Exploring the HONO source during the COVID-19 pandemic in a megacity in China.

HONO is a critical precursor of •OH, but its sources are controversial due to its complex formation mechanism. This study conducted comprehensive observations in Zhengzhou from April 26 to May 11, 2022. Low NOx concentrations were observed during the Covid epidemic period (EP) (10.4 ± 3.0 ppb), compared to the pre-epidemic period (PEP) (12.5 ± 3.8 ppb). The mean HONO concentration during EP (0.53 ± 0.34 ppb) was 0.09 ppb lower than that during PEP (0.62 ± 0.53 ppb). The decrease in HONO concentration during EP came mainly at night due to the reduction in the direct emission (Pemi) (0.03 ppb/hr), the homogeneous reaction between •OH and NO (POH+NO) (0.02 ppb/hr), and the heterogeneous conversion of NO2 on the ground (0.01 ppb/hr). Notably, there was no significant change in daytime HONO concentration. The daytime HONO budget indicated that the primary HONO sources during PEP were the nitrate photolysis (Pnitrate), followed by the POH+NO, Pemi, the photo-enhanced reaction of NO2 on the ground (Pground+hv) and aerosol surface (Paerosol+hv). The primary HONO sources were Pnitrate, POH+NO, Pemi, and Paerosol+hv during EP, respectively. The missing source has a high correlation with solar radiation, there might be other photo-related HONO sources or the contributions of photosensitized reactions were underestimated. In the extremely underestimated cases, HONO production rates from the Pnitrate, Pground+hv, and Paerosol+hv increased by 0.17, 0.10, and 0.10 ppb/hr during PEP, 0.23, 0.13, and 0.16 ppb/hr during EP, and Pnitrate was still the primary source during both PEP and EP.

[Epidemiological features of visceral leishmaniasis cases in Henan Province from 2021 to 2023].

OBJECTIVE: To analyze the characteristics of visceral leishmaniasis cases in Henan Province, so as to provide insights into formulation of the visceral leishmaniasis control srtrategy. METHODS: All epidemiological data of reported visceral leishmaniasis cases in Henan Province from 2021 to 2023 were retrieved from the National Notifiable Disease Report Information Management System of Chinese Center for Disease Control and Prevention, and the epidemiological features and diagnosis of visceral leishmaniasis cases were descriptively analyzed. RESULTS: A total of 93 visceral leishmaniasis cases were reported in Henan Province from 2021 to 2023, with a male to female ratio of 2.58∶1, and including 2 imported cases from other provinces and 91 local cases. The number of visceral leishmaniasis cases peaked during the period between March and May, and between July and October. The reported visceral leishmaniasis cases had ages of 7 months to 74 years, with the largest number of cases found at ages of 0 to 9 years (26 cases, 27.96%), followed by at ages of 60 to 70 years (24 cases, 25.81%). Farmer (47 cases, 50.54%) and diaspora children (19 cases, 20.43%) were predominant occupations, and 91 local visceral leishmaniasis cases were found in 6 cities of Zhengzhou, Luoyang, Anyang, Hebi, Sanmenxia and Xuchang. The median duration from onset of visceral leishmaniasis to diagnosis was 20 days, and there were 25.81% (24/93) cases with 10 days and less duration from onset to diagnosis, 38.71% (36/93) cases receiving diagnosis at 11 to 30 days following onset, and 35.48% (33/93) cases receiving diagnosis for more than 30 days following onset. All cases were predominantly diagnosed in province- (60.00%) and city-level (28.89%) medical institutions. CONCLUSIONS: The number of visceral leishmaniasis is on the rise in Henan Province, with a gradually expanding coverage. Intensified monitoring of visceral leishmaniasis cases, dogs, and vectors, dog management, sandflies control and improved individual protection are recommended to prevent the spread of visceral leishmaniasis.

[Prevalence of diabetic retinopathy assessed using two-field mydriatic fundus photography]. / Otsenka rasprostranennosti diabeticheskoi retinopatii s pomoshch'yu dvukhpol'nogo midriaticheskogo fundus-fotografirovaniya.

