General Population In China Research Articles

The Impact of Quarantine on Pain Sensation among the General Population in China during the COVID-19 Pandemic.

During the pandemic era, quarantines might potentially have negative effects and disproportionately exacerbate health condition problems. We conducted this cross-sectional, national study to ascertain the prevalence of constant pain symptoms and how quarantines impacted the pain symptoms and identify the factors associated with constant pain to further guide reducing the prevalence of chronic pain for vulnerable people under the pandemic. The sociodemographic data, quarantine conditions, mental health situations and pain symptoms of the general population were collected. After adjusting for potential confounders, long-term quarantine (≥15 days) exposures were associated with an increased risk of constant pain complaints compared to those not under a quarantine (Odds Ratio (OR): 1.26; 95% Confidence Interval (CI): 1.03, 1.54; p = 0.026). Risk factors including unemployment (OR: 1.55), chronic disease history (OR: 2.38) and infection with COVID-19 (OR: 2.15), and any of mental health symptoms including depression, anxiety, insomnia and PTSD (OR: 5.44) were identified by a multivariable logistic regression. Additionally, mediation analysis revealed that the effects of the quarantine duration on pain symptoms were mediated by mental health symptoms (indirect effects: 0.075, p < 0.001). These results advocated that long-term quarantine measures were associated with an increased risk of experiencing pain, especially for vulnerable groups with COVID-19 infection and with mental health symptoms. The findings also suggest that reducing mental distress during the pandemic might contribute to reducing the burden of pain symptoms and prioritizing interventions for those experiencing a long-term quarantine.

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Cost-effectiveness of lung cancer screening by low-dose CT in China: a micro-simulation study

BackgroundThe effectiveness of lung cancer screening with low-dose computed tomography (LDCT) has been established. The current study evaluates the cost-effectiveness of lung cancer screening with LDCT in a general population in China. MethodsA previously validated micro-simulation model was used to simulate a cohort of men and women on a lifetime horizon in the presence and absence of LDCT screening. The modeling data were collected from numerous national and international sources. Simulated screening scenarios included different combinations of screening intervals and start and stop ages. Additional costs (valued in Chinese Yuan, CNY; 1 USD = 6.8976 CNY, 1 EUR = 7.8755 CNY in 2020), life-years gained (LYG) and mortality reduction due to screening were also determined. The costs and life-years were discounted by 3%. All results were scaled to 1,000 individuals. The average cost-effectiveness ratio (ACER) was calculated. A willingness-to-pay threshold of CNY 217.3k / LYG was considered. A healthcare system perspective was adopted. ResultsCompared to no screening, lung cancer screening by LDCT in a general Chinese population yielded 21.0 – 36.7 LYG in men and 9.2 – 16.6 LYG in women across the scenarios. For men, biennial LDCT screening yielded an ACER of CNY 171.4k – 306.3k / LYG relative to no screening. Biennial screening performed between 55 and 75 years of age was optimal at the defined threshold; it resulted in CNY 174.6k / LYG and a lung cancer mortality reduction of 9.1%, and this scenario had a 75% probability of being cost-effective. For women, the ACER ranged from CNY 364.2k to 1193.3k / LYG. ConclusionsIn China, lung cancer screening with LDCT in the general population including never smokers could be cost-effective for men with 75% probability, but not for women. The optimal strategy for men would be performing biennial screening between 55 and 75 years of age.

Public Stigma of COVID-19 and Its Correlates in the General Population of China.

This study aimed to examine the profile of COVID-19-related public stigma and its correlates in the general population of China. A cross-sectional online survey was conducted in China from 7 May to 25 May in 2020. A total of 1212 participants from the general population completed the survey measuring their stigmatizing attitudes towards COVID-19, as well as knowledge and causal attributions of COVID-19. Univariate and multivariate analyses were performed to examine the correlates of COVID-19-related public stigma. A total of 31.8% of participants endorsed stigmatization towards people with COVID-19. Those who were of older age (t = −3.97, p < 0.001), married (F = 3.04, p < 0.05), had a lower level of education (F = 8.11, p < 0.001), and a serious psychological response (F = 3.76, p < 0.05) reported significantly higher scores of public stigma. Dangerousness (B = 0.047, p < 0.001), fear (B = 0.059, p < 0.001), anger (B = 0.038, p < 0.01), and responsibility (B = 0.041, p < 0.001) were positively associated with public stigma. This study shows that public stigma related to COVID-19 is prevalent in the general population of China. Actions against public stigma need to contain the spread of misinformation about COVID-19, alter inappropriate attributions, alleviate unfavorable reactions, and provide psychosocial support for the public.

