Trends in mortality due to tracheal, bronchial, and lung cancer across the BRICS: An age-period-cohort analysis based on the Global Burden of Disease Study 1990-2019.

BACKGROUND: Tracheal, bronchus, and lung cancer (TBL) is a major cause of mortality and top contributor to productivity loss in large emerging economies such as the BRICS (Brazil, Russia, India, China, and South Africa). We examined the time trends of TBL mortality across the BRICS to better understand the disease burden in these countries and inform public health and healthcare resource allocation. METHODS: TBL mortality-related data between 1990 and 2019 were obtained from the Global Burden of Disease Study 2019 and analyzed using age-period-cohort models. Net drift (local drift) was used to describe the expected age-adjusted TBL mortality rate over time overall (each age group); the longitudinal age curve was used to reflect the age effect; the period rate ratios (RRs) were used to reflect the period effect; and the cohort RR was used to reflect the cohort effect. RESULTS: In 2019, there were 958.3 thousand TBL deaths across the BRICS, representing 46.9% of the global TBL deaths. From 1990 to 2019, the age-standardized mortality rate (ASMR) of TBL decreased in Russia, Brazil, and South Africa while increased in China and India, with the largest reduction reported in Russia (-29.6%) and the largest increase in China (+22.4%). India showed an overall increase (+15.7%) in TBL mortality but the mortality risk decreased among individuals born after 1990 (men) and 1995 (women). Although South Africa and Brazil experienced an overall decline in TBL mortality, their recent birth cohorts, such as Brazilian individuals born after 1985 (men) and 1980 (women), and South African men born after 1995, had an increasing TBL mortality risk. China has experienced an overall increase in TBL mortality, with the mortality risk rising among individuals born after 1995 for both men and women. Russia, which had the highest TBL mortality among the BRICS countries in 1990, has demonstrated significant improvement over the past three decades. CONCLUSIONS: Over the past 30 years, the BRICS accounted for an increasing proportion of global TBL mortality. TBL mortality increased in older women in all the BRICS countries except Russia. Among the recent birth cohort, the risk of TBL mortality increased in Brazil, China, and South Africa. More effective efforts are needed in the BRICS to reduce the burden of TBL and help achieve the United Nation's Sustainable Development Goals.

Temporal trends in disease burden and attributable risk factors for tracheal, bronchus, and lung cancer in Nepal, 1990-2019.

BACKGROUND: Tracheal, bronchus, and lung (TBL) cancer is one of the most common cancers in Nepal. The aim of this study was to analyze the changing disease burden and risk factors for TBL cancer in Nepal from 1990 to 2019. METHODS: TBL cancer burden data were obtained from the Global Burden of Disease Study 2019. A decomposition analysis was used to explore the impact of changes in population size, population age structure, age-specific prevalence, and disease severity on long-term trends of the TBL cancer burden in Nepal. RESULTS: In 2019, TBL cancer resulted in the loss of 45.2 thousand (95% uncertainty interval [UI]: 32.3-59.2 thousand) disability-adjusted life years (DALYs) in Nepal, with the age-standardized incidence and prevalence rates increasing by 12.7% (95% UI: -21.0 to 63.9%) and 12.8% (95% UI: -21.1 to 62.0%), respectively, compared with 1990. The proportion of DALYs due to TBL cancer increased significantly among people aged 70 years and older from 1990 to 2019. However, the proportion of DALYs due to TBL cancer still dominated among males and females aged 50-69 years. Population growth, population aging, and increased age-specific prevalence led to an increased disease burden of TBL cancer, while disease severity led to a decreased burden. In 2019, smoking remained the major risk factor for TBL cancer in Nepal, while ambient particulate matter pollution exhibited the most significant rise. CONCLUSIONS: The disease burden of TBL cancer in Nepal has continued to increase over the past three decades, and given the continuing population growth and aging process, TBL cancer is likely to have a considerable impact on health in Nepal in the future. There is a need to further establish effective TBL cancer prevention and control policies.

The relationship between intergenerational financial support and depressive symptoms among older adults: Evidence from China Health and Retirement Longitudinal Study, 2011-2018.