Early detection of diabetic retinopathy (DR) is an urgent ophthalmological problem in Russia and globally. PURPOSE: This study assesses the prevalence of asymptomatic retinopathy and attempts to identify risk groups for its development in patients with type 1 and 2 diabetes mellitus (T1DM and T2DM). MATERIAL AND METHODS: The study involved clinics from 5 cities in the Russian Federation and it included 367 patients with DM, 34.88% men and 65.12% women, aged 50.88±20.55 years. 34.88% of patients suffered from T1DM, 65.12% suffered from T2DM, the average duration of the disease was 9.02±7.22 years. 58.31% of patients had a history of arterial hypertension, 13.08% had a history of smoking. The primary endpoint was the frequency of detection of diabetic changes in the eye fundus of patients with T1DM and T2DM in general; the secondary endpoint - same but separately, and for T2DM patients depending on the duration of the disease. The exploratory endpoint was the assessment of the influence of various factors on the development of DR. The patients underwent visometry (modified ETDRS table), biomicroscopy, mydriatic fundus photography according to the «2 fields¼ protocol. RESULTS: The average detection rate of DR was 12.26%, primarily observed in patients with T2DM (13.81%), women (9.26%), in both eyes (8.17%). Among patients with DR, 26 (19.55%) had glycated hemoglobin (HbA1c) level exceeding 7.5% (p=0.002), indicating a direct relationship between this indicator and the incidence of DR. Logistic regression analysis showed that the duration of diabetes of more than 10 years has a statistically significant effect on the development of DR. In the modified model for odds estimation, the likelihood of developing DR is increased by the duration of DM for more than 10 years; increased blood pressure; HbA1c level >7.5%. CONCLUSION: The obtained results, some of which will be presented in subsequent publications, highlight the effectiveness of using two-field mydriatic fundus photography as a screening for DR.

Wastewater genomic surveillance to track infectious disease-causing pathogens in low-income countries: Advantages, limitations, and perspectives.

The emergence of infectious diseases, particularly those caused by respiratory pathogens like COVID-19 and influenza viruses, poses a significant threat to public health, especially in the context of climate change. Vulnerable variants and major pathogenicities are appearing, leading to a wide range of illnesses and increased morbidity. Wastewater genomic surveillance represents a cost-effective and a crucial tool for tracking infectious diseases, particularly in regions where clinical testing resources might be limited or inadequate. However, there are numerous limitations that need to be addressed in order to enhance its effectiveness for monitoring a wide range of pathogens. The current study uses this approach for the first time in Morocco to monitor the epidemiology of SARS-CoV-2 and Influenza A, B and RSV virus infections during the third wave of COVID-19 caused by the Omicron variant. The virome was concentrated from wastewater collected from two sewersheds of two cities, Agadir and Inezgane, using the the polyethylene glycol (PEG)/NaCl method. All 26 samples from both cities exhibited positive results for SARS-CoV-2, indicating varying viral loads. In the case of the Influenza A virus, four samples tested positive in Inezgane. However, no detection of Influenza B or RSV was observed in any of the samples. The estimated SARS-CoV-2 viral RNA copy numbers observed were then used to estimate the number of infected individuals using the SEIR model. The estimated number of cases correlates positively with the number of reported cases. Next Generation Sequencing showed that samples contain the following two variants: BA.1 and BA.2 that have been detected in clinical samples. In the case of Influenza A, clinical samples revealed a mild presence of the influenza virus subtype A(H3N2). This study demonstrates the effectiveness and feasibility of wastewater genomic surveillance in monitoring pathogens such as SARS-CoV-2 in Morocco. This approach can become an even more powerful tool for monitoring and predicting the spread of infectious diseases by addressing several key considerations. These include enhancing data collection methods, making environmental corrections for factors affecting RNA stability in wastewater, and refining mathematical models to improve their accuracy in predicting the number of infected cases. Incorporating statistical and machine learning models can further enhance the precision of these predictions.

Improvement of model simulation for summer PM2.5 and O3 through coupling with two new potential HONO sources in the North China Plain.

A large fraction of fine particulate matter (PM2.5) and ozone (O3) in the troposphere originates from secondary formation through photochemical processes, which remarkably contributes to the deterioration of regional air quality in China. The photochemical reactions initiated by hydroxyl radicals (OH) play vital roles in secondary PM2.5 and O3 formation. In contrast, the OH levels in polluted areas are underestimated by current chemical transport models (CTMs) because of the strongly unknown daytime sources of tropospheric nitric acid (HONO), which has been recognized as the dominant source of primary OH in polluted areas of China. In this study, the atmospheric HONO levels at two urban sites were found to be significantly underestimated by the WRF-Chem model based on available information on HONO sources. The HONO levels could be well reproduced by the WRF-Chem model after incorporating two new potential HONO sources from the photochemical reactions of NOx, as proposed in our previous study based on chamber experiment results. Comparing the simulations with available information of HONO sources, the simulated levels of atmospheric OH, secondary inorganic and organic aerosols (SIA and SOA), PM2.5 and daily maximum 8-h average (MDA8) O3 were evidently elevated or were closer to the observations over the North China Plain (NCP), with elevation percentages of 0.48-20.1 %, and a decrement percentage of -5.79 % for pNO3-. Additionally, the compensating errors in modeling PM2.5 and the gap in MDA8 O3 levels between observation and simulation in 2 + 26 cities became evidently smaller. The results of this study indicated that the empirical parameterization of two new potential HONO sources through photochemical reactions of NOx improved the model performance in modeling PM2.5 and O3 by narrowing the gap in daytime HONO levels between simulation and observation, although their detailed chemical mechanisms are still unknown and should be further investigated and explicitly parameterized.

