Coinfection of human adenovirus and recombinant human astrovirus in a case of acute gastroenteritis: A report from China.

Diarrhea is one of the major public health issues worldwide. Although the infections of individual enteric virus have been extensively studied, elucidation of the coinfection involving multiple viruses is still limited. In this study, we identified the coinfection of human adenovirus (HAdV) and human astrovirus (HAstV) in a child with acute gastroenteritis, analyzed their genotypes and molecular evolution characteristics. The sample was collected and identified using RT-PCR and subjected to whole-genome sequencing on the NovaSeq (Illumina) platform. Obtained sequences were assembled into the complete genome of HAdV and the ORF1 of HAstV. We conducted phylogenetic analysis using IQ-TREE software and conducted recombination analysis with the Recombination Detection Program. The sequenced HAdV was confirmed to be genotype 41, and was genetically close to some European strains. Phylogenetic analysis revealed that the HAstV was genetically close to both HAstV-2 and HAstV-4 and was different from the genotype prevalent in Shenzhen before. The recombination analysis confirmed that the sequenced HAstV strain is a recombinant of HAstV-2 and HAstV-4. Our analysis has shown that the strains in this coinfection are both uncommon variants in this geographical region, instead of dominant subtypes that have prevailed for years. This study presents a coinfection of HAdV and HAstV and conducts an evolutionary analysis on involved viruses, which reveals the genetic diversity of epidemic strains in Southern China and offers valuable insights into vaccine and medical research.

Diagnosis of the fragmentation of urban ecological network structure and its social-ecological responses.

The fragmentation of ecological network structures has become a common problem faced by cities. By establishing the urban ecological network under a specific socio-ecological system framework, we aimed to propose a quantitative index to diagnose the fragmentation of the network structure, and to construct detection model to explore the driving factors and mechanism of the network fragmentation. Using Shenzhen City as an example, we used the Floyd-Prim algorithm to generate the skeleton structure of the ecological network and construct a density discontinuity index to diagnose network fragmentation. Combined with the ecological network scenario, social-ecological system framework and a two-layer indicator system were constructed. The detection models were then established to explore the drivers of network disruption and their mode of impact. The models show that the average degree of network fragmentation in Shenzhen was 0.13, and the density of about 85% of corridor discontinuities was greater than 0.01, reflecting the serious state of structural fragmentation. Corridors with more severe structural fragmentation have poorer social-ecological coordination. The fragmentation in Shenzhen was mainly affected by the activities of actors (A) at the microlevel and the resource system (RS) at the macrolevel. The methods and the framework of socio-ecosystem analysis proposed in this paper can reveal the driving factors and influence modes of network fragmentation, providing decision-making reference for ecological restoration practice in urbanized areas.

Association between the guardians' educational levels and unintentional injuries in children aged 6-18 in Shenzhen, China.

BACKGROUND: Unintentional injuries is the leading cause of death in children aged 6-18 in China. Previous studies on the association between the guardians' educational levels and unintentional injuries in children have been inconclusive, and it remains unclear among the Chinese population. Therefore, this study aimed to identify the association between guardians' educational levels and unintentional injuries in children aged 6-18 in Shenzhen, China. METHODS: This cross-sectional study enrolled 9,903 children aged 6-18 in Shenzhen in 2020 using a multistage cluster sampling method. Information on the children and guardians were collected, and unintentional injuries in the past year was examined by using two nested questions. Logistic regression analyses were used to test the association between the guardians' educational levels and unintentional injuries in children aged 6-18, and the crude odds ratios (ORs) and adjusted ORs with 95% confidence intervals (95% CI) were calculated. RESULTS: 275 of the 9,903 children reported experiencing at least one unintentional injuries in the past year, and the weighted incidence of unintentional injuries was 6.3% (95% CI: 5.8-6.8%) in children aged 6-18 in Shenzhen, China. The incidence of unintentional injuries differed significantly in the guardians' education levels (P < 0.05). After adjustment for the children's variables, multiple binary logistic regression analysis showed that compared to children whose guardians' educational levels were low, children whose guardians' educational levels were high (adjusted OR = 0.57, 95% CI: 0.37-0.87) and medium (adjusted OR = 0.56, 95% CI: 0.39-0.81) had a lower odds of unintentional injuries. Similar results were also observed when further adjustment for both the children's and guardians' variables. CONCLUSION: The overall incidence of unintentional injuries in children aged 6-18 in Shenzhen was low, and it was associated with the guardians' educational levels. Children whose guardians' educational levels were low should be given special concern to prevent unintentional injuries, and it is suggested to reduce the incidence of unintentional injuries in children by improving the guardians' educational levels.