OBJECTIVE: Aimed to investigate the effect of intergenerational financial support on depressive symptoms among older adults over time. METHODS: Data were obtained from China Health and Retirement Longitudinal Study (CHARLS) 2011, 2013, 2015, and 2018. A finite distributed lag (FDL) model was employed, long-run cumulative effect was evaluated. 1426 respondents followed in four waves were included in FDL model. CES-D score was used to measure depressive symptoms, intergenerational financial support was defined as financial support received from older adults' children or grandchildren. Sociodemographic characteristics, health behaviors, social insurance, and social contact factors were controlled in the model. RESULTS: More than a third older adults in China had a CES-D score of 10 or higher. Intergenerational financial support has a significant long-run cumulative negative effect on older adults' depressive symptoms (CES-D scores: coef. = -0.674, P < 0.001; % with CES-D scores ≥10: Coef. = -0.154, P = 0.018). While, the intergenerational financial support in previous period exhibited a significant negative association with depressive symptoms, the 2, 3, and 4 periods did not reach statistical significance. CONCLUSIONS: Intergenerational financial support has a significant negative effect on older adults' depressive symptoms over time, while the effect may diminish. Programs need to be explored to support home-based eldercare to mitigate this diminished effect.

Projections of future life expectancy in China up to 2035: a modelling study.

BACKGROUND: To plan social and health services, future life expectancy projections are needed. The aim of this study was to forecast the future life expectancy for mainland China and its provinces. METHODS: Following the same approach as the Global Burden of Disease Study, we used the largest compiled epidemiological and demographic datasets to estimate age-specific mortality and evaluate population data from 1990 to 2019. A total of 21 life expectancy forecasting models were combined by a probabilistic Bayesian model to forecast the life expectancy for mainland China and its provinces in 2035. FINDINGS: The projected life expectancy at birth in mainland China in 2035 is 81·3 years (95% credible interval 79·2-85·0), and there is a high probability that the national goals of improving life expectancy will be achieved (79 years in 2030, and over 80 years in 2035). At the provincial level, women in Beijing have the highest projected life expectancy in 2035 with an 81% probability of reaching 90 years, followed by Guangdong, Zhejiang, and Shanghai, which all have more than a 50% probability of surpassing 90 years. Men in Shanghai are projected to have the highest life expectancy at birth in 2035, with a 77% probability of life expectancy being over 83 years, the highest provincial life expectancy in mainland China in 2019. The projected gains in life expectancy are mainly derived from older individuals (aged ≥65 years), except those in Xinjiang, Tibet, and Qinghai (for men), in which the main contributions come from younger (0-29 years) or middle-aged (30-64 years) individuals. INTERPRETATION: Life expectancy in mainland China and its provinces has a high probability of continuing to increase through to 2035. Adequate policy planning of social and health services will be needed. FUNDING: China National Natural Science Foundation and Social Science Fund of Jiangsu Province.

Exploring the relationship between air quality and health shocks to the elderly: A retrospective cross-sectional study in China.

Methods: We selected 5,172 microdata on individuals from the China Health and Retirement Longitudinal Study (CHARLS) 2018. The binary logit model, the ordered logit model, and the stepwise regression were employed to compare the effects of air pollution on self-rated health (SRH) and activities of daily living (ADL) in an elderly population. The effects on health shocks were explored in different age groups, different gender groups, different regions and different sources of pollutants, respectively. Results: We found that air pollution significantly increased the risk of health shocks in the elderly population, especially in the 60-69 year age group, and the eastern/central region, where NO2 and O3 were important pollutant sources. Conclusion: Targeted management of the environment is necessary to improve the health status of China's elderly population. In addition, paying attention to the health status of vulnerable populations is needed to achieve social equity.

How Different Is the Annual Physical Examination of Older Migrants than That of Older Nonmigrants? A Coarsened Exact Matching Study from China.