Investigating the impact of fuel price shocks on bicycle sharing usage in Budapest.

The creation of sustainable urban communities is contingent upon the establishment of a sustainable, efficient, and fast transportation system. Bicycle sharing systems (BSS) are one of the most sustainable and inclusive ways of transportation in cities. An important question is how to increase BSS ridership and whether it can effectively replace cars in cities, hence contributing to achieving the 11th Sustainable Development Goal and creating sustainable urban communities. This paper aims to contribute to this stream of research by investigating the effect of fuel prices on BSS ridership. We exploit a natural experiment from Budapest, Hungary, where fuel prices were capped between November 15, 2021, and December 6, 2022. Once the price cap was suddenly eliminated, fuel prices increased by around one-third immediately leading to a very substantial and rarely observable one-time price increase. The difference-in-difference regression results indicate a 2-6% increase in BSS ridership after the elimination of the fuel price cap. The geographical pattern of the change shows that BSS usage mainly increased in the outer part of the city; however, some areas observed a decline. The regression results are also reinforced by survey findings. Understanding these dynamics is crucial for effective urban planning and transportation policymaking.

Vaccine effectiveness against anal HPV among men who have sex with men aged 18-45 years attending sexual health clinics in three United States cities, 2018-2023.

BACKGROUND: We assessed human papillomavirus (HPV) vaccine effectiveness (VE) against anal HPV among men who have sex with men (MSM) in 2018-2023. METHODS: Residual anal specimens from MSM without HIV ages 18-45 years were tested for HPV. We calculated adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for associations between vaccination (≥1 dose) and quadrivalent vaccine (4vHPV)-type prevalence adjusting for city, race/ethnicity, and non-vaccine-type HPV prevalence, stratified by age group (18-26, 27-45). VE was calculated as (1-aPR)x100. RESULTS: Among 2802 persons aged 18-26, 4vHPV-type prevalence was lower in those vaccinated at age <18 (aPR=0.13, CI: 0.08-0.22, VE=87%) and those vaccinated ≥2 years before specimen collection (aPR=0.52, CI: 0.42-0.64, VE=48%), compared with unvaccinated persons. Among 3548 persons aged 27-45, 4vHPV-type prevalence was lower in those vaccinated at ages 18-26 (aPR=0.68, CI: 0.57-0.82, VE=32%) and those vaccinated ≥2 years before specimen collection (aPR=0.66, CI: 0.57-0.77, VE=33%), compared with unvaccinated persons. While we observed no VE in persons vaccinated at age >26 overall, 4vHPV-type prevalence was lower in the subgroup vaccinated ≥2 years before specimen collection (aPR=0.71, CI: 0.56-0.89, VE=29%). CONCLUSIONS: We found high VE against anal 4vHPV-type prevalence among MSM aged 18-26 who were vaccinated at age <18. Lower VE was observed among MSM ages 27-45 who were vaccinated at age 18-26 or ≥2 years before specimen collection. While ideally vaccination should be given at younger ages, vaccination can prevent some future infections in this population.

[Nutritional composition of three cities restaurants in Shandong Province in 2021].

OBJECTIVE: To understand the current status of protein, fat, carbohydrates, energy, vitamins, minerals and other contents in common dishes of large, small, and medium-sized restaurants in Shandong Province. METHODS: From July to October 2021, 90 Shandong cuisine dishes were collected from 9 large, medium, and small restaurants in Shandong Province. One dish was collected from each restaurant, and samples from different types of restaurants were mixed as one sample. The content of nutrients and their carbohydrate and energy levels were detected and calculated. RESULTS: The median fat and protein content detected in the 90 dishes collected were 7.7 and 6.8 g/100 g, respectively. The calculated median values of energy and carbohydrates were 528 kJ/100 g and 5.4 g/100 g, respectively. The energy supply ratio of carbohydrates per 100 g of dishes was 17.2%, fat was 55.3%, and protein was 21.4%. The content of vitamin A, vitamin B_1, vitamin B_2, vitamin C and vitamin E was trace(tr)-26 700 µg/100 g, tr-0.12 mg/100 g, tr-0.40 mg/100 g, tr-56.5 mg/100 g and tr-5.31 mg α-TE/100 g. The medium number of dishes and potassium content was 375 and 219 mg/100 g. The detection rate of trans fat acid was 81.1%, and the median content was 0.06 g/100 g. CONCLUSION: The energy supply ratio of protein and fat in dishes is relatively high, while the energy supply ratio of total carbohydrates is relatively low. The sodium content is high, showing the characteristics of high sodium and low potassium. Vitamin, especially vitamin B_1 and vitamin B_2, has a low content.

