Provinces In Mainland China Research Articles

COVID-19 distributes socially in China: A Bayesian spatial analysis.

PurposeThe ongoing coronavirus disease 2019 (COVID-19) epidemic increasingly threatens the public health security worldwide. We aimed to identify high-risk areas of COVID-19 and understand how socioeconomic factors are associated with the spatial distribution of COVID-19 in China, which may help other countries control the epidemic.MethodsWe analyzed the data of COVID-19 cases from 30 provinces in mainland China (outside of Hubei) from 16 January 2020 to 31 March 2020, considering the data of demographic, economic, health, and transportation factors. Global autocorrelation analysis and Bayesian spatial models were used to present the spatial pattern of COVID-19 and explore the relationship between COVID-19 risk and various factors.ResultsGlobal Moran’s I statistics of COVID-19 incidences was 0.31 (P<0.05). The areas with a high risk of COVID-19 were mainly located in the provinces around Hubei and the provinces with a high level of economic development. The relative risk of two socioeconomic factors, the per capita consumption expenditure of households and the proportion of the migrating population from Hubei, were 1.887 [95% confidence interval (CI): 1.469~2.399] and 1.099 (95% CI: 1.053~1.148), respectively. The two factors explained up to 78.2% out of 99.7% of structured spatial variations.ConclusionOur results suggested that COVID-19 risk was positively associated with the level of economic development and population movements. Blocking population movement and reducing local exposures are effective in preventing the local transmission of COVID-19.

Human papillomavirus vaccination at the national and provincial levels in China: a cost-effectiveness analysis using the PRIME model

BackgroundHuman papillomavirus (HPV) vaccines have been proven effective against cervical cancer. However, HPV vaccination is not included in the Chinese immunization program. This study aimed to assess the cost-effectiveness of incorporating different HPV vaccines into immunization programs at the Chinese national and provincial levels.MethodsThe Papillomavirus Rapid Interface for Modeling and Economics model was used to estimate the possible cost and social and economic benefits of adopting various HPV vaccination immunization strategies in 31 provinces in Mainland China in 2019. Demographic and regional economic data were obtained from the national and provincial Statistical Yearbook. The cost of vaccines was gathered from the centralized procurement information platform of all Chinese provinces. Treatment costs, epidemiological data, and other model parameters were obtained from published literature. The cost of vaccination, treatment costs saved, net costs, cases and deaths averted, life years saved, disability-adjusted life years (DALYs) prevented, and incremental cost-effectiveness ratios were predicted both provincially and nationally. Deterministic sensitivity analyses were used to explore model uncertainty.ResultsThe net cost of vaccinating with the domestic bivalent HPV vaccine was the lowest. At the national level, after bivalent or quadrivalent HPV vaccination, the number of cases and deaths averted due to cervical cancer were 12,545 and 5109, respectively, whereas the 9-valent HPV vaccine averted 28,140 cases and 11,459 deaths. HPV vaccines were cost-effective at a national level (maximum cost US$ 18,165 per DALY gained.) compared to the 3 times GDP per capita (US$ 30,837). Bivalent HPV vaccines were cost-effective in all 31 provinces. Imported quadrivalent and 9-valent HPV vaccines were cost-effective in 29 provinces, except Heilongjiang and Gansu. The univariate sensitivity analysis showed that the results were robust when the model parameters were changed, and that the discount rate was the main factor affecting the baseline results.ConclusionsThis study provides evidence that the inclusion of HPV vaccination in the immunization program would be cost-effective at a national level and in most provinces. Provinces with a higher population have more prevented cases, deaths, and DALYs. The economics of HPV vaccination at the provincial level differs from that at the national level, and provinces with an inability to pay should seek help from state subsidies.

Molecular Epidemiology and Evolution of Coxsackievirus A9.