It has become a top priority to ensure equal rights for older migrants in China. This study aims to explore how different the annual physical examination of older migrants is compared to that of older nonmigrants in China by using a coarsened exact matching method, and to explore the factors affecting annual physical examination among older migrants in China. Data were drawn from the China Migrants Dynamic Survey 2015 and China Health and Retirement Longitudinal Survey 2015. The coarsened exact matching method was used to analyse the difference in the annual physical examination of older migrants and nonmigrants. A logistic regression was used to analyse the factors affecting annual physical examination among older migrants. The annual physical examination of older migrants was 35.6%, which was significantly lower than that of older nonmigrants after matching (Odds ratios = 0.91, p < 0.05). It was affected by education, employment, hukou, household economic status, health, health insurance, main source of income, type of migration, range of migration, years of migration, having health records in local community and number of local friends among older migrants in China. Older migrants adopted negative strategies in annual physical examination compared to older nonmigrants. Active strategies should be made to improve the equity of annual physical examination for older migrants in China.

Is Travel Time Associated with Health Service Utilization in Northwest China? Evidence from Shaanxi Province.

Purpose: Northwest China has a large area, low population density, and few health resources, which makes the utilization of health resources in this region difficult. The objective of this study was to assess utilization of health services and its association with travel time in Shaanxi Province. Patients and Methods: Data were obtained from the fifth Household Health Service Survey of Shaanxi Province conducted in 2013. Binary logistic regression was used to assess the relationship between travel time and health service utilization, and negative binomial regression was conducted to assess the relationship between travel time and the frequency of health service utilization. Results: A total of 42.6% of patients used health services, with a higher use rate among rural residents than among urban residents (47.0% and 27.4%, respectively). A total of 30.9% of patients traveled more than 15 min to the nearest medical facility (33.3% in rural areas and 22.6% in urban areas). A total of 12.4% of patients traveled more than 30 min to the nearest medical facility (15.1% in rural areas and 3.0% in urban areas). Urban residents living farthest from health care facilities (more than 30 min) had a 2.12-fold higher probability of health service utilization and expected to have a health service utilization rate 1.77 times greater than that of residents with a travel time of less than 5 min. Among the rural population, there was no significant correlation between travel time and health service utilization. Conclusion: Urban patients living farthest from hospitals were more likely to use health services and used health services more frequently. This suggests that more attention should be given to urban patients who live far away from health service providers in Shaanxi Province.

Prevalence of and Factors Associated With Nutritional Supplement Use Among Older Chinese Adults: A Nationwide Cross-Sectional Study in China.

Objective: This study identified the prevalence of nutritional supplement (NS) use among older Chinese adults and explored the factors associated with NS use in this population. Methods: We used data from 11,089 Chinese men and women aged ≥ 65 years from the 2018 Chinese Longitudinal Healthy Longevity Survey. The chi-square test was used to examine the differences in demographics, health status and lifestyles at different levels. Multivariate logistic regression was used to assess the association between NS use and demographic and lifestyle characteristics. Results: Twelve percent of Chinese adults aged 65 years and above used NS. In terms of the type of supplement used, the most commonly used was calcium (8.49%), followed by protein (2.73%) and multivitamins (2.40%). In terms of demographic characteristics, women, older people, urban residents with other marital status, higher educational level, better living conditions and better lifestyle habits showed a greater use of some kinds of NS to varying degrees. Factors associated with the use of any NS included female gender [OR = 1.71, 95% confidence intervals (95% CI): 1.09-1.44], age 85-94 (OR = 1.30, 95% CI: 1.08-1.58), urban household registration (hukou) (OR = 1.25, 95% CI:1.46-2.00), higher education (primary school and middle school: OR = 1.32, 95% CI:1.14-1.52; high school and above: OR = 1.56, 95% CI:1.25-1.94), average and poor living standard (average: OR = 0.64, 95% CI:0.56-0.73; poor: OR = 0.42, 95% CI:0.32-0.55), poor health status (OR = 1.36, 95% CI:1.13-1.63), former smoking (OR = 1.33, 95% CI:1.11-1.60), and having exercise habits (former exercise: OR = 2.24, 95% CI:1.83-2.74; current exercise: OR = 2.28, 95% CI:2.00-2.61). Women reported taking 2-3 kinds of NSs, and more than 50% of NS users reported taking supplements often. Conclusion: This study provides information on the current prevalence of NS use among older Chinese adults, and it clarifies the association of NS use with demographic, lifestyle and other factors. Providing scientifically based health guidance on NS use for older people is crucial to promoting their health.

Temporal Trends in the Incidence and Disability Adjusted Life Years of Schizophrenia in China Over 30 Years.