Efficient organized colorectal cancer screening in Shenzhen: a microsimulation modelling study.

BACKGROUND: Colorectal cancer (CRC) is a global health issue with noticeably high incidence and mortality. Microsimulation models offer a time-efficient method to dynamically analyze multiple screening strategies. The study aimed to identify the efficient organized CRC screening strategies for Shenzhen City. METHODS: A microsimulation model named CMOST was employed to simulate CRC screening among 1 million people without migration in Shenzhen, with two CRC developing pathways and real-world participation rates. Initial screening included the National Colorectal Polyp Care score (NCPCS), fecal immunochemical test (FIT), and risk-stratification model (RS model), followed by diagnostic colonoscopy for positive results. Several start-ages (40, 45, 50 years), stop-ages (70, 75, 80 years), and screening intervals (annual, biennial, triennial) were assessed for each strategy. The efficiency of CRC screening was assessed by number of colonoscopies versus life-years gained (LYG). RESULTS: The screening strategies reduced CRC lifetime incidence by 14-27 cases (30.9-59.0%) and mortality by 7-12 deaths (41.5-71.3%), yielded 83-155 LYG, while requiring 920 to 5901 colonoscopies per 1000 individuals. Out of 81 screening, 23 strategies were estimated efficient. Most of the efficient screening strategies started at age 40 (17 out of 23 strategies) and stopped at age 70 (13 out of 23 strategies). Predominant screening intervals identified were annual for NCPCS, biennial for FIT, and triennial for RS models. The incremental colonoscopies to LYG ratios of efficient screening increased with shorter intervals within the same test category. Compared with no screening, when screening at the same start-to-stop age and interval, the additional colonoscopies per LYG increased progressively for FIT, NCPCS and RS model. CONCLUSION: This study identifies efficient CRC screening strategies for the average-risk population in Shenzhen. Most efficient screening strategies indeed start at age 40, but the optimal starting age depends on the chosen willingness-to-pay threshold. Within insufficient colonoscopy resources, efficient FIT and NCPCS screening strategies might be CRC initial screening strategies. We acknowledged the age-dependency bias of the results with NCPCS and RS.

High-resolution emission inventory of biogenic volatile organic compounds for rapidly urbanizing areas: A case of Shenzhen megacity, China.

The effects of volatile organic compounds on urban air quality and the ozone have been widely acknowledged, and the contributions of relevant biogenic sources are currently receiving rising attentions. However, inventories of biogenic volatile organic compounds (BVOCs) are in fact limited for the environmental management of megacities. In this study, we provided an estimation of BVOC emissions and their spatial characteristics in a typical urbanized area, Shenzhen megacity, China, based on an in-depth vegetation investigation and using remote sensing data. The total BVOC emission in Shenzhen in 2019 was estimated to be 3.84 × 109 g C, of which isoprene contributed to about 24.4%, monoterpenes about 44.4%, sesquiterpenes about 1.9%, and other VOCs (OVOCs) about 29.3%. Metropolitan BVOC emissions exhibited a seasonal pattern with a peak in July and a decline in January. They were mainly derived from the less built-up areas (88.9% of BVOC emissions). Estimated BVOCs comprised around 5.2% of the total municipal VOC emissions in 2019. This percentage may increase as more green spaces emerge and anthropogenic emissions decrease in built-up areas. Furthermore, synergistic effects existed between BVOC emissions and relevant vegetation-based ecosystem services (e.g., air purification, carbon fixation). Greening during urban sprawl should be based on a trade-off between BVOC emissions and ecosystem benefits of urban green spaces. The results suggested that urban greening in Shenzhen, and like other cities as well, need to account for BVOC contributions to ozone. Meanwhile, greening cites should adopt proactive environmental management by using plant species with low BVOC emissions to maintain urban ecosystem services while avoid further degradation to ozone pollution.