Nineteen CVA9 isolates were obtained between 2010 and 2019 from six provinces of mainland China, using the HFMD surveillance network established in China. Nucleotide sequencing revealed that the full-length VP1 of 19 CVA9 isolates was 906 bases encoding 302 amino acids. The combination of the thresholds of the phylogenetic tree and nucleotide divergence of different genotypes within the same serotype led to a value of 15–25%, and enabled CVA9 worldwide to be categorized into ten genotypes: A–J. The phylogenetic tree showed that the prototype strain was included in genotype A, and that the B, C, D, E, H, and J genotypes disappeared during virus evolution, whereas the F, I, and G genotypes showed co-circulation. Lineage G was the dominant genotype of CVA9 and included most of the strains from nine countries in Asia, North America, Oceania, and Europe. Most Chinese strains belonged to the G genotype, suggesting that the molecular epidemiology of China is consistent with that observed worldwide. The 165 partial VP1 strains (723 nt) showed a mean substitution rate of 3.27 × 10−3 substitution/site/year (95% HPD range 2.93–3.6 × 10−3), dating the tMRCA of CVA9 back to approximately 1922 (1911–1932). The spatiotemporal dynamics of CVA9 showed the spread of CVA9 obviously increased in recent years. Most CVA9 isolates originated in USA, but the epidemic areas of CVA9 are now concentrated in the Asia–Pacific region, European countries, and North America. Recombination analysis within the enterovirus B specie (59 serotypes) revealed eight recombination patterns in China at present, CVB4, CVB5, E30, CVB2, E11, HEV106, HEV85, and HEV75. E14, and E6 may act as recombinant donors in multiple regions. Comparison of temperature sensitivity revealed that temperature-insensitive strains have more amino acid substitutions in the RGD motif of the VP1 region, and the sites T283S, V284M, and R288K in the VP1 region may be related to the temperature tolerance of CVA9.

Prevalence and patient characteristics of familial hypercholesterolemia in a Chinese population aged 35–75 years: Results from China PEACE Million Persons Project

Background and aimsFamilial hypercholesterolemia (FH) is a genetic disorder with a high burden of arteriosclerotic cardiovascular disease. The prevalence of heterozygous FH is currently 0.2%–0.5% in Europe, while no such data has yet been published about the general population in China. We aimed to investigate the prevalence and characteristics of FH in a Chinese population aged 35–75 years. MethodsWe used a nationwide general population from 31 provinces in mainland China (n = 1,059,936, age 35–75) based on the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) MPP (Million Persons Project). The diagnosis of FH was based on 2 (untreated LDL-C ≥4.7 mmol/L and first-degree relatives with premature ASCVD history) of the 3 diagnostic criteria from the Chinese expert consensus on diagnosis of FH (CEFH criteria). FH prevalence was estimated and clinical phenotypic characteristics were further analyzed. ResultsThe overall FH prevalence was 0.13% (95% confidence interval [CI], 0.12–0.14) by the CEFH criteria, and age and sex standardized FH prevalence was slightly lower (0.11%; 95%CI, 0.10–0.12). FH prevalence in female was twice as high as in male (0.16% vs. 0.08%, p < 0.001). Across different age groups, the prevalence also varied and peaked among 55-to 64-year-olds. Regarding geographical areas, the prevalence ranged from 0.19% in Eastern, to 0.11% in Central, and 0.08% in Western China (p < 0.001). Participants living in rural areas had a lower prevalence than urban participants (0.10% vs. 0.18%, p < 0.001). The rate of coronary artery disease in FH patients was 5 folds higher than in the general population (10.5% vs. 2.1%, p < 0.001). The rate of FH patients receiving lipid-lowering medications was 18.1%. None of the treated patients achieved guideline recommended LDL-C targets. ConclusionsThe prevalence of FH in the Chinese population aged 35–75 years was 0.13% (about 1 in 769) defined by 2 of the CEFH criteria, and the patients were seriously undertreated and under-controlled. The screened FH prevalence varied by age, sex, geographical distributions, and urban/rural areas.