Background: Schizophrenia is an important public health problem in China. This study aims to assess the long-term trends in the incidence and disability-adjusted life years (DALYs) rate of schizophrenia in China between 1990 and 2019. Methods: The incidence and DALYs data were drawn from the Global Burden of Disease Study 2019, and an age-period-cohort model was used in the analysis. Results: The age-standardized incidence rate (ASIR) and age-standardized DALYs rate (ASDR) of schizophrenia increased by 0.3 and 3.7% for both sexes between 1990 and 2019. For males, the local drift for incidence was higher than 0 (P < 0.05) in those aged 10 to 29 years (local drifts, 0.01 to 0.26%) and lower than 0 (P < 0.05) in those aged 35 to 74 years (local drifts, -1.01 to -0.06%). For females, the local drift was higher than 0 (P < 0.05) in those aged 10 to 34 years (local drifts, 0.05 to 0.26%) and lower than 0 (P < 0.05) in those aged 40 to 74 years (local drifts, -0.86 to -0.11%). The local drift for DALYs rate was higher than 0 (P < 0.05) in the age group from 10 to 69 years (local drifts, 0.06 to 0.26% for males and 0.06 to 0.28% for females). The estimated period and cohort relative risks (RR) for DALYs rate of schizophrenia were found in monotonic upward patterns, and the cohort RR for the incidence increased as the birth cohort moved forward starting with those born in 1972. Conclusion: Although the crude incidence of schizophrenia has decreased in China, the ASIR, ASDR, and crude DALYs rate all showed a general increasing trend over the last three decades. The DALYs rate continue to increase as the birth cohort moved forward, and the increasing trend of incidence was also found in individuals born after 1972. More efforts are needed to promote mental health in China.

Trends in depression incidence in China, 1990-2019.

BACKGROUND: Depression is one of the most widespread health burdens for the general population in China. This study aims to assess the long-term trends of depression incidence in China between 1990 and 2019. METHODS: The incidence data were drawn from the Global Burden of Disease Study 2019, and an age-period-cohort model was used in the analysis. RESULTS: The net drift was -0.66% (95% CI: -0.79% to -0.53%) per year for both genders. For males, the local drift was lower than 0 (P<0.05) in those aged 10-54 years, and higher than 0 (P<0.05) in those aged 60-69 years. For females, the local drift was lower than 0 (P<0.05) in those aged 10-49 years and higher than 0 (P<0.05) in those aged 55-84 years. Females had a higher risk of depression incidence than males. Compared with the 1990-1994 period, the relative risk (RR) of depression incidence in 2015-2019 decreased by 12.2% in males and 12.3% in females, and compared to the 1903-1907 birth cohort, the cohort RRs in the 2008-2012 birth cohort decreased by 42.1% in males and 34.5% in females. Period and cohort RRs all showed an increased tendency in recent periods and birth cohorts. LIMITATIONS: These data are macrolevel estimates at the national level, may have ecological fallacies. CONCLUSIONS: Although the age-standard incidence of depression has declined in China as a whole in the last three decades, the incidence of depression among older individuals has increased. More efforts are needed to promote the mental health of elderly individuals in China.

Trends in Under-5 Mortality Rates and Their Associations with Socioeconomic Factors Among Countries Participating in the Belt and Road Initiative: A Panel Data Analysis.

PURPOSE: The Belt and Road Initiative (BRI) provided a platform to promote trade and economic collaboration, with health promotion also being an important component. This study examined the burden of the under-5 mortality rate (U5MR) among BRI countries and studied the impact of socioeconomic development on the U5MR. PATIENTS AND METHODS: Data were collected from 137 BRI countries for the period 2000-2018. The temporal changes in the U5MR and the estimated annual percentage change (EAPC) were used to assess the U5MR burden. A quantile fixed-effects model was used to access the associations between socioeconomic factors and the U5MR. RESULTS: The U5MR varied widely among the 137 analyzed countries in 2018, being highest in Somalia (121.5 per 1000) and lowest in Slovenia (2.1 per 1000). The decreasing trend in U5MR was largest in Montenegro (EAPC = -9.6, 95% confidence interval [CI] = -10.2 to -9.0), while the increasing trend was largest in Dominica (EAPC = 6.0, 95% CI = 5.3 to 6.7). Countries with higher U5MRs in 2000 experienced more rapid decreases in the U5MR from 2000 to 2018. The influence of socioeconomic factors on U5MR was related to the distribution of U5MR. CONCLUSION: The U5MR remains a major public-health issue in some BRI countries. Improving the economic situation will benefit child health in BRI countries in the long run.