[Knowledge, attitude and practices of adult vaccine among the staff of vaccination units in Shandong Province].

In order to understand the knowledge, attitude and practice (KAP) of vaccination against influenza, pneumonia, human papillomavirus (HPV), herpes zoster (HZ), COVID-19, and hepatitis B among staff of vaccination units in Shandong Province, a sample survey was conducted among 797 staffs of adult vaccination units in 12 counties (cities and districts) of Shandong Province from August to September 2022. The results showed that the respondents had the highest total score of knowledge and attitude for the COVID-19 vaccine, with the M (Q1, Q3) of 23 (20, 25) and 10 (10, 10), respectively, and had the lowest score of knowledge and attitude for the herpes zoster vaccine, with the M (Q1, Q3) of 19 (15, 22) and 8 (8, 10), respectively. The vaccine-related knowledge point"vaccine applicable population"had the highest score, with the M (Q1,Q3) of 26 (23, 30). The "contraindications/adverse reactions" and "adverse reaction management" had the lowest score, with the M (Q1, Q3) of 24 (20, 29) and 24 (20, 28), respectively. About 89.71% of respondents received one adult vaccine within two years at least. The principal driver for vaccination of 53.58% of recipients was their understanding of vaccines, which was"it was necessary to receive the vaccine". About 66.00% of respondents who had not received any adult vaccine in the past two years had insufficient awareness of the necessity of vaccination and believed that they were in good health and did not need to receive it. In summary, the staff of adult vaccination units in Shandong Province have a poor understanding of the herpes zoster vaccine in terms of vaccines and a relatively poor understanding of"contraindications/adverse reaction and management"in adult vaccination knowledge points.

Health impact assessment of port-sourced air pollution in Barcelona.

INTRODUCTION: Air pollution is a major health risk factor. Ports might be an understudied source of air pollution. METHODS: We conducted a spatial health impact assessment (HIA) of port-sourced air pollution for Barcelona for 2017 at the neighbourhood level. Total NO2 and PM10 and port-sourced NO2, PM10 and PM2.5 concentrations were available through the ADMS-Urban model. Population data, mortality and morbidity data, and risk estimates were obtained. We followed standard HIA methodologies and calculated relative risks and impact fractions for 1.35 million adults living in 73 neighbourhoods. RESULTS: The city-wide mean total NO2 and PM10 concentrations were 37.88 µg/m3 (range: 19.61-52.17 µg/m3) and 21.68 µg/m3 (range: 17.33-26.69 µg/m3), respectively, of which 7% (range: 2-36%) and 1% (range: 0-7%) were port-sourced, respectively. The mean port-sourced PM2.5 concentration was 0.19 µg/m3 (range: 0.06-1.38 µg/m3). We estimated that 1,123 (PI: 0-3,060) and 1,230 (95% CI: 0-2,566) premature deaths were attributable to total NO2 and PM10, respectively, of which 8.1% (91; PI: 0-264) and 1.1% (13; 95% CI 0-29) were attributable to port-sourced NO2 and PM10, respectively. 20 (95% CI: 15-26) premature deaths were attributable to port-sourced PM2.5. Additionally, a considerable morbidity burden and losses in life expectancy were attributable to port-sourced air pollution. Neighbourhoods closest to the port in the south-east were most adversely affected, gradually decreasing towards the north-west. CONCLUSIONS: The port is an understudied air pollution source in Barcelona with strong health impacts. Cities need local insight into health risk factors, their sources, attributable burdens and distributions for defining targeted policies.

Geography versus sociodemographics as predictors of changes in daily mobility across the USA during the COVID-19 pandemic: a two-stage regression analysis across 26 metropolitan areas.

