Differences of height and body mass index of youths in urban vs rural areas in Hunan province of China

Background: Economic reforms in China were implemented approximately 30 years ago. Since then, people's nutrition, living conditions and overall health have continually improved, but there has been an imbalance between the progresses in urban vs rural areas. Height and body mass index (BMI) are regarded as two important indicators of nutritional status and overall health.

Aim: The aim of this study was to investigate differences in height and BMI between Chinese youths of rural vs urban areas and further, to determine whether these differences have changed over time (1990s vs 2000s).

Subject and methods: 24 194 urban youths and 7130 rural youths were recruited in Hunan province of China. In each gender group, the subjects were divided into eight subsets according to age, geographic area residence, and decade when the youths were measured. Independent t-tests were used to test the differences of height and BMI between the studied groups.

Results: Both male and female youths from urban areas were significantly taller than youths from rural areas in both the 1990s and 2000s (all p<0.001), with the exception of the 1990s female 15–18 years subset (p=0.21). The height of youths was significantly greater in the 2000s compared to the corresponding gender and geographic subset in the 1990s (p<0.001), except for the female 15–18 years subset from rural areas (p=0.10). Similar results were obtained for BMI.

Conclusion: There are significant differences in height and BMI between youths raised in urban vs rural areas, and positive growth trends of height and BMI over time (1990s vs 2000s) in youths in Hunan Province of China.     

Rheumatic fever and rheumatic heart disease in Bangladesh: A review

Rheumatic fever (RF) and rheumatic heart disease (RHD) are the most-common cardiovascular disease in young people aged <25 years, globally. They are important contributors to cardiovascular morbidity and mortality in Bangladesh. Classical risk factors, i.e. poverty, overcrowding, ignorance, and insufficient health care services were responsible for the high incidence and prevalence of these diseases over the last century. In concert with the progresses in socioeconomic indicators, advances in health sectors, improved public awareness, and antibiotic prophylaxis, acute RF came into control. However, chronic RHD continues to be prevalent, and the actual disease burden may be much higher. RHD predominantly affects the young adults, seriously incapacitates them, follows a protracted course, gets complicated because of delayed diagnosis and is sometimes maltreated. The treatment is often palliative and expensive. Large-scale epidemiological and clinical researches are needed to formulate evidence-based national policy to tackle this important public health issue in future.     

The Distribution and Composition of Vector Abundance in Hanoi City,Vietnam: Association with Livestock Keeping and Flavivirus Detection

Background: Dengue virus and Japanese encephalitis virus are two common flaviviruses that are spread widely by Aedes and Culex mosquitoes. Livestock keeping is vital for cities; however, it can pose the risk of increasing the mosquito population. Our study explored how livestock keeping in and around a large city is associated with the presence of mosquitoes and the risk of them spreading flaviviruses. Methods: An entomological study was conducted in 6 districts with 233 households with livestock, and 280 households without livestock, in Hanoi city. BG-Sentinel traps and CDC light traps were used to collect mosquitoes close to animal farms and human habitats. Adult mosquitoes were counted, identified to species level, and grouped into 385 pools, which were screened for flaviviruses using a pan-flavivirus qPCR protocol and sequencing. Results: A total of 12,861 adult mosquitoes were collected at the 513 households, with 5 different genera collected, of which the Culex genus was the most abundant. Our study found that there was a positive association between livestock keeping and the size of the mosquito population—most predominantly between pig rearing and Culex species (p < 0.001). One pool of Cx. tritaeniorhynchus, collected in a peri-urban district, was found to be positive for Japanese encephalitis virus. Conclusions: The risk of flavivirus transmission in urban areas of Hanoi city due to the spread of Culex and Aedes mosquitoes could be facilitated by livestock keeping.     

From the Cover: Large contribution of biomass burning emissions to ozone throughout the global remote troposphere