Whether high government subsidies reduce the healthcare provision of township healthcare centers in rural China.

BACKGROUND: China's government launched a large-scale healthcare reform from 2009. One of the main targets of this round reform was to improve the primary health care system. Major reforms for primary healthcare institutions include increasing government investment. However, there are insufficient empirical studies based on large sample to catch long-term effect of increased government subsidy and lack of sufficient incentives on township healthcare centers (THCs), therefore, this study aims to provide additional empirical evidence on the concern by conducting an empirical analysis of THCs in Shaanxi province in China. METHODS: We collected nine years (2009 to 2017) data of THCs from the Health Finance Annual Report System (HFARS) that was acquired from the Health Commission of Shaanxi Province. We applied two-way fixed effect model and continue difference-in-difference (DID) model to estimate the effect of percentage of government subsidy on medical provision. RESULTS: A clear jump of the average percentage of government subsidy to total revenue of THCs can be found in Shaanxi province in 2011, and the average percentage has been more than 60% after 2011. Continue DID models indicate every 1% percentage of government subsidy to total revenue increase after 2011 resulted in a decrease of 1.1 to 3.5% in THCs healthcare provision (1.9% in medical revenue, 1.2% in outpatient visit, 3.5% in total occupy beds of inpatient, 1.1% in surgery revenue, 2.1% in sickbed utilization rate). The results show that the THCs with high government subsidy reduce the number of medical services after 2011. CONCLUSIONS: We think that it is no doubt that the government should take more responsibility for the financing of primary healthcare institutions, the problem is when government plays a central role in the financing and delivery of primary health care services, more effective incentives should be developed.

Trends in Mortality Rates for Alzheimer's Disease and Other Dementias Over 30 Years in China.

OBJECTIVE: This study examines trends in the mortality of Alzheimer's disease and other dementias in China from 1990 to 2019. METHODS: The data were drawn from the Global Burden of Disease Study 2019 (GBD 2019), and an age-period-cohort model was used for analysis. RESULTS: The net drift was .152% (95% confidence interval [CI]: .069%, .235%) per year for men (P < .05) and .024% (95% CI: -.078%, .126%) per year for women. The local drift values were below 0 in both genders for people aged 45-54 years (P < .05), and above 0 for males aged 60-94 years and females aged 60-79 years (P < .05). In the same birth cohort, the risk of mortality of Alzheimer's disease and other dementias exponentially increases with age for both genders. CONCLUSION: More rapid and effective efforts are needed to mitigate the substantial impact of Alzheimer's and other dementias on the health of China's elderly.

Exploring the relationship between functional limitations of the older adults and the health-related quality of life of their spouse in Shaanxi Province, China.

BACKGROUND: With trends towards longer life expectancy, lifetime with disability has also been prolonged. It is increasingly recognized that not only the person with disability but also those around them are affected. The relationship between functional limitation (FL) of the older adults and health-related quality of life (HRQoL) of their spouse is of interest. So too is the determination of the factors aside from FL that influence HRQoL. METHODS: The sample was derived from the 2013 National Health Service Survey conducted in Shaanxi Province in China. Married couples aged ≥ 60 years were selected (n = 3463). The European quality of life five dimensions (EQ-5D) and visual analogue scale were used to measure HRQoL. RESULTS: Both wife and husband reported lower HRQoL if either the male or female partner had some or serious FLs (P < 0.001). Other factors associated with lower HRQoL of the spouse included age, lower educational level, presence of chronic disease, and lower household economic status. Family size was associated with wife's HRQoL only when the male had no FL and lived with another 1-2 persons, or when the male had some FLs and lived in a larger family (n ≥ 5). Residential status did not relate to the HRQoL of spouses regardless of FL status. CONCLUSIONS: Older adults in Shaanxi province who have partners with FLs tend to report poorer EQ-5D, suggesting that couples amongst whom one has FL may be particularly vulnerable to lower HRQoL.