OBJECTIVE: We investigated whether a zip code's location or demographics are most predictive of changes in daily mobility throughout the course of the COVID-19 pandemic. DESIGN: We used a population-level study to examine the predictability of daily mobility during the COVID-19 pandemic using a two-stage regression approach, where generalised additive models (GAM) predicted mobility trends over time at a large spatial level, then the residuals were used to determine which factors (location, zip code-level features or number of non-pharmaceutical interventions (NPIs) in place) best predict the difference between a zip code's measured mobility and the average trend on a given date. SETTING: We analyse zip code-level mobile phone records from 26 metropolitan areas in the USA on 15 March-31 September 2020, relative to October 2020. RESULTS: While relative mobility had a general trend, a zip code's city-level location significantly helped to predict its daily mobility patterns. This effect was time-dependent, with a city's deviation from general mobility trends differing in both direction and magnitude throughout the course of 2020. The characteristics of a zip code further increased predictive power, with the densest zip codes closest to a city centre tended to have the largest decrease in mobility. However, the effect on mobility change varied by city and became less important over the course of the pandemic. CONCLUSIONS: The location and characteristics of a zip code are important for determining changes in daily mobility patterns throughout the course of the COVID-19 pandemic. These results can determine the efficacy of NPI implementation on multiple spatial scales and inform policy makers on whether certain NPIs should be implemented or lifted during the ongoing COVID-19 pandemic and when preparing for future public health emergencies.

Pathogen characteristics of respiratory infections in the season after the COVID-19 pandemic between August and December 2023: evidence from direct-to-consumer testing-based surveillance in Guangzhou and Beijing, China.

OBJECTIVES: In the fall-winter of 2023, China experienced its first epidemic season of respiratory diseases since the COVID-19 pandemic. Gathering timely data about pathogenetic characteristics of respiratory infections is crucial to complement current respiratory surveillance mechanisms in China. Data from direct-to-consumer (DTC) multi-respiratory pathogen (MRP) testing could serve as a novel source of multi-pathogen data for community-based surveillance. METHODS: A pioneering initiative was launched to detect multiple respiratory pathogens in Beijing and Guangzhou, China. DTC MRP tests were used to provide proactive surveillance ahead of medical services. RESULTS: A total of 28,018 participants were enrolled between 22 August and 10 December 2023. Positive findings for at least one respiratory pathogen were observed in 26,202 (93.5%) participants. Influenza virus A, respiratory syncytial virus (RSV), and human adenovirus are the three leading viral pathogens detected with proportions of 18.0%, 10.6%, and 8.8%. Viral-bacterial pathogens were co-detected in 9736 (34.7%) of participants, which reduced to 22.2% for bacterial-bacterial co-detection, and 22.0% for bacterial mono-detection. The epidemiological ecology of respiratory pathogens within both viral clusters and specific pathogens varied among cities. The peak of RSV epidemics in Guangzhou occurred in the fall of 2023, earlier than in Beijing. CONCLUSION: The innovative program offered enhanced surveillance capabilities beyond traditional methods, enabling prompt feedback about test results and mitigating the risk of cross-infection caused by waits in healthcare facilities.

Construction of ecological security pattern in combination with landslide sensitivity: A case study of Yan'an City, China.

The ecological security pattern can harmonize the relationship between natural environmental protection and socio-economic development. This study proposes a regional ecological security pattern optimization framework by integrating theory and practice with landslide sensitivity and landscape structure. Using Yan'an City as an example, this study optimizes the landscape layout of preliminary ecological sources. The landslide sensitivity index is generated using the information value model and then used to adjust the ecological resistance surface. The Minimum Cumulative Resistance (MCR) approach is used to extract ecological corridors, locate ecological nodes utilizing circuit theory, and outline crucial ecological control areas. The results demonstrate: (1) the ecological sources are primarily composed of forestlands, with a total area of 2,352.2400 km2, concentrated in the southwest, central, and southeast regions. The optimal landscape granularity for the source patches is 600 m. (2) Yan'an is divided into four landslide sensitivity level zones: extremely high, high, medium, and low, with the overall landslide sensitivity of the region being high. (3) The highest ecological resistance is observed in built-up land and the lowest in forestland. The total number of ecological corridors is 26, avoiding most of the highly sensitive areas of landslides. (4) The number of ecological pinch points is 61, while the ecological barrier points amounted to 54. The critical ecological control areas consist mainly of cropland, forestland, and grassland, and differentiated restoration strategies are proposed to address their unique characteristics. The findings of the research can offer scientific guidance for the practice of ecological security protection in geohazard-prone areas.

The burden and trends of child and maternal malnutrition across the regions in Ethiopia, 1990-2019: The Global Burden of Disease Study 2019.