Several typical endocrine-disrupting chemicals in human urine from general population in China: Regional and demographic-related differences in exposure risk

Endocrine-disrupting chemicals (EDCs) are ubiquitous in the environment, and human exposure to these pollutants has caused great public concern. Five groups of EDCs, including parabens, antimicrobials (triclosan (TCS) and triclocarban (TCC)), bisphenols (BPs), tetrabromobisphenol A and its alternatives (TBBPAs), and benzophenones, in urines of general populations from three cities with different economic levels in China were determined simultaneously to evaluate the coexposure levels of such chemicals. The total concentration of target compounds was approximately two times higher in the urines from Chengdu (a first-tier city; geometric mean: 2.50 μg/L) than that from Nantong (a second-tier city; 1.34 μg/L), and was one order of magnitude higher than that from Shehong (a fifth-tier city; 0.73 μg/L). Urinary target compounds were significantly correlated with gender, age, body mass index (BMI), education level, occupation, and diet. The estimated daily intakes of target chemicals ranged from 0.002 (benzophenones) to 10.2 µg/kg-bw/day (parabens). The exposure estimate showed that females were more vulnerable to exposure to these EDCs. This study profiles the regional and demographic-related differences in the concentrations and exposure risks of several typical EDCs in urines from general populations in three cities with different economic levels in China.

Trends in depression incidence in China, 1990–2019

BackgroundDepression 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. MethodsThe incidence data were drawn from the Global Burden of Disease Study 2019, and an age–period–cohort model was used in the analysis. ResultsThe 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. LimitationsThese data are macrolevel estimates at the national level, may have ecological fallacies. ConclusionsAlthough 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.

Seroepidemiology of Chlamydia trachomatis Infection in the General Population of Northern China: The Jidong Community Cohort Study

A longitudinal serological study to investigate the seropositive frequency, incidence, and antibody dynamics of Chlamydia trachomatis infection in the general population of China is urgently needed in order to optimize the strategies for surveillance and precise prevention of C. trachomatis infection. This longitudinal study enrolled 744 subjects aged 18–65 years from Jidong Community of Northern China from 2014 to 2018. Seropositive frequency, incidence, and reinfection of C. trachomatis were determined by detecting antibody against C. trachomatis Pgp3 using “in-house” luciferase immunosorbent assay (LISA). The dynamic of anti-Pgp3 antibody was analyzed using the Generalized Estimating Equation (GEE) model. The overall Pgp3 seropositive frequency among the 18–65-year-old population was 28.1% (95% CI 24.9–31.5), and significantly increased from 12.0% in those aged 18–29 years to 48.6% in the 60–65 years old. The seropositive frequency was slightly higher in women than in men (31.3% vs. 25.4%) without statistical significance. The C. trachomatis incidence and reinfection rate were 11 and 14 per 1,000 person-years, respectively, and showed no significant difference with respect to age, gender, ethnicity, marital status, and education levels. Furthermore, anti-Pgp3 antibody remained detectable in 93.3% (195/209) of the seropositive subjects during the 5 years of follow-up. The overall decay rate for anti-Pgp3 antibody for CT-infected persons was −0.123 Log2 RLU/year, which was dramatically slower than in CT new infection (−3.34 Log2 RLU/year) or reinfection (−1.1 Log2 RLU/year). In conclusion, at least one quarter of the people aged 18–65 years have been infected with C. trachomatis over their lifetime while all age groups are susceptible to C. trachomatis infection in the community of Northern China. Therefore, comprehensive prevention strategies are urgently needed.

Current Status and Associated Factors of Depression and Anxiety Among the Chinese Residents During the Period of Low Transmission of COVID-19.