Benefit of China's Social Health Insurance Schemes: Trend Analysis and Associated Factors Since Health Reform.

With the deepening of health insurance reform in China, the integration of social health insurance schemes was put on the agenda. This paper aims to illustrate the achievements and the gaps in integration by demonstrating the trends in benefits available from the three social health insurance schemes, as well as the influencing factors. Data were drawn from the three waves of the China Health and Nutrition Survey (2009, 2011, 2015) undertaken since health reforms commenced. χ2, Kruskal-Wallis test, and the Two-Part model were employed in the analysis. The overall reimbursement rate of the Urban Employee Basic Medical Insurance (UEBMI) is higher than that of Urban Resident Basic Medical Insurance (URBMI) or the New Rural Cooperative Medical Scheme (NRCMS) (p < 0.001), but the gap has narrowed since health reform began in 2009. Both the outpatient and inpatient reimbursement amounts have increased through the URBMI and NRCMS. Illness severity, higher institutional level, and inpatient service were associated with significant increases in the amount of reimbursement received across the three survey waves. The health reform improved benefits covered by the URBMI and NRCMS, but gaps with the UEBMI still exist. The government should consider more the release of health benefits and how to lead toward healthcare equity.

Soybean residue based biochar prepared by ball milling assisted alkali activation to activate peroxydisulfate for the degradation of tetracycline.

The advanced oxidation process (AOPs) has caused great concern in recent years. Among them, biochar has been widely studied as a catalyst for advanced oxidation process because of its low price and low environmental risk. In this study, a novel ball milling assisted KOH activation biochar (MKBC) was prepared and applied in peroxydisulfate (PDS) activation to degrade tetracycline hydrochloride (TC-H). In comparison with the oxidation (3.48%) by PDS alone and adsorption (36.19%) by MKBC alone, the removal rate of TC-H was increased to 84.15% in the MKBC/PDS system, indicating that MKBC can successfully activate PDS. Besides, the catalytic activity of the MKBC to activate PDS for the degradation of TC-H is 58.33% higher than that of pristine biochar (PBC). In addition, MKBC has outstanding stability that after three repeated experiments, the removal rate of TC-H by the MKBC/PDS system still remains 77.35%. Meanwhile, the mechanism was investigated that the singlet oxygen (1O2) seized the principal position in the degradation of TC-H in the PDS/MKBC system. This study explored a novel, solvent-free and economic method to propose this extraordinary biochar, which provided a new strategy for the future research of biochar.

Unique MIL-53(Fe)/PDI Supermolecule Composites: Z-Scheme Heterojunction and Covalent Bonds for Uprating Photocatalytic Performance.

It is important to find an effective way to enhance the photocatalytic efficiency of metal-organic frameworks. In this work, an organic supermolecule perylene diimide (PDI) semiconductor with a carboxyl terminal was added into the synthesis process of MIL-53(Fe) crystals. The PDI/MIL-53(Fe) (PM) composite photocatalyst was first obtained. The TC-H photodegradation rate of the most efficient 5PM was nearly 94.08% within 30 min, whose apparent reaction rate constant (k) is 4 times that of PDI and 33 times that of MIL-53(Fe), respectively. By investigation and characterization, it has been found that PDI nanofibers were dispersed and fixed in MIL-53(Fe) and bonded to each other by covalent bonds. The radical trap experiments and electron spin resonance analysis illustrated that hydroxyl radical (·OH), superoxide radical (·O2-), and photogenerated holes (h+) were active species. Combined with the band structure of PDI and MIL-53(Fe), it is proposed that the PM photocatalyst was a Z-scheme heterojunction mechanism. Therefore, PM photocatalysts showed excellent charge separation and transfer ability. The performance improvement of 5PM is due to enhanced visible light absorption, efficient charge separation, and excellent redox potential. Five cyclic photocatalytic tests and experiments further demonstrate that the 5PM photocatalyst has a promising future for pollutant removal.

Rapid removal of organic pollutants by a novel persulfate/brochantite system: Mechanism and implication.