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OBJECTIVES: To investigate the current status of delivery room transitional care management for very/extremely preterm infants in Shenzhen City. METHODS: A cross-sectional survey was conducted in November 2022, involving 24 tertiary hospitals participating in the Shenzhen Neonatal Data Network. The survey assessed the implementation of transitional care management in the delivery room, including prenatal preparation, delivery room resuscitation, and post-resuscitation management in the neonatal intensive care unit. Very/extremely preterm infants were divided into four groups based on gestational age: <26 weeks, 26-28+6 weeks, 29-30+6 weeks, and 31-31+6 weeks. Descriptive analysis was performed on the results. RESULTS: A total of 140 very/extremely preterm infants were included, with 10 cases in the <26 weeks group, 45 cases in the 26-28+6 weeks group, 49 cases in the 29-30+6 weeks group, and 36 cases in the 31-31+6 weeks group. Among these infants, 99 (70.7%) received prenatal counseling, predominantly provided by obstetricians (79.8%). The main personnel involved in resuscitation during delivery were midwives (96.4%) and neonatal resident physicians (62.1%). Delayed cord clamping was performed in 52 cases (37.1%), with an average delay time of (45±17) seconds. Postnatal radiant warmer was used in 137 cases (97.9%) for thermoregulation. Positive pressure ventilation was required in 110 cases (78.6%), with 67 cases (60.9%) using T-piece resuscitators and 42 cases (38.2%) using a blended oxygen device. Blood oxygen saturation was monitored during resuscitation in 119 cases (85.0%). The median time from initiating transitional care measures to closing the incubator door was 87 minutes. CONCLUSIONS: The implementation of delivery room transitional care management for very/extremely preterm infants in the hospitals participating in the Shenzhen Neonatal Data Network shows varying degrees of deviation from the corresponding expert consensus in China. It is necessary to bridge the gap through continuous quality improvement and multicenter collaboration to improve the quality of the transitional care management and outcomes in very/extremely preterm infants.

Genetic characteristics of classical astroviruses in Shenzhen, China, 2016-2019.

Human astrovirus (HAstV) is a single-stranded, positive-sense RNA virus and is the leading cause of viral gastroenteritis. However, despite its prevalence, astroviruses still remain one of the least studied enteroviruses. In this study, we sequenced 11 classical astrovirus strains from clinical samples collected in Shenzhen, China from 2016 to 2019, analyzed their genetic characteristics, and deposited them into GenBank. We conducted phylogenetic analysis using IQ-TREE software, with references to astrovirus sequences worldwide. The phylogeographic analysis was performed using the Bayesian Evolutionary Analysis Sampling Trees program, through Bayesian Markov Chain Monte Carlo sampling. We also conducted recombination analysis with the Recombination Detection Program. The newly sequenced strains were categorized as HAstV genotype 1, which is the predominant genotype in Shenzhen. Phylogeographic reconstruction indicated that HAstV-1 may have migrated from the United States to China, followed by frequent transmission between China and Japan. The recombination analysis revealed recombination events within and across genotypes, and identified a recombination-prone region that produced relatively uniform recombination breakpoints and fragment lengths. The genetic analysis of HAstV strains in Shenzhen addresses the current lack of astrovirus data in the region of Shenzhen and provides key insights to the evolution and transmission of astroviruses worldwide. These findings highlight the importance of improving surveillance of astroviruses.

Impact of environmental factors on diversity of fungi in sediments from the Shenzhen River Estuary.