Background: The outbreak of coronavirus disease 2019 (COVID-19) has contributed to depression and anxiety among the general population in China. The purpose of this study is to investigate the prevalence and associated factors of these psychological problems among Chinese adults during the period of low transmission, which could reflect the long-term depression and anxiety of the COVID-19 outbreak.Methods: A cross-sectional survey was conducted in China from 4 to 26 February 2021. Convenient sampling strategy was adopted to recruit participators. Participants were asked to filled out the questions that assessed questionnaire on the residents’ depression and anxiety.Results: A total of 2,361 residents filled out the questionnaire. The mean age was 29.72 years (SD = 6.94) and majority of respondents were female (60.10%). Among the respondents, 421 (17.83%), 1470 (62.26%), and 470 (19.91%) were from eastern, central, and western China, respectively. 1704 (72.17%) consented COVID-19 information has been disclosed timely. 142 (6.01%) and 130 (5.51%) patients suffered from depression and anxiety symptoms. Furthermore, some influencing factors were found, including marital status, place of residence, employment status.Conclusion: This study revealed that anxiety and depression still are potential depression and anxiety for some residents, which suggested early recognition and initiation of interventions during the period of low transmission is still indispensable.

Family caregivers of rare disease: A survey on health-related quality of life in family caregivers for Gaucher disease patients in China.

BackgroundRare diseases affect the health‐related quality of life (HRQoL) of patients and their family caregivers (FCs). However, limited evidence is available on the HRQoL of FCs of patients with Gaucher disease (GD). This study aimed to assess HRQoL and related factors among FCs of patients with GD in China.MethodsA cross‐sectional online survey was conducted with 49 FCs recruited by convenience sampling. Participants completed the Medical Outcome Study Short Form‐36 (SF‐36), Zung's Self‐Rating Anxiety Scale, Zung's Self‐Rating Depression Scale, the Multi‐dimensional Scale of Perceived Social Support, the Herth Hope Index, and a questionnaire about FCs’ and patients’ sociodemographic characteristics. Single‐sample t tests, one‐way analysis of variance, and multivariate linear regression analysis were used to analyze the data analysis.ResultsParticipating FCs had significantly lower scores in all eight SF‐36 domains compared with the general population in China (p < 0.01). FCs’ gender, education, daily care time, anxiety, and the perceived disease severity of patients were significant predictors of SF‐36 physical component summary scores. Caregiving help from others, anxiety, perceived disease severity, and medical insurance type were significant predictors of SF‐36 mental component summary scores.ConclusionThe findings showed FCs of patients with GD had lower HRQoL. There is an urgent need to address the health concerns of FCs of people with rare diseases including their HRQoL.

Patterns of mental health problems before and after easing COVID-19 restrictions: Evidence from a 105248-subject survey in general population in China.

The COVID-19 pandemic has alarming implications for individual and population level mental health. Although the future of COVID-19 is unknown at present, more countries or regions start to ease restrictions. The findings from this study have provided the empirical evidence of prevalence and patterns of mental disorders in Chinese general population before and after easing most COVID-19 restrictions, and information of the factors associated with these patterns. A cross-sectional population-based online survey was carried out from February to March 2020 in the general population across all provinces in China. The 12-item General Health Questionnaire (GHQ-12) was incorporated in the survey. Latent class analyses were performed to investigate the patterns of mental disorders and multinomial logistic regressions were used to examine how individual and regional risk factors can predict mental disorder patterns. Four distinctive patterns of mental health were revealed in the general population. After the ease of most COVID-19 restrictions, the prevalence of high risk of mental disorders decreased from 25.8% to 20.9% and prevalence of being high risk of unhappiness and loss of confidence decreased from 10.1% to 8.1%. However, the prevalence of stressed, social dysfunction and unhappy were consistently high before and after easing restrictions. Several regional factors, such as case mortality rate and healthcare resources, were associated with mental health status. Of note, healthcare workers were less likely to have mental disorders, compared to other professionals and students. The dynamic management of mental health and psychosocial well-being is as important as that of physical health both before and after the ease of COVID-19 restrictions. Our findings may help in mental health interventions in other countries and regions while easing COVID-19 restrictions.