INTRODUCTION: Child malnutrition is the main contributor to the disease burden in Ethiopia. The objective of this study was to determine the prevalence and trends of child malnutrition and maternal anemia in Ethiopia at the national and regional state levels between 1990 and 2019. METHODS: We used all accessible data sources and analyzed prevalence, death, and years of life lost (YLL) due to child malnutrition and maternal anemia across nine regions and two chartered cities in Ethiopia, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. The burden and trends of child and maternal malnutrition and anemia at the national level, across the regions, and in cities were assessed. Point estimates with 95% uncertainty intervals (UI) are presented. FINDINGS: Of the 190,173 total under-5 deaths in Ethiopia in 2019, 108,864 (95% UI: 83,544-141,718; 57·2%, 51·3-62·7) were attributed to malnutrition. The prevalence of stunting, underweight, and wasting was 37·0%, 27·0%, and 7·0%, respectively, in 2019. The YLL rate attributable to child malnutrition declined from 251,964 per 100,000 population (95% UI: 218,720-287,559) in 1990 to 57,615 (95% UI: 44,190-75,015) in 2019. The YLL rate of wasting, stunting, and underweight in Ethiopia was 18,566 per 100,000 population (95% UI: 12,950-26,123), 3,290 (95% UI: 1,443-5,856), and 5,240 (95% UI: 3,608-7,312) in 2019, respectively. Gambella showed the highest YLL rate reduction among regions, with a 98·2% change for stunting, 95·9% for wasting, and 97·9% for underweight between 1990 and 2019. The prevalence of anemia among under-5 children in Ethiopia was 62·0% (95% UI: 59·1%-65·1%) in 2019. Somali has the highest child anemia prevalence, 84·4% (95% UI: 79·8%-88·8%), compared to others in 2019. The prevalence of anemia in women of reproductive age (15-49 years) in Ethiopia was 20·4% (95% UI: 19·0%-21·8%) in 2019. INTERPRETATION: The prevalence of child malnutrition and maternal anemia in Ethiopia remains high compared to national, WHO, and UNICEF 2030 targets in all indicators of child malnutrition and anemia despite several interventions in the last three decades. The YLL rate due to child malnutrition was high, with regional variations. In conjunction with other sectors, especially agriculture, the National Nutrition Program and other nutrition initiatives must make greater efforts with short-term and long-term interventions to improve access and better nutrition.

PM10-bound trace elements in pan-European urban atmosphere.

Although many studies have discussed the impact of Europe's air quality, very limited research focused on the detailed phenomenology of ambient trace elements (TEs) in PM10 in urban atmosphere. This study compiled long-term (2013-2022) measurements of speciation of ambient urban PM10 from 55 sites of 7 countries (Switzerland, Spain, France, Greece, Italy, Portugal, UK), aiming to elucidate the phenomenology of 20 TEs in PM10 in urban Europe. The monitoring sites comprised urban background (UB, n = 26), traffic (TR, n = 10), industrial (IN, n = 5), suburban background (SUB, n = 7), and rural background (RB, n = 7) types. The sampling campaigns were conducted using standardized protocols to ensure data comparability. In each country, PM10 samples were collected over a fixed period using high-volume air samplers. The analysis encompassed the spatio-temporal distribution of TEs, and relationships between TEs at each site. Results indicated an annual average for the sum of 20 TEs of 90 ± 65 ng/m3, with TR and IN sites exhibiting the highest concentrations (130 ± 66 and 131 ± 80 ng/m3, respectively). Seasonal variability in TEs concentrations, influenced by emission sources and meteorology, revealed significant differences (p < 0.05) across all monitoring sites. Estimation of TE concentrations highlighted distinct ratios between non-carcinogenic and carcinogenic metals, with Zn (40 ± 49 ng/m3), Ti (21 ± 29 ng/m3), and Cu (23 ± 35 ng/m3) dominating non-carcinogenic TEs, while Cr (5 ± 7 ng/m3), and Ni (2 ± 6 ng/m3) were prominent among carcinogenic ones. Correlations between TEs across diverse locations and seasons varied, in agreement with differences in emission sources and meteorological conditions. This study provides valuable insights into TEs in pan-European urban atmosphere, contributing to a comprehensive dataset for future environmental protection policies.

Personalized bacteriophage therapy outcomes for 100 consecutive cases: a multicentre, multinational, retrospective observational study.