Relationship between the geographical environment and the forest carbon sink capacity in China based on an individual-tree growth-rate model

Forests play an important role in the global carbon cycle, and the growth of forest trees is essential to forest carbon sinks. It is necessary to explore the diameter at breast height (DBH) growth of trees and to quantify the effects of different factors on their growth to predict forest development. This study constructed an individual-tree annual growth-rate model of 41 dominant tree species in China to explore the effects of genetic characteristics and the environment on tree growth and the relationship between forest carbon sink capacity and the geographical environment. The model was estimated and evaluated based on 492,555 samples of 7801 permanent plots (covering 31 provinces in mainland China) and then decomposed into a general annual growth-rate component and an environmental modifier component. The results showed that tree species and size were the dominant factors that affected the growth rate, showing an inverse J-curve trend, and temperature was the most important of all environmental factors. In addition, there was a significant correlation between the potential aboveground carbon sink (PACS) and the geographic growth pattern index (GPI) (Spearman’s = 0.445, p-value < 0.001) and a significant correlation between the geographic growth structure index PACS and the geographic growth structure index (GSI) (Spearman’s = 0.014, p-value < 0.001). Areas with high GPI and GSI may have better environmental conditions for tree growth, leading to higher PACS. In China, the GPI was higher in the southeastern regions than in the northwestern regions and was also higher in the more humid regions than in the dry regions, resulting in a higher PACS. In conclusion, in forest resource management and future afforestation planning, we should first consider the suitability of the geographical environment, and then take the topographical structure into consideration to determine the proportion of suitable tree species and forest structure.

The Prevalence of and Factors Associated With Anxiety and Depression Among Working-Age Adults in Mainland China at the Early Remission Stage of the Coronavirus 2019 Pandemic.

BackgroundThe Coronavirus 2019 (COVID-19) outbreak has led to a considerable proportion of adverse psychological symptoms in different subpopulations. This study aimed to investigate the status of anxiety and depression and their associated factors in the adult, working-age population in Mainland China at the early remission stage of the COVID-19 pandemic.MethodsAn online study was conducted among 1,863 participants in 29 provinces in Mainland China from March 23 to 31, 2020. Their mental health was evaluated by the generalized anxiety disorder scale (GAD-7) and the patient health questionnaire (PHQ-9). Descriptive analysis, Chi-square, and multiple logistic regressions were applied.ResultsAbout 44.5% of the participants had anxiety, 49.2% had depression, and 37.9% showed a combination of depression and anxiety. Around 83.7% of the participants claimed that the pandemic had a negative impact on their medical needs, which was the primary predictor of mental health, the degree of impact being positively related to the prevalence of anxiety and depression. More chronic diseases, moderate to bad self-rated health, severe perceived infection risk, and younger age group were the common risk factors for anxiety and depression. Having no children, unemployment, and a college-level educational background were associated with higher anxiety prevalence, whereas unmarried participants were correlated with higher depression prevalence.ConclusionThe working-age population showed a relatively high risk of anxiety and depression in Mainland China at the early remission stage of the pandemic. To improve medical services capacity for routine and delayed medical service needs should be a part of policy-makers’ priority agenda during this period of crisis.

Atherosclerotic Cardiovascular Disease Risk and Lipid-Lowering Therapy Requirement in China