Factors related to perceived stress during the COVID-19 epidemic context among the general population in China: A cross-sectional nationwide study

BackgroundThis study aimed to investigate factors related to high stress levels among the general population in China during the novel coronavirus disease (COVID-19) pandemic when its containment measures were in place and to identify the most stressed populations. MethodsA nationwide study was conducted online among 5,039 adults in all 31 provinces in mainland China between March 1 and March 16, 2020. Bivariate analysis and multivariate logistic regressions were performed to explore the related factors of high perceived stress. ResultsAmong all respondents, 36.0% reported a high level of stress. Respondents in Hubei province (the epicenter) were more likely to report high stress levels than those in low epidemic areas. Respondents who went outside every day or every other day reported greater odds of experiencing a high level of stress than those who went outside every 8–14 days. People with higher risk perceptions were more prone to report high stress levels. Respondents aged 16–35 were more likely to report high stress than respondents aged 46 or older. Lower household income and lower health literacy were related to increased odds of reporting high stress levels. LimitationsWe used a convenience sample and self-reported survey data. ConclusionsWe identified risk factors for high stress levels related to the epidemic (epidemic intensity in residential areas, risk perception, and frequency of going outside) and other vulnerabilities (younger age, low household income, low health literacy). Our findings can directly inform interventions and policies for mitigating stress among the general population for this or future epidemics.

B-PO02-002 ANXIETY AND DEPRESSION AMONG ARRHYTHMIA INPATIENTS IN CHINA: A CROSS-SECTIONAL STUDY OF A SINGLE TERTIARY CENTER

Few studies have demonstrated psychological status in forms of anxiety and depression among overall arrhythmia patients. To assess whether arrhythmia inpatients have a higher prevalence of mental disorders than the general population in China and identify potential factors. This cross-sectional survey was conducted in the arrhythmia department of a single Chinese tertiary center. The psychological status of all enrolled inpatients was assessed using the Zung Self-Rating Anxiety Scale (SAS) and the Zung Self-Rating Depression Scale (SDS). Four hundred and ninety-five arrhythmia inpatients were enrolled in this study. The mean age of the participants was 52.80±14.38 years, and 58.0% were male. Moreover, 90.1% of the participants were married, 41.2% were unemployed. Of these patients, 18.8% were in an anxious state and 34.1% were in a depressive state. The overall anxiety (41.24±9.42) and depression (44.11±12.05) scores were much higher than the Chinese norm (29.78±10.46 and 33.50±8.60, respectively), and the differences were statistically significant (t=27.075, P<0.001 and t=34.381, P<0.001, respectively). Multivariable logistic regression results showed that being unemployed (B=0.787, P=0.016) was significantly associated with anxiety; arrhythmia type (B=-0.830, P=0.003) was significantly associated with depression; marital status (B=-0.981, P=0.045) and arrhythmia type (B=-0.772, P=0.006) were significantly associated with mental disorders (anxiety or depression). Patients with cardiac implanted electronic devices were at higher mental disorders than patients under radiofrequency catheter ablation, (48.5% vs 34.3%, Chi-square values =6.782, P =0.009). Anxiety and depression are widespread in arrhythmia patients. Being unemployed has a positive association with anxiety. Cardiac implanted electronic devices have a positive association with depression. Being married has a negative association with mental disorders.

Knowledge and attitudes toward expanded carrier screening between the medical staff and general population in China

ObjectiveThe purpose of our study was to assess the knowledge and attitudes toward expanded carrier screening (ECS) between the medical staff and general population in China. Study designIt was a survey-based cross-sectional study in Chinese. We provided an online survey for the general public nationwide. We classified the population into the medical staff and general population to evaluate the knowledge gap and provide a reference for ECS's education programs. Except for obstetrician-gynecologists and nurses in the department of Obstetrics and Gynecology, other medical staff were not included in our study. A total of 1947 questionnaires were collected from July 11, 2020 to February 10, 2021. Two hundred and eighty-four questionnaires were excluded from further analysis. The remaining 1663 cases were incorporated into the final analysis. Data were analyzed using IBM SPSS Statistics 26. Comparisons between categorical variables were tested by the use of crosstabs and χ2 test. ResultsThe total awareness rates of the knowledge about monogenic diseases and ECS in the respondents were low, with 35.7%, 26.1%, 3.3%, 23.3%, 24.1%, 55.2%, and 23.4% for questions Q1–Q7, respectively. Medical staff had more knowledge than general population. Knowledge about monogenic diseases and ECS was positively correlated with educational level. Most respondents showed a positive attitude toward ECS: 54.4% thought ECS was necessary, and 80.5% wanted to know more about monogenic diseases. ConclusionAlthough the public had little knowledge about monogenic disease and ECS, most of them showed a positive attitude. Our cross-analysis showed that medical staff had more knowledge compared to general population. Pre-test education for ECS can be carried out by medical staff who are not qualified for genetic counseling. ECS training for medical staff, especially obstetrician-gynecologist and nurse in the department of Obstetrics and Gynecology, can reduce the workload of genetic counseling.