Ozone is the third most important anthropogenic greenhouse gas after carbon dioxide and methane but has a larger uncertainty in its radiative forcing, in part because of uncertainty in the source characteristics of ozone precursors, nitrogen oxides, and volatile organic carbon that directly affect ozone formation chemistry. Tropospheric ozone also negatively affects human and ecosystem health. Biomass burning (BB) and urban emissions are significant but uncertain sources of ozone precursors. Here, we report global-scale, in situ airborne measurements of ozone and precursor source tracers from the NASA Atmospheric Tomography mission. Measurements from the remote troposphere showed that tropospheric ozone is regularly enhanced above background in polluted air masses in all regions of the globe. Ozone enhancements in air with high BB and urban emission tracers (2.1 to 23.8 ppbv [parts per billion by volume]) were generally similar to those in BB-influenced air (2.2 to 21.0 ppbv) but larger than those in urban-influenced air (−7.7 to 6.9 ppbv). Ozone attributed to BB was 2 to 10 times higher than that from urban sources in the Southern Hemisphere and the tropical Atlantic and roughly equal to that from urban sources in the Northern Hemisphere and the tropical Pacific. Three independent global chemical transport models systematically underpredict the observed influence of BB on tropospheric ozone. Potential reasons include uncertainties in modeled BB injection heights and emission inventories, export efficiency of BB emissions to the free troposphere, and chemical mechanisms of ozone production in smoke. Accurately accounting for intermittent but large and widespread BB emissions is required to understand the global tropospheric ozone burden.

Tropospheric ozone (O₃) has been the focus of decades of scientific research due to its central role in atmospheric chemistry (1), its adverse impact on human and ecosystem health (2, 3), and its role as a climate forcer (4, 5). Despite this focus, there remains considerable uncertainty in tropospheric O₃ production pathways, precursor sources, and long-term trends. Sources of tropospheric O₃ include downward transport from the stratosphere and photochemical production from a complex set of coupled reactions between nitrogen oxides (NO_x) and volatile organic compounds (VOCs), each of which is in turn emitted from both anthropogenic and natural sources (1, 6). The contribution of fossil fuel combustion to tropospheric O₃ has recently declined in the United States and in Europe, proportionally increasing the contribution from natural sources (7–10). However, the spatial distribution of anthropogenic O₃ precursor emissions have shifted to lower latitudes (11, 12), where they are still increasing (13). Additionally, globally averaged tropospheric O₃ has increased over the past five decades (14, 15). Understanding the sources of tropospheric O₃ is thus essential to explain this trend and to inform the development of effective mitigation strategies from regional to hemispheric scales.Biomass burning (BB) is an important source of O₃ precursors (16–19). A recent study based on observed O₃ to carbon monoxide (CO) enhancements in smoke plumes attributed 3.5% of the global tropospheric chemical O₃ production to BB emissions (19). Other studies have accounted for the numerous production and destruction pathways of O₃ in the troposphere using global chemical transport models (CTMs) to estimate the global budget of O₃ (20, 21). However, few studies separately quantify the contributions of fossil fuel combustion and BB emissions to global tropospheric O₃ (22). Global inventories attribute five times more NO_x (23, 24) but roughly equal VOC emissions (17, 25) to fossil fuel combustion (hereafter referred to as urban sources) compared with BB. However, precursor emissions do not necessarily determine tropospheric O₃ production close to the sources because of the nonlinearity of O₃ formation chemistry (26, 27). Additionally, global CTMs do not always agree on the tropospheric O₃ burden, suggesting possible deficiencies with emission inventories of O₃ precursors and/or an incomplete representation of O₃ chemistry (21, 28–30), although a recent model intercomparison study showed that the model ensemble reproduced well the salient spatial, seasonal, and decadal variability and trends of tropospheric O₃ (31).Large-scale in situ observational constraints commensurate with the grid resolution of current global CTMs are rare. Instead, modeling studies often rely on ozonesonde-derived climatologies and satellite-based remote sensing observations to constrain tropospheric O₃ distributions and precursor sources (20, 32, 33). The recent NASA Atmospheric Tomography (ATom) mission provides global-scale and seasonally resolved in situ measurements of O₃ and CO and a comprehensive suite of trace gases and aerosol parameters, including tracers of BB and urban emissions (34). ATom sampled the remote troposphere from the Arctic to the Antarctic over the Pacific and Atlantic Oceans using repeated vertical profiles from ∼0.2 to ∼13 km in altitude during four seasonal deployments between 2016 and 2018 (Fig. 1). Recently, the ubiquitous presence of dilute BB smoke in the remote troposphere and its significant contribution to aerosol mass loading was established using ATom observations (35). Here, we use ATom measurements to quantify the individual contributions of urban and BB emissions to O₃ in the remote global troposphere using tracers specific to each source. We compare this analysis with simulations from three global CTMs that alternatively set BB and urban emissions to zero to evaluate their impact on modeled tropospheric O₃.Open in a separate windowFig. 1.Map of ATom flight tracks from the four seasonal global circuits colored by tropospheric O₃ mixing ratios. Note that the color scale terminates at 70 ppbv of O₃, and higher values are shown in red. Measurements with a strong stratospheric influence were parsed out as indicated in Materials and Methods.     