BackgroundLipid-lowering therapy (LLT) is one of the key strategies for reducing the atherosclerotic cardiovascular disease (ASCVD) burden. However, little is known about the percentage of people in need of different LLT regimens to achieve optimal targets of low-density lipoprotein cholesterol (LDL-C), and the corresponding cost and benefit.MethodsWe conducted a simulation study based on the data from the nationwide China PEACE MPP population cohort (2015–2020), from which we included 2,904,914 participants aged 35–75 years from all the 31 provinces in mainland China. Participants were grouped based on their 10-year ASCVD risks, then entered into a Monte Carlo model which was used to perform LLT intensification simulation scenarios to achieve corresponding LDL-C goals in each risk stratification.ResultsAfter standardizing age and sex, the proportions of participants included at low, moderate, high, and very-high risk were 70.8%, 15.6%, 11.5%, and 2.1%, respectively. People who failed to achieve the corresponding LDL-C goals −8.1% at low risk, 19.6% at moderate risk, 53.2% at high risk, and 93.6% at very-high risk (either not achieving the goal or not receiving LLT)—would be in need of the LLT intensification simulation. After the use of atorvastatin 20 mg was simulated, over 99% of the population at low or moderate risk could achieve the LDL-C goals; while 11.3% at high and 24.5% at very-high risk would still require additional non-statin therapy. After the additional use of ezetimibe, there were still 4.8% at high risk and 11.3% at very-high risk in need of evolocumab; and 99% of these two groups could achieve the LDL-C goals after the use of evolocumab. Such LLT intensification with statin, ezetimibe, and evolocumab would annually cost $2.4 billion, $4.2 billion, and $24.5 billion, respectively, and prevent 264,170, 18,390, and 17,045 cardiovascular events, respectively.ConclusionsModerate-intensity statin therapy is pivotal for the attainment of optimal LDL-C goals in China, and around 10–25% of high- or very-high-risk patients would require additional non-statin agents. There is an opportunity to reduce the rising ASCVD burden in China by optimizing LLT.

Improvement Pathway of Energy Transition: From the Perspective of Directed Technical Change

Energy transition can effectively promote the green transformation of economic development. With capital, traditional fossil energy, clean energy generation, thermal power generation, and the GDP of the provinces, we built a stochastic production frontier model based on a translog production function, which measures the bias of directed technical changes and substitution elasticities of 30 provinces in mainland China from 2000 to 2017. The results show that the directed technical change in China is more biased to thermal power generation and deviated from clean energy generation. In addition, except for traditional fossil generation and thermal power generation with a complementary relationship, there is a substitution relationship between other energy factors. At the regional level, the production patterns of 9 provinces (Beijing, Fujian, Hainan, Tianjin, Chongqing, Gansu, Neimenggu, Ningxia, and Xinjiang) are conducive to the external electric transition, and nine provinces (Beijing, Fujian, Guangxi, Hainan, Hubei, Jilin, Jiangsu, Qinghai, and Zhejiang) are beneficial to the internal electric transition. We find that there is a large room for improvement in external and internal electric transitions in most provinces. We propose that the Chinese government should promote the reform of the market-oriented energy pricing mechanism according to different production modes in different regions. Furthermore, the results from the analysis of China show that it is also possible for other countries to treat their energy transition differently due to their characteristic production patterns.

Evaluation of Copper Levels in Dental Calculus of OSF Patients with Chewing Dried Areca-Nut Quids in Hunan Province of Mainland China.

Dental calculus is a potential material that can be used for assessing chronic exposure to trace heavy metals in oral cavity as it is a long-term reservoir. The aim of this study was to investigate the correlation between dental calculus copper levels and risk of oral submucous fibrosis (OSF) due to chewing dried areca-nut quids in Mainland China. This study included 34 OSF (grade 1) sufferers with dried areca-nut quids chewing as the patient group and 23 healthy individuals without areca-nut chewing as the control group. The dental calculus sample was obtained from all 57 participants and evaluated by inductively coupled plasma mass spectrometry (ICP-MS) for dental calculus level of copper. This work revealed that the mean copper level of dental calculus was significantly higher in OSF (grade 1) sufferers with areca-nut chewing than those in healthy individuals without areca-nut chewing (p < 0.001). This work provided an evidence to support that there may be a positive correlation between elevated levels of copper in dental calculus caused by chewing dried areca-nut quids and an increased risk of developing OSF in Mainland China.