Effectiveness of a Brief Mindfulness-Based Intervention of “STOP" (Stop, Take a Breath, Observe, Proceed) Touching Your Face” During the COVID-19 Pandemic: Randomised Controlled Trial

Background: Avoid touching our eyes, nose, and mouth (T-zone) is one of recommended strategies to reduce the spread of the coronavirus disease 2019 (COVID-19) and other infectious diseases. However, face-touching is a frequent behaviour, and it is often done automatically without self-awareness. Raising self-awareness of habituated face-touching behaviour may help individuals to avoid face-touching by contaminated hands. Our aim was to evaluate whether mindfulness-based brief behaviour-change intervention (MBI) named “STOP (Stop, Take a Breath, Observe, Proceed) touching your face” can reduce face-touching behavior. Methods: In this online-based, two group, wait-list, randomized controlled trial, participants aged 18 years or more from general population in China were recruited via Chinese social media platforms. Eligible participants were randomly assigned in a 1:1 ratio to receive “STOP touching your face” intervention or control intervention. Those researchers who assessing outcomes were masked to group allocation. A 60-minute self-monitoring of face-touching behaviour was required to report in the pre- and post-intervention. Reduction of percentage of T-Zone touching was set as primary outcome, with reduction of face-touching frequency being a key secondary outcome. These outcomes were analysed in the intention-to-treat (ITT) basis with a complete case analysis (CCA). Safety was monitored in all randomly assigned participants. This trial is registered at ClinicalTrials.gov (Trial registration number: NCT04330352), and is completed. Findings: Between April 2, 2020 to July 2, 2020, 10194 participants were invited to the trial. Of these, we recruited and randomly assigned 1090 (10.7%) participants to the “STOP touching your face” intervention group (n=545) or to the wait-list control intervention (comparator) group (n=545) after reporting the first 60-minute self-monitoring of face-touching behaviour (pre-intervention). Among them, 71.6% (n=390) participants from the intervention group and 63.9% (n=348) from the control group reported the second 60-minute self-monitoring of face-touching behaviour (post-intervention). ITT analysis revealed that percentage of T-Zone touching was significantly reduced by 8.1% in the intervention group (from 81.1% to 73.0%, RR=0.901, OR=0.631, RD=-0.081, p=0.002), and insignificantly reduced by 0.6% in the control intervention (from 80.0% to 79.4%, p=0.821). Group comparison showed that fewer participants had T-Zone touching in the intervention group than that in the control group (73.0% vs 79.4%, RR=0.919, OR=0.700, RD=-0.064, p=0.015) after intervention, and that there was more reduction of T-Zone touching frequency in the intervention group than that in the control group (mean ± SD: 1.7 ± 5.13 vs 0.7 ± 3.98, Mean difference (95% CI): 1.03 (0.48 to 1.58), pInterpretation This trial is the first to evaluate the efficacy of “STOP touching your face” intervention to reduce face-touching behaviour during the outbreak of COVID-19. The findings of significantly reduced T-Zone touching behaviour in the intervention group supports the widely dissemination of this brief and simple mindfulness-based behaviour-change intervention to low the risk for the COVID-19 and other hand-to face-touching infectious diseases.Trial registration number: NCT04330352Trial Registration. Funding: Zhejiang University, number (2020XGZX046). Declaration of Interest: We declare no competing interests.Ethical Approval: The trial was approved by The Ethics Committee of Sir Run Run Shaw hospital, an affiliate of Zhejiang University, Medical College (NO. 20200401-32).

Phenotype and management of chronic obstructive pulmonary disease patients in general population in China: a nationally cross-sectional study

This study aims to investigate the characteristics of the phenotype and management of chronic obstructive pulmonary disease (COPD) patients in the general population in China. We analyzed spirometry-confirmed COPD patients who were identified from a population-based, nationally representative sample in China. All participants were measured with airflow limitation severity based on post-bronchodilator FEV1 percent predicted, bronchodilator responsiveness, exacerbation history, and respiratory symptoms. Among a total of 9134 COPD patients, 90.3% were non-exacerbators, 2.9% were frequent exacerbators without chronic bronchitis, 2.0% were frequent exacerbators with chronic bronchitis, and 4.8% were asthma-COPD overlap. Less than 5% of non-exacerbators ever had pulmonary function testing performed. The utilization rate of inhaled medication in non-exacerbators, exacerbators without chronic bronchitis, exacerbators with chronic bronchitis, and asthma-COPD overlap was 1.4, 23.5, 29.5, and 19.4%, respectively. A comprehensive strategy for the management of COPD patients based on phenotype in primary care is urgently needed.