In this study, to explore the relationship between environmental factors and fungal diversity in the Shenzhen River ecosystem, multiple methods including chemical analysis, culture isolation, qPCR analysis of fungal ITS region and ITS-based Illumina next-generation-sequencing were integrated. A total of 115 isolates were finally isolated and could be classified into 23 genera. Top three abundant genera isolated were Meyerozyma (18 strains), Aspergillus (17 strains) and Penicillium (14 strains). Based on the Illumina sequencing approach, 829 OTUs were affiliated to seven phyla, 17 known classes, and 162 genera, indicating the Shenzhen estuary sediments are rich in fungal diversity. The major fungal genera were Meyerozyma, Trichoderma and Talaromyces. Environmental factors showed a gradient change in Shenzhen estuary, and fungal abundance was only significantly correlated with NH4+. Shannon index was significantly correlated with pH and IC (P < 0.05). Principal coordinate analysis based on OTU level grouped into three clusters among sampling sites along with the IC and pH gradient. Functional guilds analysis suggests most of the fungi in this studying area were almost all saprotrophs, suggesting a large number of saprophytic fungi may play a significant role in the organic matter decomposition and nutrient cycling process. In summary, this study will deepen our understanding of fungi community in Shenzhen River ecosystem and their distribution and potential function shaped by environmental factors.

Stronger susceptibilities to air pollutants of influenza A than B were identified in subtropical Shenzhen, China.

Air pollution was indicated to be a key factor contributing to the aggressive spread of influenza viruses, whereas uncertainty still exists regarding to whether distinctions exist between influenza subtypes. Our study quantified the impact of five air pollutants on influenza subtype outbreaks in Shenzhen, China, a densely populated and highly urbanized megacity. Daily influenza outbreak data of laboratory-confirmed positive cases were obtained from the Shenzhen CDC, from May 1, 2013 to Dec 31, 2015. Concentrations of nitrogen dioxide (NO2), sulfur dioxide (SO2), particulate matters ≤2.5 µm (PM2.5), particulate matters ≤10 µm (PM10), and ozone (O3), were retrieved from the 18 national monitoring stations. The generalized additive model (GAM) and distributed lag non-linear model (DLNM) were used to calculate the concentration-response relationships between environmental inducers and outbreak epidemics, respectively for influenza A (Flu-A) and B (Flu-B). There were 1687 positive specimens were confirmed during the study period. The cold season was restricted from Nov. 4th to Apr. 20th, covering all seasons other than the long-lasting summer. Relatively heavy fine particle matter (PM2.5) and NO2 pollution was observed in cold months, with mean concentrations of 46.06 µg/m3 and 40.03 µg/m3, respectively. Time-series analysis indicated that high concentrations of NO2, PM2.5, PM10, and O3 were associated with more influenza outbreaks at short lag periods (0-5 d). Although more Flu-B (679 cases) epidemics occurred than Flu-A (382 cases) in the cold season, Flu-A generally showed higher susceptibility to air pollutants. A 10 µg/m3 increment in concentrations of PM2.5, PM10, and O3 at lag 04, was associated with a 2.103 (95%CI: 1.528-2.893), 1.618 (95%CI: 1.311-1.996), and 1.569 (95%CI: 1.214-2.028) of the relative risk (RR) of Flu-A, respectively. A 5 µg/m3 increase in NO2 was associated with higher risk of Flu-A at lag 03 (RR = 1.646, 95%CI: 1.295-2.092) and of Flu-B at lag 04 (RR = 1.319, 95%CI: 1.095-1.588). Nevertheless, barely significant effect of particulate matters (PM2.5, PM10) on Flu-B and SO2 on both subtypes was detected. Further, the effect estimates of NO2 increased for both subtypes when coexisting with other pollutants. This study provides evidence that declining concentrations of main pollutants including NO2, O3, and particulate matters, could substantially decrease influenza risk in subtropical Shenzhen, especially for influenza A.

Schools as Drivers of Capitalist Accumulation Conditional Socialized Reproduction in Shenzhen.