Identifying opportunities to close yield gaps in China by use of certificated cultivars to estimate potential productivity

Even though China has increased grain output in the past decade and greatly contributed to reducing global hunger, the country is still confronted with intense food security pressure due to its huge population base and severe loss of farmland. It has become increasingly important to fully exploit yield gaps (the difference between potential and actual yields) of all staple grains and to identify priority areas in order to achieve the UN sustainable development goal of zero hunger by 2030. The objective of this study was to calculate the production and yield gaps for rice (Oryza sativa L.), wheat (Triticum aestivum L.), and corn (Zea mays L.) across 31 provinces of mainland China, and then to propose sustainable ways to exploit the production and yield gaps in relation to the availability of natural resources and the ecological conditions of the various regions. The yield potential was estimated by assuming that certificated cultivars were adopted in each agricultural ecological zone (AEZ) and that state-of-the-art technologies and best management practices were used. The results suggested that the gross potential productivity of the three staple grains of mainland China in 2016 was 8.86 × 108 tons, with a production gap of 2.99 × 108 tons. Corn exhibited the greatest yield gap. The highest potential productivity was observed in the Northeast Plain and the Huang-Huai-Hai/North China Plain, accounting for 26.35% and 35.91% of the country’s total potential productivity, respectively. The greatest yield gaps were also found in these two plains. To narrow yield gaps, farmland infrastructure, especially irrigation facilities, should be improved, and field management should be strengthened for the provinces with the greatest gaps. However, in view of natural resource constraints (e.g., water shortages in Northern China), water-saving measures and techniques have been encouraged throughout mainland China and the planting of high water-consuming crops such as rice has been discouraged and should be reduced and replaced by other crops in the North China Plain and Northwest China. Using presently available cultivars and field management technologies, China still has great potential to increase grain production and improve food security by closing exploitable yield gaps through the use of suitable production methods based on existing natural resource capacity and ecological status.

Can China’s Policy of Carbon Emissions Trading Optimize Manufacturing Structure? Evidence from Guangdong Based on a Synthetic Control Approach

On 16 July 2021, the national carbon emissions trading market opened, and the national carbon market officially started online trading. However, it is still unclear whether the carbon emissions trading policy can effectively optimize the manufacturing structure. We studied the experiment of the carbon emissions trading policy that has been ongoing in Guangdong, China, since 2013 to assess the impact of this policy on the manufacturing structure in Guangdong Province compared to other provinces in mainland China that have not implemented a carbon trading pilot policy. The methodology uses a synthetic control method. Using this method, a “synthetic Guangdong” was constructed using data from 23 provinces (municipalities and autonomous regions) in mainland China that did not implement carbon trading policies from 2009 to 2019. The synthetic province had similar observed characteristics to Guangdong before the carbon emissions trading experiment in 2013. Therefore, manufacturing structure differences between Guangdong and the synthetic province after 2013 could be attributed only to the carbon emissions trading policy. The conclusion indicates that in the short term, the carbon emissions trading policy implemented in 2013 can significantly promote manufacturing upgrading and manufacturing greening in Guangdong Province. This policy can optimize the manufacturing structure of Guangdong Province through improving the technological innovation of enterprises and increasing foreign direct investment. Therefore, in regions whose manufacturing structure is similar to Guangdong Province, implementing a carbon emissions trading policy can promote manufacturing upgrading and manufacturing greening.

Human Activity Intensity in China under Multi-Factor Interactions: Spatiotemporal Characteristics and Influencing Factors

Human activities involving nature have various environmental impacts. The assessment of the spatial and temporal evolution of human activity intensity (HAI) and its driving forces is significant for determining the effects of human activities on regional ecological environments and regulating such activities. This research quantified the HAI of China, assessed its spatiotemporal characteristics, and analyzed its influencing factors based on the land use data and panel data of 31 provinces in mainland China. The results indicate that the HAI in China is increasing, with the average value increasing from 15.83% in 1980 to 20.04% in 2018, and the HAI was relatively serious in the Beijing–Tianjin–Hebei region, Yangtze River Delta and Pearl River Delta in this period. The spatial differences in the HAI in China show a pattern of being strong in the east and weak in the west, and the spatial center of gravity of China’s HAI has gradually moved west, changing from a central enhancement mode to a point-like “core” enhancement mode. The dominant factors affecting spatial differences in HAI are economic and industrial levels. Labor, population, and capital factors also strongly impact HAI, and energy consumption and pollution emissions have little impact. These results deepen the understanding of the underlying mechanism of the environmental impact of human activities and provide a scientific basis for land-use-related decision making and eco-environment construction.