Welcome back survey: exploring concerns impacting HIV care engagement and retention

The current study describes the development of a short pre-clinic survey that helped multidiscipline providers to elicit patient perspective on barriers to HIV primary care. The survey was piloted with 318 patients returning to care after being lost to care for at least 12 months. Reasons for breaks in care were dependent on age, gender, and race. Concerns about confidentiality in care were more commonly reported by African-American, Latino, and younger patients, while concerns relating to acceptance of diagnosis and side effects were greater for women, African-American, and Latino participants. Further, Intimate Partner Violence (IPV) and transportation were greater concerns for women and younger patients in the sample.     

Improving COPD Care in a Medically Underserved Primary Care Clinic: A Qualitative Study of Patient Perspectives

We conducted a focus group study in an urban hospital-based primary care teaching clinic serving an indigent and Hispanic (predominantly Puerto Rican) population in New England in order to learn how patients with Chronic Obstructive Lung Disease (COPD) perceive their disease, how they experience their medical care, and the barriers they face managing their disease and following medical recommendations. The research team included medical doctors, nurses, a medical anthropologist, a clinical pharmacist, a hospital interpreter, and a systems analyst. Four focus groups were conducted in Spanish and English in April and May 2014. The demographic characteristics of the 25 focus group participants closely reflected the demographics of the total COPD clinic patients. The participants were predominantly female (72%) and Hispanic (72%) and had a median age of 63. The major themes expressed in the focus groups included: problems living with COPD; coping with complexities of comorbid illnesses; challenges of quitting smoking and maintaining cessation; dealing with second-hand smoke; beliefs and myths about quitting smoking; difficulty paying for and obtaining medications; positive experiences obtaining and managing medications; difficulties in using sleep machines at home; expressions of disappointment with the departure of their doctors; and overall satisfaction with the clinic health care providers. The study led to the creation of an action plan that addresses the concerns expressed by the focus study participants. The action plan is spearheaded by a designated bilingual and bicultural nurse and is now in operation.     

Development of Water Retentive and Thermal Resistant Cement Concrete and Cooling Effects Evaluation

The high pavement temperature plays an important role in the development of urban heat island (UHI) in summer. The objective of this study was to develop water retentive and thermal resistant cement concrete (WTCC) to enhance the pavement cooling effects. The WTCC was prepared by combining a water retentive material and a high aluminum refractory aggregate (RA) with porous cement concrete (PCC). Water retention capacity test, fluidity test, and compressive strength test were used to determine the composition ratio of the water retentive material. Mechanical performance and cooling effects of WTCC were evaluated by compressive and flexural strength tests and temperature monitoring test. The mass ratios of fly ash, silica fume, cement, and water in the water retentive material were determined as 65:35:15:63.9. The compressive strength and the flexural strength of WTCC after 28 days curing were 30.4 MPa and 4.6 MPa, respectively. Compared with stone mastic asphalt (SMA) mixture, PCC, and water retentive cement concrete (WCC), surface temperature of WTCC decreased by 11.4 °C, 5.5 °C, and 4.1 °C, respectively, and the internal temperatures of WTCC decreased by 10.3 °C, 6.1 °C, and 4.6 °C, respectively. The water retentive material has benefits of strength improvements and temperature reduction for WTCC. Based on the results, WTCC proved to have superior cooling effects and the potential to efficiently mitigate the UHI effects and be used in medium traffic roads.     

Drivers of fatal bird collisions in an urban center

Millions of nocturnally migrating birds die each year from collisions with built structures, especially brightly illuminated buildings and communication towers. Reducing this source of mortality requires knowledge of important behavioral, meteorological, and anthropogenic factors, yet we lack an understanding of the interacting roles of migration, artificial lighting, and weather conditions in causing fatal bird collisions. Using two decades of collision surveys and concurrent weather and migration measures, we model numbers of collisions occurring at a large urban building in Chicago. We find that the magnitude of nocturnal bird migration, building light output, and wind conditions are the most important predictors of fatal collisions. The greatest mortality occurred when the building was brightly lit during large nocturnal migration events and when winds concentrated birds along the Chicago lakeshore. We estimate that halving lighted window area decreases collision counts by 11× in spring and 6× in fall. Bird mortality could be reduced by ∼60% at this site by decreasing lighted window area to minimum levels historically recorded. Our study provides strong support for a relationship between nocturnal migration magnitude and urban bird mortality, mediated by light pollution and local atmospheric conditions. Although our research focuses on a single site, our findings have global implications for reducing or eliminating a critically important cause of bird mortality.