PNS99 Using an Online Survey to Elicit Preferences in China: Comparison of Different Methods Based on SF-6DV2

To compare the performance of 3 different elicitation methods in an online survey environment in China. An online panel of general population in China participated in a web survey. Each participant was randomized to complete two out of three preference elicitation technique tasks, which were 8 random Discrete Choice Experiment (DCE) tasks, 6 random Time Trade Off (TTO) tasks, and 10 random Best Worst Scaling (BWS) tasks. Ordinal method results were self-anchored on the death values to estimate the utilities. Models assuming homogeneous preference (Conditional Logit and linear regressions (OLS)) and preference heterogeneity (Hierarchical Bayes and Mixed Effects Linear Hierarchical Bayes) were used. The number of significant levels, percent certainty and Root Likelihood (RLH) were employed for the comparison. A total of 961 participants (40.6% <40 years, 49 % female, 76.4% healthy) who passed the quality checks were utilized in the analysis. Based on the number of significant levels, percent certainty and RLH, the BWS homogenous preference model was the best (0, 30.5%, 0.39) compared to DCE (6, 20%, 0.38) and TTO (17, 26%, 0.27). The worst state (PITS) was valued at 0.17, -0.69 and -0.033 respectively. The TTO heterogenous preference model had a whole dimension insignificant. Between BWS and DCE, the preferred model specifications changed for the DCE and both had none insignificant levels. The Percent certainty was 70 & 55.2, RLH at 0.58 & 0.61 and PITS valued at 0.197 and 0.359 for BWS and DCE models respectively. Using online DCE or BWS to elicit preference in china is feasible while TTO requires further optimization. Data from ordinal methods modeled by heterogenous preference were more consistent than the one from the cardinal method (TTO) or modeled assuming homogenous preference. Cardinal methods still perform worse than ordinal methods in online surveys and generates less reliable results.

Urinary concentrations of acetaminophen in young children in central and south China: Repeated measurements and associations with 8-hydroxy-guanosine and 8-hydroxy-2′-deoxyguanosine

Acetaminophen (AAP) is the most widely used over-the-counter analgesic in the world; it is also a metabolite of industrial chemical aniline. It may predispose individuals to oxidative stress. However, the exposure profile of AAP in the general population in China and the associations between AAP and oxidative stress biomarkers have scarcely been investigated. In this study, we determined the urinary concentrations of AAP and evaluated its associations with 8-hydroxy-guanosine (8-OHG) and 8-hydroxy-2′-deoxyguanosine (8-OHdG), the most widely used biomarkers of nucleoside oxidation affecting RNA and DNA, in 393 urine samples collected from 131 healthy children (0–6.6 y) on three consecutive days from Wuhan, central China, and Shenzhen, south China. AAP was found in all urine samples, suggesting that exposure to AAP was ubiquitous in young children in central and south China. The median concentration of specific gravity (SG)-adjusted AAP was 9.21 ng/mL (range: 1.11–1 453 ng/mL). Good inter-day reproducibility was observed for SG-adjusted AAP concentrations (intraclass correlation coefficient, 0.75). The SG-adjusted urinary 8-OHdG and 8-OHG concentrations were positively correlated with AAP (β = 0.08; 95% confidence interval [95% CI]: 0.02–0.13, and β = 0.10; 95% CI: 0.04–0.15, respectively). The data indicated that AAP exposure might be associated with oxidative DNA and RNA damage in the general population with unintentional exposure. To our knowledge, this is the first report of AAP exposure in young healthy children in central and south China. This is also the first study to evaluate the inter-day variations in urinary AAP concentrations and to explore the associations between AAP exposure and oxidative stress biomarkers in the general population.

The Relationship Between Quarantine Length and Negative Affect During the COVID-19 Epidemic Among the General Population in China: The Roles of Negative Cognition and Protective Factors.