Antimicrobial resistance and population genomics of multidrug-resistant Escherichia coli in pig farms in mainland China

The expanding use of antimicrobials in livestock is an important contributor to the worldwide rapid increase in antimicrobial resistance (AMR). However, large-scale studies on AMR in livestock remain scarce. Here, we report findings from surveillance of E. coli AMR in pig farms in China in 2018–2019. We isolated E. coli in 1,871 samples from pigs and their breeding environments, and found AMR in E. coli in all provinces in mainland China. We detected multidrug-resistance in 91% isolates and found resistance to last-resort drugs including colistin, carbapenems and tigecycline. We also identified a heterogeneous group of O-serogroups and sequence types among the multidrug-resistant isolates. These isolates harbored multiple resistance genes, virulence factor-encoding genes, and putative plasmids. Our data will help to understand the current AMR profiles of pigs and provide a reference for AMR control policy formulation for livestock in China.

Gender Differences in Burnout Among Endocrinologists in China.

ObjectiveTo survey the prevalence of burnout in a national sample of endocrinologists in China and to examine its correlates, with a special focus on gender differences.MethodsAn anonymous online survey was conducted among endocrinologists in 31 provincial government-owned “People’s Hospitals” of each province in mainland China. Demographic and work-related factors were collected from participants. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to assess burnout, including emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA).ResultsA total of 711 endocrinologists (72.1% were female and mean age was 39.63 ± 8.51 years old) completed the survey. Burnout was reported by 32.8% of the participants. There were no significant gender differences in the overall prevalence of burnout or EE, DP, and PA (all p > 0.05). A multi-level linear regression revealed: (1) In male participants, PA was significantly associated with age (β = 0.03, p = 0.003), DP was inversely associated with age (β = −0.06, p = 0.005), EE was significantly associated with shorter sleep duration (β = −0.25, p = 0.006), and longer work hours (β = 0.01, p = 0.016). (2) In females, PA was significantly associated with age (β = 0.01, p = 0.038), EE and DP were both significantly associated with shorter sleep duration (β = −0.19, p = 0.001; and β = −0.15, p = 0.011, respectively). EE and DP were also associated with work hours (β = 0.02, p < 0.001; and β = 0.01, p < 0.001, respectively).ConclusionNearly one-third of endocrinologists in China experienced burnout. Although there were no significant gender differences in the prevalence of overall burnout or EE, DP, and PA scores, male and female participants differed in factors associated with EE, DP, and PA. Interventions need to be tailored to target different aspects in male and female endocrinologists and target different subgroups.

A Factor Analysis Model for Rapid Evaluation of the Semen Quality of Fertile Men in China.