Based on fieldwork in an urbanized village of Shenzhen, this paper analyzes the place of schools in the reproduction of Chinese state capitalism. It retraces the circuit of socialized capital that allows for the social reproduction of the native elite and the exclusion of many migrant workers in the context of Shenzhen's development as a special economic zone and its efforts to upgrade the economy. The native villagers, now forming an urban upper-class of rentiers, have capitalized on their overseas connections and capital accumulation to finance their school, allowing for their elite's upward social mobility after, but also already under Mao. After China's transition to capitalism, this school has served as an asset in generating value in the context of redevelopment and the real estate-driven upgrading of Shenzhen's economy. Property ownership is now a major criterion in points-based systems for accessing school places. I make two interrelated arguments. First, there is a closer relationship between the secondary circuit of socialized capital and the larger circuit of capital than what the literature on social reproduction implies. Second, the conditionality of quality education upon value generation amounts to separating the population deemed worthy of socialized reproduction and the surplus population that is left out. The paper connects diverse strands of social reproduction theory, Althusser's interpellation and ideological state apparatuses, feminist agentive social reproduction theories, and Bourdieu's capital conversion recuperated within a Marxian framework, to provide an integrated approach to social reproduction within capitalism.

Influenza A and B outbreaks differed in their associations with climate conditions in Shenzhen, China.

Under the variant climate conditions in the transitional regions between tropics and subtropics, the impacts of climate factors on influenza subtypes have rarely been evaluated. With the available influenza A (Flu-A) and influenza B (Flu-B) outbreak data in Shenzhen, China, which is an excellent example of a transitional marine climate, the associations of multiple climate variables with these outbreaks were explored in this study. Daily laboratory-confirmed influenza virus and climate data were collected from 2009 to 2015. Potential impacts of daily mean/maximum/minimum temperatures (T/Tmax/Tmin), relative humidity (RH), wind velocity (V), and diurnal temperature range (DTR) were analyzed using the distributed lag nonlinear model (DLNM) and generalized additive model (GAM). Under its local climate partitions, Flu-A mainly prevailed in summer months (May to June), and a second peak appeared in early winter (December to January). Flu-B outbreaks usually occurred in transitional seasons, especially in autumn. Although low temperature caused an instant increase in both Flu-A and Flu-B risks, its effect could persist for up to 10 days for Flu-B and peak at 17 C (relative risk (RR) = 14.16, 95% CI: 7.46-26.88). For both subtypes, moderate-high temperature (28 C) had a significant but delayed effect on influenza, especially for Flu-A (RR = 26.20, 95% CI: 13.22-51.20). The Flu-A virus was sensitive to RH higher than 76%, while higher Flu-B risks were observed at both low (< 65%) and high (> 83%) humidity. Flu-A was active for a short term after exposure to large DTR (e.g., DTR = 10 C, RR = 12.45, 95% CI: 6.50-23.87), whereas Flu-B mainly circulated under stable temperatures. Although the overall wind speed in Shenzhen was low, moderate wind (2-3 m/s) was found to favor the outbreaks of both subtypes. This study revealed the thresholds of various climatic variables promoting influenza outbreaks, as well as the distinctions between the flu subtypes. These data can be helpful in predicting seasonal influenza outbreaks and minimizing the impacts, based on integrated forecast systems coupled with short-term climate models.

Spatial identification of restored priority areas based on ecosystem service bundles and urbanization effects in a megalopolis area.

