Seeking a sense of control or escapism? The role of video games in coping with unemployment

Unemployment can have devastating effects on people's psychological and social wellbeing. The effects of unemployment can be exacerbated during the COVID-19 pandemic due to the lack of control over one's life and the loss of social connectedness. Through a survey of 480 unemployed workers, this study examined how emotion-focused coping using video game can affect the workers' wellbeing and reemployment. The findings showed that escapism was associated with decreased wellbeing, which reduced job-search efficacy and behaviors. However, when video game playing was viewed as a source of self-determination, it can support the unemployed workers' intrinsic needs of autonomy and relatedness, which improved their wellbeing, their job-search efficacy, and job-search behaviors. Further comparison of effects between gender, age, race, and income found that unemployed workers who made lower to medium income were more likely to seek escapism through games compared to female unemployed workers. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Forward-backward and period doubling bifurcations in a discrete epidemic model with vaccination and limited medical resources.

A discrete epidemic model with vaccination and limited medical resources is proposed to understand its underlying dynamics. The model induces a nonsmooth two dimensional map that exhibits a surprising array of dynamical behavior including the phenomena of the forward-backward bifurcation and period doubling route to chaos with feasible parameters in an invariant region. We demonstrate, among other things, that the model generates the above described phenomena as the transmission rate or the basic reproduction number of the disease gradually increases provided that the immunization rate is low, the vaccine failure rate is high and the medical resources are limited. Finally, the numerical simulations are provided to illustrate our main results.

Ovatodiolide inhibits SARS-CoV-2 replication and ameliorates pulmonary fibrosis through suppression of the TGF-ß/TßRs signaling pathway.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection continues to pose threats to public health. The clinical manifestations of lung pathology in COVID-19 patients include sustained inflammation and pulmonary fibrosis. The macrocyclic diterpenoid ovatodiolide (OVA) has been reported to have anti-inflammatory, anti-cancer, anti-allergic, and analgesic activities. Here, we investigated the pharmacological mechanism of OVA in suppressing SARS-CoV-2 infection and pulmonary fibrosis in vitro and in vivo. Our results revealed that OVA was an effective SARS-CoV-2 3CLpro inhibitor and showed remarkable inhibitory activity against SARS-CoV-2 infection. On the other hand, OVA ameliorated pulmonary fibrosis in bleomycin (BLM)-induced mice, reducing inflammatory cell infiltration and collagen deposition in the lung. OVA decreased the levels of pulmonary hydroxyproline and myeloperoxidase, as well as lung and serum TNF-ɑ, IL-1ß, IL-6, and TGF-ß in BLM-induced pulmonary fibrotic mice. Meanwhile, OVA reduced the migration and fibroblast-to-myofibroblast conversion of TGF-ß1-induced fibrotic human lung fibroblasts. Consistently, OVA downregulated TGF-ß/TßRs signaling. In computational analysis, OVA resembles the chemical structures of the kinase inhibitors TßRI and TßRII and was shown to interact with the key pharmacophores and putative ATP-binding domains of TßRI and TßRII, showing the potential of OVA as an inhibitor of TßRI and TßRII kinase. In conclusion, the dual function of OVA highlights its potential for not only fighting SARS-CoV-2 infection but also managing injury-induced pulmonary fibrosis.

Prevalence of oropharyngeal dysphagia and risk of mortality among hospitalized COVID-19 patients: A meta-analysis.