ObjectiveThe objective of this study is to reduce the dimension of several indicators with a strong correlation when conducting semen quality analysis in a small number of comprehensive variables that could retain most of the information in the original variables.MethodsA total of 1132 subjects were recruited from the Maternal and Child Health Institutions of seven provinces in mainland China. They completed the questionnaire and provided semen samples. Visualization of the correlation between variables was realized by using a function chart and correlation in the PerformanceAnalytics package of the R programming language (version 3.6.3 [2020-02-29]). Factor analysis was conducted using the principal function in the psych package of R. Principal component analysis, combined with varimax rotation, was used in the operation of the model, and two common factors were selected and measured to provide values for the common factor. The score coefficient was estimated using the regression method.ResultsThe contribution rates of the two common factors to variable X were 43.7% and 33.98%, respectively. When the two common factors were selected, approximately 78% of the information of the original variables could be explained. The correlation coefficients between the first common factor (the quantitative factor) and sperm density, total sperm count, and semen volume were 0.824, 0.984, and 0.544, respectively. The correlation coefficients between the second common factor (the quality factor) and sperm motility and the percentage of forward-moving (progressive spermatozoa) sperm were 0.978 and 0.976, respectively.ConclusionThe correlation between the original variables of a semen quality analysis was strong and suitable for dimensionality reduction by factor analysis. Factor analysis and dimensionality reduction provide a fast and accurate assessment of semen quality. Patients with low fertility or infertility can be identified and provided with corresponding treatments.

A comprehensive emission inventory of hazardous air pollutants from municipal solid waste incineration in China

The Hazardous air pollutants (HAPs) released from increasing municipal solid waste incineration (MSWI) plants have drawn great concerns in China. However, a full picture of their emission characteristics is still urgently needed, especially after the implementation of stricter emission limits on MSWI. In this study, a comprehensive historical emission inventory of HAPs emitted from MSWI plants in China during the period of 2006–2017 was dedicatedly established by integrating with detailed plant-level activity data and renewed localized emission factors. Overall, HAPs emissions initially increased with years, then peaked or slowed increase in the year 2014, but leveled off after 2016 due to the gradually and fully implementing of newly revised national emission standard (GB18485–2014) applied to mainland China and much stricter local standards for several provinces and cities. It was estimated that totally 50,716 tons (t) of NOx, 13,026 t of CO, 7988 t of SO2, 4399 t of PM, 1943 t of HCl, 9916 kg of Pb, 5901 kg of Mn, 4805 kg of Cu, 3574 kg of Cr, 3329 kg of Ni, 2154 kg of Hg, 1168 kg of Cd, 862 kg of As, 409 kg of Co, 216 kg of Sb, 13 kg of Tl, and 19 g toxic equivalent quantity of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans were emitted from 337 MSWI plants scattered in 30 provinces of mainland China in 2017, respectively. HAPs emissions were heavily concentrated in developed coastal provinces and cities. Scenario analysis highlighted the importance of continuous improvement and upgrade on advanced air pollution control devices and MSWI management to meet the future ultra-low emission limits and minimize the harmful impacts of HAPs on atmospheric environment and public health.

The influence of fear of isolation on contact experience disclosure: Evidence from safety management of the COVID-19 pandemic.

As the coronavirus disease 2019 (COVID‐19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), continues to rage, disclosure of exposure to the virus is of great significance to safety management, especially considering the long latency of the disease. We conducted a survey based on terror management theory of 2,542 people in 71 cities, representing all provinces in mainland China. The results revealed that fear of being isolated influenced disclosure of exposure to the virus and that this influence was mediated by defensive impression management motivation. An inclusive climate buffered both the direct and the indirect effects of fear of isolation on disclosure behaviour via defensive impression management motivation. The implications of these findings for research and safety management during the COVID‐19 pandemic are discussed.

Resilience and intention of healthcare workers in China to receive a COVID-19 vaccination: The mediating role of life satisfaction and stigma.

AimsThe present study investigated the association between resilience, stigma, life satisfaction and the intention to receive a COVID‐19 vaccination among Chinese HCWs. It also explored the mediating role of stigma and life satisfaction on the association between resilience and intention to receive a COVID‐19 vaccination.DesignAn anonymous cross‐sectional survey.Methods1733 HCWs from five hospitals in four provinces of mainland China completed a cross‐sectional online survey in October and November 2020.ResultsAmong the HCWs, the rate of intention to receive a COVID‐19 vaccination was 73.1%. Results from structural equation modelling showed that resilience was associated both directly, and indirectly with greater intent to receive a COVID‐19 vaccination through two pathways: first by increasing life satisfaction, and second by reducing stigma and increasing life satisfaction.ConclusionPromoting the resilience of HCWs has the potential to increase the COVID‐19 vaccination uptake rate among HCWs in China.ImpactThis study tested the relationship between several psychological factors and the COVID‐19 vaccination intention of HCWs in China, finding that resilience played a significant role in improving COVID‐19 vaccination intention rates by reducing stigma and increasing life satisfaction.