Rapid urbanization has altered the structure and function of urban ecosystems with respect to the demand for planning ecological restoration to inhibit ecological degradation. However, there is still a challenge to quickly and effectively identify the restored priority areas to maximize ecological service (ES) supply and enhance human well-being. Taking the Shenzhen metropolitan region as a case study area, this study identified the restored priority sites based on the ES bundles evolution and urbanization effects. The ES bundles were identified by analyzing the spatial dynamics under the hybrid urban landscape, then the impact of urbanization on the ES bundles was explored using linear regression analysis characterized by different levels of urbanization in different stages. Furthermore, the spatial statistics were used to identify the priority sites. The results showed that 68.78% of the grids had changed their ES bundles in terms of their quantities, types, and sites in Shenzhen during 1978-2018. The urbanization driver spatially shifts from provision of service to regulation and cultural ecosystem services and significantly negatively influences the composition and structure of the ES bundles in different urbanization stages. 1196 of the 1 square kilometer grids, which accounted for 54.17%, were identified to prioritize for ecological restoration in Shenzhen. However, only 4.08% of them need to set as the key ecological restoration site. This study explored an effectively spatial way to implement ecological restoration planning in a rapidly urbanized area.

A procedure for comparing the ecological status and transformation measures in an anthropized coastal area.

The overall vitality and quality of the coastline can be improved through ecological transformation; ecological status assessment can scientifically guide this modification by putting forward a transformation plan for the coastline. This study took the Shenzhen Bay area between Hong Kong and Shenzhen as the study area to build an index system and combined it with quantitative and qualitative methods by designing the code of data processing, calculation, and analysis through the MATLAB platform, with the goal being to put forward the directions and suggestions for coastline transformation based on the analysis of results. The results and conclusions are as follows: (1) The key aspects of the ecological transformation of the Shenzhen Bay Coastline are water quality, coastal wetland restoration, landscape diversity, beach stability, and infrastructure improvement. (2) Actions to promote these aspects include overall shoreline control of water pollution, cultural landscape implantations, the improvement of existing infrastructure, and the restoration of selected beach sand regions, mangrove wetlands, and eroded shorelines. Suggestion includes the critical support which comes from the public needs for information acquisition and science education, in addition with the policy and management, all should be formulated into the transformation plan. The index system can be applied to other regions at home and abroad, and the results and conclusions based on the index system could also provide criteria for planning the ecological transformation process.

The effectiveness of travel restriction measures in alleviating the COVID-19 epidemic: evidence from Shenzhen, China.

With the expansion of the global novel coronavirus disease (COVID-19) pandemic, unprecedented interventions have been widely implemented in many countries, including China. In view of this scenario, this research aims to explore the effectiveness of population mobility restriction in alleviating epidemic transmission during different stages of the outbreak. Taking Shenzhen, a city with a large immigrant population in China, as a case study, the real-time reproduction number of COVID-19 is estimated by statistical methods to represent the dynamic spatiotemporal transmission pattern of COVID-19. Furthermore, migration data between Shenzhen and other provinces are collected to investigate the impact of nationwide population flow on near-real-time dynamic reproductive numbers. The results show that traffic flow control between populated cities has an inhibitory effect on urban transmission, but this effect is not significant in the late stage of the epidemic spread in China. This finding implies that the government should limit international and domestic population movement starting from the very early stage of the outbreak. This work confirms the effectiveness of travel restriction measures in the face of COVID-19 in China and provides new insight for densely populated cities in imposing intervention measures at various stages of the transmission cycle.

Socio-demographic factors, dental status, oral health knowledge and attitude, and health-related behaviors in dental visits among 12-year-old Shenzhen adolescents: a multilevel analysis.