Quarantine and isolation at extended length, although considered as highly effective countermeasures for the novel coronavirus (COVID-19) which started at the end of 2019, can have great impact on individual's mental health, especially emotional state. The present research recruited 5,115 participants from the general public across 32 provinces and autonomous regions in China in an online survey study, about 20 days after the lockdown of the epicenter (Wuhan), to investigate the relationship between the length of the quarantine and negative affect (including depression and anxiety), as well as the mediating roles of negative cognition (including worry and anticipation), and the moderating roles of dispositional optimism, tolerance of uncertainty, social support, and healthy behavior. The results showed that: (1) Worry and anticipation mediated the relationship between quarantine length and depression and anxiety; (2) Dispositional optimism moderated the path coefficients of quarantine length to worry, worry to anxiety, and anticipation to depression; (3) Tolerance of uncertainty moderated the path coefficient of worry to anxiety; (4) Social support moderated the path coefficient of anticipation to anxiety. In conclusion, during quarantine, dispositional optimism, uncertainty tolerance, and social support can buffer the direct or indirect effects of quarantine length on depression and anxiety. These findings could have profound implications on the societal responses to COVID-19 and future pandemics.

Insecticide fipronil and its transformation products in human blood and urine: Assessment of human exposure in general population of China

Fipronil (FP) is widely used as a highly effective insecticide worldwide, thereby raising concern about environmental contamination and risk for human health. However, data on the occurrence of FP and its transformation products (FPs) in human blood and urine are limited. In this study, 39 pairs of serum, plasma, blood cells (BCs), and urine samples were collected from adults in Wuhan, central China (2020), in order to characterize the concentration profiles of FPs in different matrices. FPs were also determined in serum samples (n = 226, including 57, 56, 56, and 57 samples for Wuhan, Huangshi, Nanjing, and Zhenjiang, respectively) collected from four cities of China (2015) to characterize the exposure levels of FPs among the general population and potential spatial variations. Fipronil sulfone (FP-SFO) was 100% detectable in blood samples, and it was the predominant metabolite (accounting for 86–95% of the cumulative concentrations of FPs [ΣFPs]), with the median concentrations (ng/mL) of 0.17, 0.16, and 0.03 in serum (range: 0.07–1.53), plasma (range: 0.06–1.41), and BCs (range: 0.01–0.24), respectively. The compositional profiles of FPs in serum, plasma, and BCs were similar; very strong positive correlations were observed between different blood matrices for FP-SFO (r = 0.94–0.97, p < 0.01) but not between blood and urine. The median ΣFPs (ng/mL) in the serum (0.20; range: 0.09–1.56) and the plasma samples (0.19; range: 0.09–1.43) was higher than that in BCs samples (0.04; range: 0.01–0.24). In the urine samples, only the major metabolite FP-SFO was detectable in approximately 10% of the samples. Additionally, the highest median ΣFPs (ng/mL) in the serum samples was found in Nanjing (0.56; range: 0.13–1.88), followed by Wuhan (0.34; range: 0.06–1.02), Huangshi (0.10; range: 0.03–0.60), and Zhenjiang (0.08; range: 0.02–0.42). The level of ΣFPs seemed to increase with city sizes and urbanization scale, though further studies are needed to confirm the variations with larger sample size. The estimated daily intake of ΣFPs based on the median concentration of samples from Nanjing (18.5 ng/kg-bw/d) was higher than that of Wuhan (11.3), Huangshi (3.40), and Zhenjiang (2.80). Dietary intake should be the major exposure route for the general population, while water or indoor dust accounted for <1% of the ΣFPs intake. This pilot study provided the first data on the profiles of FPs in paired human serum, plasma, BCs, and urine samples, and potential spatial variations of ΣFPs in China. FP-SFO and FP desulfinyl should be considered among priority substances worthy to be bio-monitored in China due to its moderated persistence and ubiquitous occurrence in human blood.

36P Cost-effectiveness of lung cancer screening with low-dose computed tomography in China: A modeling study

Background: Smoking is considered not the only major risk factor that contributing to the lung cancer incidence in China, due to the fact that about half of patients with lung cancers are never-smokers. Considering the potential of the implementation of lung cancer screening in the general Chinese population, this study aimed to assess the potential cost-effectiveness of lung cancer screening with low-dose CT in a general population in China.