Background: Post-extubation and neurologic complications in COVID-19 patients have been shown to cause oropharyngeal dysphagia (OD). We performed the first meta-analysis to explore and estimate the pooled prevalence of OD, risk of mortality, and associated factors among hospitalized COVID-19 patients. Methods: We searched Scopus, PubMed, Embase, CINAHL, WHO COVID-19 database, and Web of Science for literature on dysphagia in COVID-19 patients. We used the generalized linear mixed model (GLMM) to determine the prevalence estimates of OD in the R software and the DerSimonian-Lard random-effects model in the Comprehensive Meta-Analysis software to explore the risk of mortality and associated factors of OD, presented as odds ratios (ORs) and corresponding 95% confidence intervals (CIs). We used Cochran's Q, τ2, and the I2 statistic to assess heterogeneity and conducted a moderator analysis to identify moderator variables. Results: We included eighteen studies with a total of 2055 participants from the 910 studies retrieved from electronic databases. The prevalence of OD among hospitalized COVID-19 patients was estimated at 35% (95% CI = 21-52; low certainty of evidence) associated with a high risk of mortality (OR = 6.41; 95% CI = 1.48-27.7; moderate certainty of evidence). Intubation (OR = 16.3; 95% CI = 7.10-37.3; high certainty of evidence), use of tracheostomies (OR = 8.09; 95% CI = 3.05-21.5; high certainty of evidence), and proning (OR = 4.97; 95% CI = 1.34-18.5; high certainty of evidence) among hospitalized COVID-19 patients were highly associated with developing OD. The prevalence of OD was higher among hospitalized COVID-19 patients who were admitted in intensive care units (ICU), intubated, and mechanically ventilated. Conclusions: The prevalence of OD among hospitalized COVID-19 patients is estimated at 35% associated with a high risk of mortality. OD assessment among hospitalized COVID-19 patients who are managed in an ICU, prone position, intubated, and mechanical ventilated deserves more attention. Registration: PROSPERO CRD42022337597.

Maintaining the Quality of Mechanical Thrombectomy after Acute Ischemic Stroke in COVID(-)19 Patients.

The COVID-19 pandemic has become increasingly worse worldwide since it was discovered in China in late December 2019. Easy contact transmission between people and a low to moderate mortality rate may cause failure in medical health services if there is no proper personal protective equipment for personnel. During the pandemic, patients with acute ischemic stroke with large-vessel occlusion who required immediate treatment through mechanical thrombectomy (MT) were still being sent to the emergency room. Knowing how to maintain effective treatment standards has become our concern. We used a retrospective, single-center study to select COVID-19 (-) patients with acute ischemic stroke undergoing mechanical thrombectomy during the years 2020-2021. Patients with acute ischemic stroke with large-vessel occlusion received mechanical thrombectomy were compared with patients admitted from December 2020 to May 2021 (the pre-COVID-19 group) and those from June 2021 to November 2021 (the during COVID-19 group). Furthermore, the time disparity of mechanical thrombectomy was compared between these two groups. Of patients confirmed with acute ischemic stroke (AIS) with large-vessel occlusion (LVO) during the study period, 62 were included. Compared with the pre-COVID-19 group (34 patients; median age, 70.5 years), the during COVID-19 group (28 patients; median age, 71.5 years) showed no major median time difference in door-to-computed-tomography-angiography (CTA) time (19.0 min vs. 20.0 min, p = 0.398) and no major median time difference in door-to-groin-puncture time (118.0 min vs. 109.0 min, p = 0.281). In our study, with a prepared protocol for the pandemic having been established in the healthcare system, we could see no difference between the pre-pandemic and during-pandemic time periods when using mechanical thrombectomy to treat COVID-19 (-) patients of AIS with LVO. By means of a quick-PCR test during triage, there was no time delay to perform MT or any lowering of safety protocol for workers in the healthcare system.

A two-stage decision-support approach for improving sustainable last-mile cold chain logistics operations of COVID-19 vaccines

The COVID-19 pandemic has become a global health and humanitarian crisis that catastrophically affects many industries. To control the disease spread and restore normal lives, mass vaccination is considered the most effective way. However, the sustainable last-mile cold chain logistics operations of COVID-19 vaccines is a complex short-term planning problem that faces many practical challenges, e.g., low-temperature storage and transportation, supply uncertainty at the early stage, etc. To tackle these challenges, a two-stage decision-support approach is proposed in this paper, which integrates both route optimization and advanced simulation to improve the sustainable performance of last-mile vaccine cold chain logistics operations. Through a real-world case study in Norway during December 2020 and March 2021, the analytical results revealed that the logistics network structure, fleet size, and the composition of heterogeneous vehicles might yield significant impacts on the service level, transportation cost, and CO2 emissions of last-mile vaccine cold chain logistics operations.

Global Container Port Network Linkages and Topology in 2021.