Using natural minerals as persulfate activators can develop effective and economical in situ chemical oxidation technology for environmental remediation. Yet, few natural minerals can provide a high activation efficiency. Here, we demonstrate that brochantite (Cu4SO4(OH)6), a natural mineral, can be used as a persulfate activator for the rapid degradation of tetracycline hydrochloride (TC-H). Approximately 70% of TC-H was removed in Cu4SO4(OH)6/PDS within 5 min, which much higher than that of Cu3P (61.99%), CuO (29.75%), CNT (25.83%), Fe2O3, (14.48%) and MnO2 (9.76%). Experiments and theoretical calculations suggested that surface copper acts as active sites induce the production of free radicals. The synergistic effect of Cu/S promotes the cycle between Cu+/Cu2+. Sulfate radicals and hydroxyl radicals are the main reactive oxygen species that are responsible for the rapid removal of TC-H. The findings of this work show a novel persulfate/brochantite system and provide useful information for the environmental remediation.

Forecasting the Populations of Overweight and Obese Chinese Adults.

PURPOSE: The objective of this study was to forecast the prevalence rates and the populations of overweight and obese in Chinese adults for 2030. MATERIALS AND METHODS: Nine waves of China Health and Nutrition Survey (CHNS) data from 1991 to 2015 were used. A polynomial regression model was fitted to obtain the average BMI change trajectory of the population born in different years according to different sexes and residence areas (urban and rural). The model fitted to CHNS 2015 survey data was used to forecast the distribution of BMI and the prevalence rates of overweight and obesity in 15 years. The United Nations population forecast was then used to predict the proportions of overweight obese adults in all age groups in China in 2030. RESULTS: The prevalence rates of overweight and obesity were projected to increase in both sexes and all geographic areas in future. By 2030, urban males will have the highest prevalence of overweight, 50.7% (95% CI: 47.5%, 53.9%). Except urban males, the prevalence of overweight and obesity in rural areas will exceed that in urban for both sexes. In 2030, the numbers of overweight and obese people in China aged 20-89 years will reach 540 million and 150 million, respectively, which are 2.8 and 7.5 times higher compared to prevalences in 2000. In 2030, the number of overweight and obese people in China aged 60-89 years will reach 200 million and 40 million, respectively, 6.3 and 8.5 times increments from the year 2000. CONCLUSION: The prevalence rates of overweight and obese in Chinese adults are projected to increase further, by 2030 more than half of adult males living in urban areas will be overweight. Combined with changes in the population age structure, overweight and obesity will have a huge impact on the health of the Chinese population over the next 15 years.

Measuring spatial accessibility and within-province disparities in accessibility to county hospitals in Shaanxi Province of Western China based on web mapping navigation data.

BACKGROUND: The Chinese government proposed the "XIAO BING BU CHU CUN, DA BING BU CHU XIAN" initiative in 2016, which states the rate of health care service provided by county hospitals should reach 90% of overall health care service provision. The prerequisite for achieving this goal is that citizens should be able to access county hospitals' services conveniently and impartially. However, little research has been done on the actual levels of the spatial accessibility of citizens to county hospitals in Western China. Therefore, we aimed to measure the spatial accessibility to county hospitals for county residents and to identify any regional disparities in Shaanxi Province in Western China. METHODS: We implemented a novel method - involving utilizing navigation data from the AutoNavi web mapping system (knows as Gaode map in Chinese) - to assess the time and distance from villages and neighborhoods to the county hospitals. The navigation data were collected by request through an application-programming-interface using a web crawler (web data extraction tool) in Python. The shortest driving time and distance were extracted from the navigation data. The travel impedance to the nearest provider (TINP) indicator was used to measure spatial accessibility. RESULTS: The results show that county residents in Western China's Shaanxi Province have poor spatial accessibility to county hospitals. Only 68.8% of villages and neighborhoods are within 60 min travel time (based on driving mode) to a county hospital, while 13.4% of such villages and neighborhoods are beyond 90 min travel time. Moreover, a significant within-province disparity exists, with residents in the central area enjoying the best accessibility to county hospitals, while the northern and southern areas still need improvements in accessibility. CONCLUSIONS: Focused health resource planning is required to improve the spatial accessibility to county hospitals and to eliminate regional disparities. Further studies are called for to integrate the navigation data of web mapping systems with GIS methods to the measure spatial accessibility of health facilities in more complex contexts.