North America has lost nearly one-third of its birdlife in the last half-century, with migratory species experiencing particularly acute declines (1). Fatal collisions with built structures represent a major source of direct, human-caused bird mortality across North America, second only to predation by domestic cats (2). Estimates indicate that between 365 million and 988 million birds die annually in collisions with buildings in the United States, with another 16 million to 42 million annual deaths in Canada (2, 3). Birds may collide with glass windows because they reflect the surrounding environment or allow birds to perceive a seemingly open pathway to the interior of the building (4). For the billions of birds that migrate at night, outdoor lighting (e.g., streetlights and floodlights) and interior lighting from buildings may be disorienting and draw birds into built-up areas, at high risk to collide with infrastructure (5–8). Light pollution not only alters nocturnal migratory behavior on a large scale (5, 7), but is also an acute conservation concern. Nocturnal collisions with well-lit communication towers alone are estimated to kill appreciable percentages of the populations of sensitive species (9).Avian collisions with lighted structures have been documented in the scientific literature as early as the 19th century (10–12). In recent decades, this link between collisions and light pollution has been the subject of detailed investigation (8, 13–16). Observers of bird–building collisions and tower kills have long remarked on the apparent influence of meteorological factors such as cloud ceiling, fog, frontal passage, and abrupt changes in conditions, all of which have been associated with large mortality events (10, 13, 17–24). Steady-burning lights may be particularly hazardous (25). Due to high building density and intensity of artificial lighting, cities are of particular concern. Reports of mass collisions at lighted buildings in urban areas are frequent in both the popular and scientific press (13, 19–21, 26).Understanding, predicting, and preventing collision mortality are areas of active scientific inquiry and priorities for policymakers (1, 13). Collisions occur more frequently during migration seasons and impact numerous species of migratory birds (29), and recent work suggests that nocturnal migratory movements can be useful for predicting bird–window collisions (30). Lights-out programs, which encourage the public to extinguish outdoor lighting to protect migratory birds, are receiving increasing attention (13). The act of extinguishing lighting allows birds to immediately return to normal, safe behavior (7) and reduces mortality at lighted buildings (13). Presently, advisories are generally issued for a given time period (e.g., peak migration periods) or on specific nights when weather conditions are favorable for large migratory movements [e.g., using migration forecasting, (31, 32)].Here, we integrate meteorological, migration-intensity, and window-radiance data to understand how these factors interact to cause bird collisions. We use a 21-y dataset of fatal collisions recorded at a single large building (McCormick Place Lakeside Center) in Chicago, IL (Fig. 1), to understand the behavioral, environmental, and anthropogenic drivers of these mortality events. Chicago poses the greatest potential risk from light pollution to migrating birds of all cities in the United States (33), and over 40,000 dead birds have been recovered from McCormick Place alone since 1978 (Figs. 2 and ​and3).3). Since 2000, we have recorded the number of birds and the lighting status of each window bay during dawn collision monitoring. Nocturnal lighting at McCormick Place correlates positively with bird collisions in many songbird species (34), but this association has not been quantified in the context of other important factors, including migration intensity and weather conditions. We estimate the effect of window lighting on collision counts and assess how the intensity of nocturnal bird migration mediates this relationship. We also test whether wind and weather conditions may magnify these associations. Finally, we investigate the spatiotemporal scales at which weather and migration data best explain collision mortality, identifying the times of night and areas of airspace associated with these events.Open in a separate windowFig. 1.Location of McCormick Place along the Chicago lakefront. The Lakeside Center building monitored in this study is highlighted in red in a three-dimensional rendering.Open in a separate windowFig. 2.Summary of collisions recorded at McCormick Place and regional bird migration between 2000 and 2020. (Upper) Individual years are drawn in different colors. Dates are given for mortality events totaling more than 50 birds. Pie charts show the family (fam.) composition of collected birds, with families representing less than 5% of total collisions merged into a single “other” category. (Lower) Summed annual migration passage at the KLOT radar in estimated number of individual birds (years colored). (Lower, Inset) Summed seasonal passage totals in estimated number of birds crossing a 75-km transect, with each point representing a year. Estimates are based on methods from ref. 35.Open in a separate windowFig. 3.Recorded collisions by year and window lighting. (A) Collisions recorded at McCormick Place between 1982 and 2020 for spring (light gray) and fall (dark gray) seasons. Horizontal lines with numeric labels show average seasonal collision totals before and after the window-lighting regime changed from fully lighted to partially lighted in 1999. The year 1997 is not shown because construction limited access to the site during that year. (B) Mean recorded daily collisions by window-lighting status from 2000 to 2020.