The maritime transport of containers between ports accounts for the bulk of global trade by weight and value. Transport impedance among ports through transit times and port infrastructures can, however, impact accessibility, trade performance, and the attractiveness of ports. Assessments of the transit routes between ports based on performance and attractiveness criteria can provide a topological liner shipping network that quantifies the performance profile of ports. Here, we constructed a directed global liner shipping network (GLSN) of the top six liner shipping companies between the ports of Africa, Asia, North/South America, Europe, and Oceania. Network linkages and community groupings were quantified through a container port accessibility evaluation model, which quantified the performance of the port using betweenness centrality, the transport impedance among ports with the transit time, and the performance of ports using the Port Liner Shipping Connectivity Index. The in-degree and out-degree of the GLSN conformed to the power-law distribution, respectively, and their R-square fitting accuracy was greater than 0.96. The community partition illustrated an obvious consistence with the actual trading flow. The accessibility evaluation result showed that the ports in Asia and Europe had a higher accessibility than those of other regions. Most of the top 30 ports with the highest accessibility are Asian (17) and European (10) ports. Singapore, Port Klang, and Rotterdam have the highest accessibility. Our research may be helpful for further studies such as species invasion and the planning of ports.

Are female-specific cancers long-term sequelae of COVID-19? Evidence from a large-scale genome-wide cross-trait analysis (preprint)

ABSTRACT Background Little is known regarding the long-term adverse effects of COVID-19 on female-specific cancers due to the restricted length of observational time, nor the shared genetic influences underlying these conditions. Methods Leveraging summary statistics from the hitherto largest genome-wide association studies conducted in each trait, we performed a comprehensive genome-wide cross-trait analysis to investigate the shared genetic architecture and the putative genetic associations between COVID-19 with three main female-specific cancers: breast cancer (BC), epithelial ovarian cancer (EOC), and endometrial cancer (EC). Three phenotypes were selected to represent COVID-19 susceptibility (SARS-CoV-2 infection) and severity (COVID-19 hospitalization, COVID-19 critical illness). Results For COVID-19 susceptibility, we found no evidence of a genetic correlation with any of the female-specific cancers. For COVID-19 severity, we identified a significant genome-wide genetic correlation with EC for both hospitalization ( r g =0.19, P =0.01) and critical illness ( r g =0.29, P =3.00×10 −4 ). Mendelian randomization demonstrated no valid association of COVID-19 with any cancer of interest, except for suggestive associations of genetically predicted hospitalization (OR IVW =1.09, 95%CI=1.01-1.18, P =0.04) and critical illness (OR IVW =1.06, 95%CI=1.00-1.11, P =0.04) with EC risk, none withstanding multiple correction. No reverse association was found. Cross-trait meta-analysis identified multiple pleiotropic SNPs between COVID-19 and female-specific cancers, including 20 for BC, 15 for EOC, and 5 for EC. Transcriptome-wide association studies revealed shared genes, mostly enriched in the hematologic, cardiovascular, and nervous systems. Conclusions Our genetic analysis highlights an intrinsic link underlying female-specific cancers and COVID-19 - while COVID-19 is not likely to elevate the immediate risk of the examined female-specific cancers, it appears to share mechanistic pathways with these conditions. These findings may provide implications for future therapeutic strategies and public health actions.

Research on Development Strategy of Henan Aviation Economy under the Background of Regional Economy

There is no doubt that economic globalization creates a golden opportunity for the development of aviation economy in the world;meanwhile, the world economy has entered the aviation century of the 21st century from the navigation century of the 20th century. As a new type of regional economy, the aviation economy is attracting more and more attention from all sectors of society and becoming a significant field for many countries and regions in the world. As the city that has been strategically promoted as the first pilot zone for airport economy development in China (Liang, 2013), Zhengzhou is endowed with remarkable geographic advantage. Coupled with policy advantages from Chinese government, its development is crucial to the development of regional economy in the entire province;therefore, this research paper studied its advantages, disadvantages, opportunities, and threats for developing aviation economy and analyzed its possibility for developing a well-established aviation industry. Secondly, the current condition of airport logistics in Henan province was analyzed, especially the current situation and noticeable problems. Thirdly, the gray analysis was carried out to analyze the relationship between aviation industry and economy development in Henan. Finally, the according development strategy and suggestions for developing aviation economy were put forward, such as innovating industrial development models, exploring new modes of financing, establishing a sound transportation system and airport supporting facilities, and improving the talent introduction program in airport industry. Overall, this paper researched the aviation economy in Henan province from the perspective of regional economy development, analyzed the current issues occurred in the aviation economy development process, and offered suggestions accordingly.

Microwave resonant absorption of SARS-CoV-2 viruses.