Profiles of positive changes in life outcomes over the COVID-19 pandemic in Chinese adolescents: the role of resilience and mental health consequence

BackgroundThe 2019 coronavirus (COVID-19) has caused enormous negative impacts on adolescents’ routines, social interaction, interpersonal relationships, psychosocial well-being, and physical health. Nevertheless, theories suggest that individuals also often seek out solutions that may facilitate positive changes when they are faced with uncertainty and crisis. However, the existing literature has disproportionately focused on the negative effect of COVID-19 on adolescents, and scant research has examined to what extent and in what aspects adolescents would experience positive changes in times of the pandemic. This pre-registered research aims to bridge said gaps by: (1) exploring different profiles of positive changes in various life outcomes in Chinese adolescents over the COVID-19 pandemic; (2) examining the role of resilience in differentiating different profiles; (3) comparing adolescents’ mental health across profiles.MethodParticipants were 2,567 adolescents aged 12 to 24 recruited from 32 provinces in mainland China (66.89% females; Mage = 19.87 years, SD = 2.02). Through an online survey, participants rated how much their lives of different domains had experienced positive changes since the outbreak of the pandemic. They also answered standardized questionnaires that measured their resilience and mental health.ResultsResults of latent profile analysis revealed three profiles: limited positive changes (33.3%), partial positive changes (49.5%), and overall strong positive changes (17.2%). Moreover, adolescents with a higher level of resilience were more likely to be categorized into the partial positive changes profile compared to the limited positive changes profile and categorized into the overall strong positive changes profile compared to the other two profiles, after controlling for multiple covariates. Adolescents in the overall strong positive changes profile had better mental health than their counterparts of the other two profiles.ConclusionChinese adolescents appear to experience positive changes in various life outcomes during the COVID-19 pandemic, especially for those with high levels of resilience. Such positive changes have important implications on adolescents’ mental health.

The emergence and transmission dynamics of HIV-1 CRF07_BC in Mainland China.

A total of 1155 partial pol gene sequences of human immunodeficiency virus (HIV)-1 CRF07_BC were sampled between 1997 and 2015, spanning 13 provinces in Mainland China and risk groups [heterosexual, injecting drug users (IDU), and men who have sex with men (MSM)] to investigate the evolution, adaptation, spatiotemporal and risk group dynamics, migration patterns, and protein structure of HIV-1 CRF07_BC. Due to the unequal distribution of sequences across time, location, and risk group in the complete dataset (‘full1155’), subsampling methods were used. Maximum-likelihood and Bayesian phylogenetic analysis as well as discrete trait analysis of geographical location and risk group were carried out. To study mutations of a cluster of HIV-1 CRF07_BC (CRF07-1), we performed a comparative analysis of this cluster to the other CRF07_BC sequences (‘backbone_295’) and mapped the mutations observed in the respective protein structure. Our findings showed that HIV-1 CRF07_BC most likely originated among IDU in Yunnan Province between October 1992 to July 1993 [95 per cent hightest posterior density (HPD): May 1989–August 1995] and that IDU in Yunnan Province and MSM in Guangdong Province likely served as the viral sources during the early and more recent spread in Mainland China. We also revealed that HIV-1 CRF07-1 has been spreading for roughly 20 years and continues to cause local transmission in Mainland China and worldwide. Overall, our study sheds light on the dynamics of HIV-1 CRF07_BC distribution patterns in Mainland China. Our research may also be useful in formulating public health policies aimed at controlling acquired immune deficiency syndrome in Mainland China and globally.