In contrast to the many reports of successful real-world cases of personalized bacteriophage therapy (BT), randomized controlled trials of non-personalized bacteriophage products have not produced the expected results. Here we present the outcomes of a retrospective observational analysis of the first 100 consecutive cases of personalized BT of difficult-to-treat infections facilitated by a Belgian consortium in 35 hospitals, 29 cities and 12 countries during the period from 1 January 2008 to 30 April 2022. We assessed how often personalized BT produced a positive clinical outcome (general efficacy) and performed a regression analysis to identify functional relationships. The most common indications were lower respiratory tract, skin and soft tissue, and bone infections, and involved combinations of 26 bacteriophages and 6 defined bacteriophage cocktails, individually selected and sometimes pre-adapted to target the causative bacterial pathogens. Clinical improvement and eradication of the targeted bacteria were reported for 77.2% and 61.3% of infections, respectively. In our dataset of 100 cases, eradication was 70% less probable when no concomitant antibiotics were used (odds ratio = 0.3; 95% confidence interval = 0.127-0.749). In vivo selection of bacteriophage resistance and in vitro bacteriophage-antibiotic synergy were documented in 43.8% (7/16 patients) and 90% (9/10) of evaluated patients, respectively. We observed a combination of antibiotic re-sensitization and reduced virulence in bacteriophage-resistant bacterial isolates that emerged during BT. Bacteriophage immune neutralization was observed in 38.5% (5/13) of screened patients. Fifteen adverse events were reported, including seven non-serious adverse drug reactions suspected to be linked to BT. While our analysis is limited by the uncontrolled nature of these data, it indicates that BT can be effective in combination with antibiotics and can inform the design of future controlled clinical trials. BT100 study, ClinicalTrials.gov registration: NCT05498363 .

Automated cooling tower detection through deep learning for Legionnaires' disease outbreak investigations: a model development and validation study.

BACKGROUND: Cooling towers containing Legionella spp are a high-risk source of Legionnaires' disease outbreaks. Manually locating cooling towers from aerial imagery during outbreak investigations requires expertise, is labour intensive, and can be prone to errors. We aimed to train a deep learning computer vision model to automatically detect cooling towers that are aerially visible. METHODS: Between Jan 1 and 31, 2021, we extracted satellite view images of Philadelphia (PN, USA) and New York state (NY, USA) from Google Maps and annotated cooling towers to create training datasets. We augmented training data with synthetic data and model-assisted labelling of additional cities. Using 2051 images containing 7292 cooling towers, we trained a two-stage model using YOLOv5, a model that detects objects in images, and EfficientNet-b5, a model that classifies images. We assessed the primary outcomes of sensitivity and positive predictive value (PPV) of the model against manual labelling on test datasets of 548 images, including from two cities not seen in training (Boston [MA, USA] and Athens [GA, USA]). We compared the search speed of the model with that of manual searching by four epidemiologists. FINDINGS: The model identified visible cooling towers with 95·1% sensitivity (95% CI 94·0-96·1) and a PPV of 90·1% (95% CI 90·0-90·2) in New York City and Philadelphia. In Boston, sensitivity was 91·6% (89·2-93·7) and PPV was 80·8% (80·5-81·2). In Athens, sensitivity was 86·9% (75·8-94·2) and PPV was 85·5% (84·2-86·7). For an area of New York City encompassing 45 blocks (0·26 square miles), the model searched more than 600 times faster (7·6 s; 351 potential cooling towers identified) than did human investigators (mean 83·75 min [SD 29·5]; mean 310·8 cooling towers [42·2]). INTERPRETATION: The model could be used to accelerate investigation and source control during outbreaks of Legionnaires' disease through the identification of cooling towers from aerial imagery, potentially preventing additional disease spread. The model has already been used by public health teams for outbreak investigations and to initialise cooling tower registries, which are considered best practice for preventing and responding to outbreaks of Legionnaires' disease. FUNDING: None.

Can China's carbon generalized system of preferences reduce urban residents' carbon emissions? Evidence from a quasi-natural experiment.