Low power microwave can effectively deactivate influenza type A virus through the nonthermal structure-resonant energy transfer effect, at a frequency matching the confined-acoustic dipolar mode frequency of the virus. Currently, aerosol is considered the major route for SARS-CoV-2 transmission. For the potential microwave-based sterilization, the microwave-resonant frequency of SARS-CoV-2 must be unraveled. Here we report a microwave absorption spectroscopy study of the SARS-CoV-2 and HCoV-229E viruses through devising a coplanar-waveguide-based sensor. Noticeable microwave absorption can be observed, while we identified the resonant frequencies of the 1st and 2nd dipolar modes of SARS-CoV-2 virus as 4 and 7.5 GHz respectively. We further found that the resonant frequencies are invariant to the virus titer, and we also studied the microwave absorption of HCoV-229E in weak acidity medium to simulate the common pH value in fluid secretion. Our results suggest the possible radiation frequency for the recently proposed microwave sterilization devices to inactivate SARS-CoV-2 virus through a nonthermal mechanism so as to control the disease transmission in the post-pandemic era.

Impact of proton pump inhibitors on the in-hospital outcome of COVID-19 patients: a retrospective study.

Background: Coronavirus disease 2019 (COVID-19) has triggered a global public health crisis. Proton pump inhibitors (PPIs) are one of the most commonly prescribed drugs. However, the effect of PPIs on the clinical outcomes of COVID-19 patients remains unclear. Methods: All COVID-19 patients admitted to the Wuhan Huoshenshan Hospital from February 2020 to April 2020 were retrospectively collected. Patients were divided into PPIs and non-PPIs groups. Logistic regression analyses were performed to explore the effects of PPIs on the outcomes of COVID-19 patients, including transfer to intensive care unit, mechanical ventilation, and death. Subgroup analyses were performed according to the presence of upper gastrointestinal symptoms potentially associated with acid and the routes, types, median total dosage, and duration of PPIs. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results: Of the 3024 COVID-19 patients included, 694 and 2330 were in PPIs and non-PPIs groups, respectively. Univariate logistic regression analysis showed that PPIs significantly increased the risk of reaching the composite endpoint in COVID-19 patients (OR = 10.23, 95% CI = 6.90-15.16, p < 0.001). After adjusting for age, sex, comorbidities, other medications, and severe/critical COVID-19, PPIs were independently associated with an increased risk of reaching the composite endpoint (OR = 7.00, 95% CI = 4.57-10.71, p < 0.001). This association remained significant in patients with upper gastrointestinal symptoms and those who received an intravenous omeprazole alone, but not those who received oral lansoprazole or rabeprazole alone. It was not influenced by dosage or duration of PPIs. Conclusion: The use of intravenous PPIs alone during hospitalization may be associated with worse clinical outcome in COVID-19 patients.

Associations Between Online Learning, Smartphone Addiction Problems, and Psychological Symptoms in Chinese College Students After the COVID-19 Pandemic.

Background: Smartphone-based online education gained popularity during and after the COVID-19 pandemic. Although recent studies have highlighted the association between problematic smartphone use (PSU) and mental health symptoms, the potential role of online learning in this relationship remains unclear. This study aimed to analyze the relationships between higher education modes, PSU, and related psychological symptoms in university students. Methods: A total of 1,629 Chinese university students from five provinces completed a web-based questionnaire survey between March 2020 and October 2021. Demographic characteristics and learning conditions were recorded. All participants completed the Smartphone Addiction Scale-Short Version, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Athens Insomnia Scale. Multiple regressions models and stratified analyses were used to examine the association between online education mode, PSU, and symptoms of depression, anxiety, and insomnia. Results: The prevalence of PSU was 58.5%. Students who relied primarily on online learning had a higher prevalence of depressive symptoms (29.95% vs. 22.24%), anxiety symptoms (25.13% vs. 18.91%), and insomnia symptoms (75.89% vs. 70.27%) than those who relied on traditional face-to-face learning (Ps < 0.05). After adjusting for covariates, subjects with PSU were more likely to report depressive symptoms (AdjOR = 3.14, 95% CI = 2.26-4.37), anxiety symptoms (AdjOR = 3.73, 95% CI = 2.13-4.59), and insomnia symptoms (AdjOR = 2.96, 95% CI = 2.23-3.92) than those without PSU. Furthermore, the associations of PSU with depressive symptoms (OR = 4.66 vs. 2.33, P for interaction = 0.015) and anxiety symptoms (OR = 6.05 vs. 2.94, P for interaction = 0.021) were more pronounced in the online learning group. Conclusion: Our study provides preliminary evidence that Chinese university students have serious smartphone addiction problems, which are associated with depressive, anxiety, and insomnia symptoms. Online learning is found to exacerbate PSU and mental health problems. Our findings provide valuable information for targeted psychological interventions in the post-COVID-19 era.