BACKGROUND: Dental visits can provide education, prevention and treatment measures for teenagers, and help to form correct oral health knowledge and attitude. The purpose of this study was to evaluate the effects of socio-demographic factors, dental status, oral health literacy, and health-related behaviors on dental visits in early 12-year-old adolescents. METHODS: 953 subjects aged 12 in Longhua district of Shenzhen were investigated. The questionnaire and clinical examination were applied in schools, and two-level logistic regression models were constructed to interpret the effect of individual and contextual factors on Shenzhen adolescents' dental visits. RESULTS: A total of 27.6% of the participants had not been to a dentist. After the multiple factors binary logistic regression analysis, it confirmed that the following variables: Shenzhen Hukou (OR 2.133, 95% CI 1.429-3.185), moderate caries (OR 1.404, 95% CI 1.022-1.928) and severe caries (OR 2.546, 95% CI 1.461-4.437), Angle Class II malocclusion (OR 1.703, 95% CI 1.134-2.556), sometimes or never toothbrushing (OR 2.985, 95% CI 1.491-5.975), dental floss usage (OR 1.829, 95% CI 1.250-2.677), having had a toothache within the last 12 months (OR 1.469, 95% CI 1.086-1.986), high knowledge attitude level (OR 1.570, 95% CI 1.106-2.229), moderate knowledge attitude level (OR 1.534, 95% CI 1.073-2.193), were associated factors for dental visit experience. CONCLUSIONS: The dental visits of 12-year-old children in Longhua district of Shenzhen is affected by multi-dimensional factors. It is suggested that oral health education should be strengthened, good oral hygiene habits should be cultivated, and the needs and utilization of oral health services for non-Shenzhen Hukou adolescents should be paid attention to, so as to effectively improve the overall oral health level of adolescents.

Predictors of waste sorting and recycling behavioural intention among youths: Evidence from Shenzhen, China and Turku, Finland.

Waste sorting and recycling (WSAR) is a crucial issue for sustainable waste management. Growing up with new values, the younger generation has the responsibility to lead the society towards a sustainable future. The successful implementation of WSAR requires an in-depth understanding of the attitudes and obstacles of the youth participation. This study seeks to explore and compare the influencing factors of youth engagement in WSAR in Shenzhen, China and Turku, Finland by drawing on the theory of planned behaviour. Quantitative data was collected from 170 youth citizens in Shenzhen and 179 in Turku. Structural equation modelling results suggest that there is a clear consistency between the youth's intention and behaviour in both cities. Two reverse pyramids were constructed to prioritize the influencing factors based on their importance in the structural models. Subjective norms, knowledge and perceived behavioural control are key influencing factors in Shenzhen group while in Turku' s setting, compatibility acts as a top determinant whereas, subjective norms have the least influencing power. Results from Turku also reveal that lower compatibility does not necessarily hinder youth participation in WSAR practice. Several suggestions and implications on boosting youth participation in WSAR are drawn, based on these findings.

Utilization of community health care centers and family doctor contracts services among community residents: a community-based analysis in Shenzhen, China.

BACKGROUND: Family doctor contract services (FDCS) began in China in 2016. Shenzhen, one of the most developed cities in China, also implemented a family doctor (FD) policy in 2017. The objectives of this study were to identify the impact of awareness of FDCS and signing service contracts with FDs on utilization of community health care centers (CHCs). METHODS: Cross-sectional secondary data based on residents living in Luohu district was used for analysis. Descriptive analysis was conducted to identify utilization of CHCs by awareness of FDCS and signing service contracts with FDs, respectively. Linear probability models (LPM) were used to determine the association of utilization of CHCs with awareness of FDCS and signing service contracts with FDs, respectively. RESULTS: Among 1205 adults included in the analysis, 27 % of the participants knew about the FDCS, 5 % signed with FD, and 20 % had chronic disease. Both awareness of the FDCS and signing service contracts with FDs significantly increased the probability of using CHCs as a first choice. CONCLUSIONS: This study provided evidence that both awareness of FDCS and signing service contracts with FDs had a positive impact on utilization of primary health care services at the community level. More interventions to improve awareness of FDCS are needed to increase the utilization of primary health care services.

Molecular Characterization of Glucose-6-Phosphate Dehydrogenase Deficiency in the Shenzhen Population.

BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is caused by one or more mutations in the G6PD gene on chromosome X. This study aimed to characterize the G6PD gene variant distribution in Shenzhen of Guangdong province. METHODS: A total of 33,562 individuals were selected at the hospital for retrospective analysis, of which 1,213 cases with enzymatic activity-confirmed G6PD deficiency were screened for G6PD gene variants. Amplification refractory mutation system PCR was first used to screen the 6 dominant mutants in the Chinese population (c.1376G>T, c.1388G>A, c.95A>G, c.1024C>T, c.392G>T, and c.871G>A). If the 6 hotspot variants were not found, next-generation sequencing was then performed. Finally, Sanger sequencing was used to verify all the mutations. RESULTS: The incidence of G6PD deficiency in this study was 3.54%. A total of 26 kinds of mutants were found in the coding region, except for c.-8-624T>C, which was in the noncoding region. c.1376G>T and c.1388G>A, both located in exon 12, were the top 2 mutants, accounting for 68.43% of all individuals. The 6 hotspot mutations had a cumulative proportion of 94.02%. CONCLUSIONS: This study provided detailed characteristics of G6PD gene variants in Shenzhen, and the results would be valuable to enrich the knowledge of G6PD deficiency.

Metal/metalloid levels in hair of Shenzhen residents and the associated influencing factors.

129 Shenzhen residents' hair samples were collected and the metal/metalloid concentrations of Hg, As, Pb, Cd, Cr, Cu, Mn, Zn, Fe and Ni were detected. Meanwhile, the relationships between metal/metalloid contents in human hair and gender, age, seafood diet habit, smoking habit, as well as the housing type (dwelling environment) were analyzed. Results showed that the average content of Hg, As, Pb, Cd, Cr, Cu, Mn, Zn, Fe and Ni in human hair of Shenzhen residents was 0.76 ± 0.96, 0.10 ± 0.04, 5.25 ± 4.88, 0.25 ± 0.33, 0.60 ± 0.31, 13.84 ± 3.67, 2.82 ± 2.01, 196.90 ± 145.01, 12.20 ± 5.10 and 0.34 ± 0.32 µg/g, respectively. Compared with other regions at home and abroad, most metal/metalloids in Shenzhen residents were at a moderate level, and the highly toxic elements (i.e. Pb, Cd, As and Hg) didn't exceed the upper limit of normal values in China. Statistical analysis showed that the young male people contained significantly higher (p < 0.05) level of Pb (in age group of 20-30 years old) and Fe (in age group of 20-40 years old) in hair than the female people. Smokers had significantly (p < 0.05) higher level of Cd (0.35 µg/g) but lower level of Zn (101.24 µg/g) than non-smokers (Cd: 0.17 µg/g; Zn: 252.63 µg/g). Hg and Pb contents in hair of Shenzhen people were positively related with the frequencies of seafood consumption and the age, respectively. Moreover, residents lived in private buildings (well decorated house) accumulated significantly higher (p < 0.05) levels of Pb, Cr, Fe and Ni as compared with those lived in public rental house and village house (no decoration or simple decoration), suggesting that decoration material was also an important way for human exposure to heavy metals.

Evaluation of work resumption strategies after COVID-19 reopening in the Chinese city of Shenzhen: a mathematical modeling study.

OBJECTIVES: As China is facing a potential second wave of the epidemic, we reviewed and evaluated the intervention measures implemented in a major metropolitan city, Shenzhen, during the early phase of Wuhan lockdown. STUDY DESIGN: Based on the classic SEITR model and combined with population mobility, a compartmental model was constructed to simulate the transmission of COVID-19 and disease progression in the Shenzhen population. METHODS: Based on published epidemiological data on COVID-19 and population mobility data from Baidu Qianxi, we constructed a compartmental model to evaluate the impact of work and traffic resumption on the epidemic in Shenzhen in various scenarios. RESULTS: Imported cases account for most (58.6%) of the early reported cases in Shenzhen. We demonstrated that with strict inflow population control and a high level of mask usage after work resumption, various resumptions resulted in only an insignificant difference in the number of cumulative infections. Shenzhen may experience this second wave of infections approximately two weeks after the traffic resumption if the incidence risk in Hubei is high at the moment of resumption. CONCLUSION: Regardless of the work resumption strategy adopted in Shenzhen, the risk of a resurgence of COVID-19 after its reopening was limited. The strict control of imported cases and extensive use of facial masks play a key role in COVID-19 prevention.