology demonstrates satisfying human-human and human-to-computer reliabilities. RESULTS: The study reveals that E-cigarettes have not received enough attention in terms of its salience in the media, though the amount of coverage has been growing. A large share of the articles is published around May of each year - which is when the No Tobacco Day of the WHO takes place. The results point to four major themes on E-cigarettes: nicotine/constituents/features, tobacco control/regulation, children's use of E-cigarettes, and tobacco market/industry. CONCLUSIONS: Overall, E-cigarettes have not been a topic at the top of media agenda; however, we have identified a considerable growth of coverage about the potential concerns regarding young people's adoption of E-cigarettes advocated by parents and educators.

Different Culture or Different Mind? Perception and Acceptance of HPV Vaccine in China and in the U.S.

Unlike the United States, where human papillomavirus (HPV) vaccines have been available for decades, China recently approved its first HPV vaccines. Setting up a baseline comparison between these two countries, this study examines the influence of message framing, motivational orientation, cultural worldview, knowledge, and gender on young adults' intentions to get vaccinated. Compared to the U.S. participants, Chinese participants perceived HPV as a more severe risk and were more willing to get the vaccine. However, they were also more skeptical about vaccine safety. Inconsistencies with previous research emerged regarding the moderating effects of motivational orientation and cultural worldview. Findings from this study offer important implications for HPV vaccine promotion in China.

The Museum as a platform for tobacco promotion in China.

The China Tobacco Museum in Shanghai is the largest in China, consisting of seven pavilions of tobacco-related exhibits. A focus group and previous survey data revealed that the museum conveys messages that make tobacco use appealing. Of the pavilions, three were found to contain blatant misinformation about tobacco and tobacco consumption. We argue that the China Tobacco Museum is a platform for tobacco promotion, a form of tobacco advertising, promotion and sponsorship, and thus contravenes the FCTC.

Media Use, Cognitive Performance, and Life Satisfaction of the Chinese Elderly.

Media use and aging is an important interdisciplinary topic pertaining to communication, gerontology, and psychology, among others. Integrating research on media-induced recovery and life satisfaction, the present study examined media uses and effects in the context of health and aging. Specifically, data from a large random sample were analyzed to investigate the relationships between media use, cognitive performance, and life satisfaction among the Chinese elderly. Results, in general, lent support to the slightly modified structural model. Specifically, media-induced recovery outcomes can be categorized into proximate (e.g., cognitive performance), intermediate (e.g., health satisfaction), and distal levels (e.g., life satisfaction). Also, situational factors (e.g., disease history) had statistically significant effects on media-induced recovery outcomes. Theoretical and practical implications of the research findings were discussed, and future research directions were suggested.

Early responses to H7N9 in southern Mainland China.

BACKGROUND: H7N9 posed potentially serious health challenges for Chinese society. The previous SARS outbreak in this country was accompanied by contradictory information, while worries about wide-spread influenza led to discrimination worldwide. Early understanding of public threat perceptions is therefore important for effective public health communication and intervention. METHODS: We interviewed 1011 respondents by phone two weeks after the first case. Questions examined risk awareness and media use, beliefs about the emergence of the threat and those most at risk, anxiety about infection and preventive and avoidant behaviours. RESULTS: Results demonstrate moderate levels of anxiety but relatively high levels of trust towards government officials. Threat emergence was associated with hygiene levels, temperature change, floating pigs in the Huangpu River and migration to the city. Anxiety predicted both recommended and non-recommended behavioural changes. CONCLUSIONS: Comparatively high levels of trust in Chinese government advice about H7N9 contrast positively with previous pandemic communications in China. Anxiety helped drive both recommended and non-recommended behaviours, with potentially important economic and social implications. This included evidence of 'othering' of those associated with the threat (e.g. migrants). Findings emphasise the need to manage public communications early during new influenza outbreaks.

Understanding the structures and interactions in gaseous mixtures of water-alcohol by high-resolution infrared spectroscopy.

Interactions of water and chemical or bio-compound have a universal concern and have been extensively studied. For spectroscopic analysis, the complexity and the low resolution of the spectra make it difficult to obtain the spectral features showing the interactions. In this work, the structures and interactions in gaseous water and water-alcohol mixtures were studied using high-resolution infrared (HR-IR) spectroscopy. The spectral features of water clusters of different sizes, including dimer, trimer, tetramer and pentamer, were observed from the measured spectra of the samples in different volume concentrations, and the interactions of water and methanol/ethanol in the mixtures were obtained. In the analysis, a method based on principal component analysis was used to separate the overlapping spectra. In water-alcohol mixtures, when water is less, water molecules tend to interact with the OH groups on the exterior of the alcohol aggregate, and with the increase of water, a water cage forms around the aggregates. Furthermore, the ratio of the molecule number of methanol in the aggregate to that of water in the cage is around 1:2.3, and the ratio for ethanol is about 1:3.2.

Antibiotic resistance of Escherichia coli isolated from food and clinical environment in China from 2001 to 2020.

Antibiotics are widely used in China's aquaculture, agricultural, and clinical settings and can lead to antibiotic resistance in various pathogens. Although the pooled prevalence estimate (PPE) and antibiotic resistance of Escherichia coli (E. coli) in food and clinical settings has been extensively studied, a comprehensive analysis of the published literature is lacking. We conducted a comprehensive search for research indicators for 2001-2020 in eight major Chinese and English literature databases. Antibiotic PPE and resistance trends of 5933 and 29,451 E. coli isolates were screened and analysed in 35 food studies (total 1821) and 62 clinical studies (total 5159). E. coli strains derived from food had the highest antibiotic resistance rate to tetracycline (TET, 71.3 %), followed by trimethoprim-sulfamethoxazole (SXT, 62.5 %) and cefazolin (CFZ, 36.2 %). E. coli strains isolated from clinical environments were highly resistant to piperacillin (PIP, 71.7 %), TET (68.3 %) and CFZ (60.9 %), consistent with foodborne E. coli drug resistance patterns. E. coli strains isolated from food and clinical samples collected in laboratories carry multiple antibiotic resistance genes (ARGs), such as blaTEM, gryA, gryB, sul1, and tetA, making E. coli a reservoir of ARGs. This study highlights the presence of drug-resistant E. coli pathogens and ARGs in food and clinical environments.

Influence of smoking norms and gain/loss antismoking messages on young Chinese adults.

INTRODUCTION: This study tested efficacy of 4 types of smoking prevention messages directed toward young Chinese adults based on message framing and the target of the message. The claim that social smoking is an entrenched behavior was also tested. METHODS: This study was based on a 2 (friends vs. self) × 2 (gain vs. loss) factorial design. Respondents were directed to a Web site, where they answered questions about demographics and smoking status and then read 1 of 4 experimental messages or continued with the no-message control condition. Descriptive and injunctive norms about the extent and acceptability of smoking were also measured. Dependent variables included measures of smoking resistance efficacy, susceptibility to the harms of smoking, smoking enjoyment, severity of smoking harms, and behavioral intention to smoke. RESULTS: Totally, 315 participants enrolled in a large Chinese university participated in this study. Overall, gain messages were more effective for smoking prevention. Participants were more persuaded to refrain from smoking by the friend-gain-framed message rather than self-targeted messages. Loss messages were largely ineffective both for smokers and nonsmokers. Participants who read messages about effects on friends indicated more susceptibility to the harms of smoking compared with participants who read messages about effects on self. Significant effects were associated with descriptive and injunctive norms for the intention to smoke. CONCLUSIONS: Future studies need to more fully investigate whether loss antismoking messages are effective in other contexts and with other moderators beyond those investigated in this study.