Seeking a Sense of Control or Escapism? The Role of Video Games in Coping with Unemployment

Unemployment can have devastating effects on people?s psychological and social wellbeing. The effects of unemployment can be exacerbated during the COVID-19 pandemic due to the lack of control over one?s life and the loss of social connectedness. Through a survey of 480 unemployed workers, this study examined how emotion-focused coping using video game can affect the workers? wellbeing and reemployment. The findings showed that escapism was associated with decreased wellbeing, which reduced job-search efficacy and behaviors. However, when video game playing was viewed as a source of self-determination, it can support the unemployed workers? intrinsic needs of autonomy and relatedness, which improved their wellbeing, their job-search efficacy, and job-search behaviors. Further comparison of effects between gender, age, race, and income found that unemployed workers who made lower to medium income were more likely to seek escapism through games compared to female unemployed workers.

Cell transcriptomic atlas of the non-human primate Macaca fascicularis.

Studying tissue composition and function in non-human primates (NHPs) is crucial to understand the nature of our own species. Here we present a large-scale cell transcriptomic atlas that encompasses over 1 million cells from 45 tissues of the adult NHP Macaca fascicularis. This dataset provides a vast annotated resource to study a species phylogenetically close to humans. To demonstrate the utility of the atlas, we have reconstructed the cell-cell interaction networks that drive Wnt signalling across the body, mapped the distribution of receptors and co-receptors for viruses causing human infectious diseases, and intersected our data with human genetic disease orthologues to establish potential clinical associations. Our M. fascicularis cell atlas constitutes an essential reference for future studies in humans and NHPs.

Neutralizing Antibodies and Cellular Immune Responses Against SARS-CoV-2 Sustained One and a Half Years After Natural Infection.

Background: COVID-19 has caused more than 2.6 billion infections and several million deaths since its outbreak 2 years ago. We know very little about the long-term cellular immune responses and the kinetics of neutralizing antibodies (NAbs) to SARS-CoV-2 because it has emerged only recently in the human population. Methods: We collected blood samples from individuals who were from the first wave of the COVID-19 epidemic in Wuhan between December 30, 2019, and February 24, 2020. We analyzed NAbs to SARS-CoV-2 using pseudoviruses and IgG antibodies to SARS-CoV-2 spike (S) and nucleocapsid (N) protein using enzyme-linked immunosorbent assay in patients' sera and determined SARS-CoV-2-specific T-cell responses of patients with ELISpot assays. Results: We found that 91.9% (57/62) and 88.9% (40/45) of COVID-19 patients had NAbs against SARS-CoV-2 in a year (10-11 months) and one and a half years (17-18 months), respectively, after the onset of illness, indicating that NAbs against SARS-CoV-2 waned slowly and possibly persisted over a long period time. Over 80% of patients had IgG antibodies to SARS-CoV-2 S and N protein one and a half years after illness onset. Most patients also had robust memory T-cell responses against SARS-CoV-2 one and a half years after the illness. Among the patients, 95.6% (43/45) had an IFN-γ-secreting T-cell response and 93.8% (15/16) had an IL-2-secreting T-cell response. The T-cell responses to SARS-CoV-2 were positively correlated with antibodies (including neutralizing antibodies and IgG antibodies to S and N protein) in COVID-19 patients. Eighty percent (4/5) of neutralizing antibody-negative patients also had SARS-CoV-2-specific T-cell response. After long-term infection, protective immunity was independent of disease severity, sex, and age. Conclusions: We concluded that SARS-CoV-2 infection elicited a robust and persistent neutralizing antibody and memory T-cell response in COVID-19 patients, indicating that these sustained immune responses, among most SARS-CoV-2-infected people, may play a crucial role in protection against reinfection.