The carbon generalized system of preferences (CGSP) is an innovative incentive mechanism implemented by the Chinese government, which has also become an important part of carbon emission reduction at the living end, and it is of great significance to study whether the Pilot Policy can reduce the carbon emissions of residents. This study firstly accounts for the total carbon emissions and per capita carbon emissions of the residents of 284 cities in China, and on this basis, adopts the SCM method to quantitatively study and analyze the overall and local implementation effects of CGSP in China by taking the first batch of CGSP pilots in China as an example, and further applies the mediation effect model to test the pathways of the role of CGSP. The main findings of the study are as follows: (1) During the period of 2010-2020, the total carbon emissions from urban residents' living in China showed a yearly growth trend, from 36,623.98 ×10-2Mt in 2010-85,241.20 ×10-2Mt in 2020, an increase of 8.83%. Total carbon emissions present a structural difference of "electricity consumption > central heating > private transport > gas (oil, natural gas) consumption". (2) Overall, the implementation of the CGSP had a robust positive impact on the overall carbon emission reduction in the pilot cities, with an average annual emission reduction effect value of 36.53 ×10-2Mt. Locally, the annual net policy effect values of Dongguan, Zhongshan, Heyuan, and Guangzhou are 6169.79 ×10-2, 26,600.17 ×10-2, 17,081.34 ×10-2 and 9393.36 ×10-2Mt respectively. (3) CGSP has a good carbon emission reduction effect by suppressing the impact on residents' carbon emissions through enhancing the city's innovation capacity and promoting electricity saving and consumption reduction, while the mediating effect played by the promotion of green and low-carbon travel in the pilot policy is not significant. Finally, based on the research findings, relevant suggestions are targeted.

Characteristics and effects of global sloping land urbanization from 2000 to 2020.

Cities usually expand on flat land. However, in recent decades, the increasing scarcity of available flat land has compelled many cities to expand to sloping land (sloping land urbanization, SLU), and the understanding for global SLU is still unclear. This study, based on the currently available high-precision global Digital Elevation Model (FABDEM) and global land cover dataset (GlobeLand30), investigated the characteristics and impacts of SLU in 26,402 urban residential areas worldwide from 2000 to 2020. Results show that the total area of SLU globally is 16,383 km2, accounting for 9.54 % of the overall urban expansion. This phenomenon is widespread globally and relatively concentrated in a few countries, with 42.78 %, 24.35 %, and 21.83 % of the area coming from cultivated land, forest, and grassland respectively. Global SLU has accommodated 34.78 million urban population, and indirectly protected 8922 km2 of flat cultivated land, while causing a net loss of 4373 km2 of green ecological land. Deliberately balancing the dual effects of SLU is crucial for advancing sustainable global urbanization.

Genomic surveillance and serological profile of SARS-CoV-2 variants circulating in Macaé and nearby cities, southeastern Brazil.

Introduction: A characteristic of the COVID-19 pandemic has been the sequential emergence and global dissemination of SARS-CoV-2 variants, noted for their enhanced transmission efficiency. These variants with mutations in the Spike glycoprotein (S-glycoprotein), which interacts with ACE2 receptors in human cells is critical for infection, affects the transmissibility of the virus, which is a matter of great concern for public health. Objective: This research analyses the effects these variants on a cohort of vaccinated and naturally infected individuals from the cities of Macaé-RJ, Rio das Ostras-RJ, and Campos dos Goytacazes-RJ, Brazil, from March 2021 to March 2023. Methods: This investigation encompasses the Alpha (B.1.1.7), Gamma (P.1), Delta (B.1.617.2, B.1.671.3), and Omicron (BQ.1, BQ.1.1 sublines, and BF.7) variants, focusing on their genomic surveillance and implications for the disease's epidemiology. The experimental analysis included a control group (vaccinated and uninfected subjects), and an infected group (post-vaccinated subjects). Samples from nasopharyngeal swabs underwent viral detection via RT-qPCR for diagnosis confirmation. RNase H-dependent RT-qPCR (rhAmp-PCR) and third-generation sequencing were used to detect SARS-CoV-2 variants. Anti-S-glycoprotein immunoglobulins were also evaluated for vaccinated infected and noninfected volunteers. Symptoms from infected individuals were compiled in order to reveal patterns of clinical signs associated with viral infection. Results: The study included 289 participants, with infections identified by Gamma (n = 44), Delta (n = 189), and Omicron (n = 56) variants. The prevalent symptoms among the naturally infected participants were cough, fever, sore throat, headache, and runny nose. For Omicron, cognitive symptoms such as memory loss and concentration issues were reported. Interestingly, the infected vaccinated group had higher anti-S-glycoprotein IgM production (n = 28, 0.2833 ± 0.09768 OD) compared to the uninfected vaccinated group (n = 14, 0.1035 ± 0.03625 OD). Conversely, anti-S-glycoprotein IgG production was higher in the control group (n = 12, 1.770 ± 0.1393 OD) than in the infected vaccinated group (n = 26, 1.391 ± 0.1563 OD). Conclusion: This comprehensive study enables monitoring of predominant variants and their correlation with clinical cases, providing valuable insights for public health. Our research group continues to survey circulating variants, contributing to the global understanding of the pandemic.