A comprehensive analysis of the intervention of a fresh air ventilation system on indoor air quality in classrooms

Adequate classroom air quality is vital to student health and learning outcomes. Prolonged periods of air conditioner use in enclosed classrooms may result in poor air quality. However, opening classroom windows may expose students to air pollutants if the outdoor air quality is poor. This study investigated CO2 and PM2.5 concentrations in 86 classrooms installed with air conditioners in elementary and middle schools in southern Taiwan, each additionally installed with a fresh air ventilation system equipped with an E11-class filter. Enclosed air-conditioned classrooms generally have a CO2 concentration greater than 2500 ppm;occasionally, this figure reaches 3500 ppm. With the installed air ventilation system operating, mean classroom CO2 concentration decreased to 1084 ± 203 ppm, and the median CO2 concentration decreased to 1120 ppm. However, the CO2 concentrations of over half the classrooms remained higher than the concentration advised by the World Health Organization (1000 ppm). This high CO2 concentration was a result of the short distance (1.5–2 m) between the indoor air outlet and the recirculated air inlet resulting in a shortened circuit of air travel. Also, the initial filter installed over the indoor air outlet of the system reduced air penetration into the classroom. When the ventilation system was manually activated without activating the air conditioners, the median PM2.5 concentration measured at the indoor air outlet and the median classroom PM2.5 concentration were 2 μg/m3 and 20 μg/m3, respectively. This implied the presence of other sources of PM2.5 in classrooms, particularly ceiling and wall-mounted fans. The activation of these fans spread dust onto classroom furniture. Overall, fresh air ventilation systems providing filtered air improve classroom ventilation efficiency and indoor air quality by reducing CO2 and PM2.5 concentrations, but the cleanliness of fans and furniture must be maintained.

Brucellosis prevalence in yaks in China in 1980-2019: A systematic review and meta-analysis.

In the Qinghai-Tibet Plateau of China, the yak is an animal of particular economic interest, which provides protein and income for herders in daily life. Brucellosis is a bacterial disease that can infect humans and animals, including yaks. It can damage the yak reproductive system, causing miscarriage and orchitis. At the same time, brucellosis threatens the health of herders. We performed this meta-analysis using R software to explore the combined prevalence and risk factors of brucellosis in yak in China. Variability was assessed by the I2 statistic and Cochran Q statistic. We identified 52 publications of related research from four databases (Wanfang Data, VIP Chinese Journal Database, China National Knowledge Infrastructure, and of PubMed). The pooled prevalence of yak brucellosis was 8.39 %. Prevalence was highest in Southwestern China (11.1 %). The point estimate of brucellosis in yak from 2012 to 2016 was the highest (11.47 %). The point estimate of age ≤ 12 months (1.44 %) was lower than that of age > 12 months (15.6 %). This study shows that yak brucellosis is serious, and its incidence is higher than before 2012. We recommend carrying out large-scale yak brucellosis investigations in Western China and conducting comprehensive testing planning. The detection of brucellosis in adult animals should be strengthened to reduce the economic loss caused by brucellosis to herders and to improve public health.

'Trend in premature mortality from four major NCDs in Nanjing, China, 2007-2018'.

BACKGROUND: This study aims to analyze the trends of premature mortality caused from four major non-communicable diseases (NCDs), namely cardiovascular disease (CVD), cancer, chronic respiratory diseases, and diabetes in Nanjing between 2007 and 2018 and project the ability to achieve the "Healthy China 2030" reduction target. METHODS: Mortality data of four major NCDs for the period 2007-2018 were extracted from the Death Information Registration and Management System of Chinese Center for Disease Control and Prevention. Population data for Nanjing were provided by the Nanjing Bureau of Public Security. The premature mortality was calculated using the life table method. Joinpoint regression model was used to estimate the average annual percent changes (AAPC) in mortality trends. RESULTS: From 2007 to 2018, the premature mortality from four major NCDs combined in Nanjing decreased from 15.5 to 9.5%, with the AAPC value at - 4.3% (95% CI [- 5.2% to - 3.4%]). Overall, it can potentially achieve the target, with a relative reduction 28.6%. The premature mortality from cancer, CVD, chronic respiratory diseases and diabetes all decreased, with AAPC values at - 4.2, - 5.0%, - 5.9% and - 1.6% respectively. A relative reduction of 40.6 and 41.2% in females and in rural areas, but only 21.0 and 12.8% in males and in urban areas were projected. CONCLUSION: An integrated approach should be taken focusing on the modifiable risk factors across different sectors and disciplines in Nanjing. The prevention and treatment of cancers, diabetes, male and rural areas NCDs should be enhanced.