Prevalence of thyroid nodule and relationship with physiological and psychosocial factors among adults in Zhejiang Province, China: a baseline survey of a cohort study.

BACKGROUND: Thyroid nodules have attracted much attention due to their high incidence and potential for malignant transformation. Compared with the clinical assessment and diagnosis of thyroid nodules, there are relatively few studies on the epidemiological risk factors for thyroid nodules. The aim of this study was to investigate the prevalence of thyroid nodule among adults in Zhejiang province and to explore their relationship with physiological and psychosocial factors. METHODS: The data used in this study were obtained from the baseline survey of the Zhejiang Provincial Cohort Study on Environment and Health. From June 2022 to December 2023, a total of 21,712 participants from five representative cities in Zhejiang were recruited for the baseline survey. Based on the inclusion and exclusion criteria, 15,595 adults were included in the analysis. The data were collected via self-report questionnaires and physical examinations. Multivariate logistic regression analysis was subsequently performed. RESULTS: The detection rate of thyroid nodules was 50.98% among adults in Zhejiang province. Age, gender, education level, BMI, tea and alcohol consumption all had a statistically significant association with thyroid nodules (p < 0.05). After adjusting for sociodemographic factors, results of logistic regression analysis showed that good life satisfaction (OR = 0.854, 95% CI: 0.780-0.934) had a lower risk of thyroid nodules, however, poor life satisfaction (OR = 1.406, 95% CI: 1.014-1.951), social isolation (OR = 1.294, 95% CI: 1.089-1.538) and a family history of thyroid nodules (OR = 1.334, 95% CI: 1.064-1.672) had a greater risk of thyroid nodules. CONCLUSION: The detection rate of thyroid nodules in adults of Zhejiang province was an increasing trend compared with that in previous years. In addition to the sensitive thyroid nodule screening technology, influencing factors mentioned in this study might also represent credible candidates for this increase. As variable influence factors, weight management, good interpersonal relationships and life satisfaction should be the focus of health interventions.

Life expectancy, long-term care demand and dynamic financing mechanism simulation: an empirical study of Zhejiang Pilot, China.

BACKGROUND: China has piloted Long-Term Care Insurance (LTCI) to address increasing care demand. However, many cities neglected adjusting LTCI premiums since the pilot, risking the long-term sustainability of LTCI. Therefore, using Zhejiang Province as a case, this study simulated mortality-adjusted long-term care demand and the balance of LTCI funds through dynamic financing mechanism under diverse life expectancy and disability scenarios. METHODS: Three-parameter log-quadratic model was used to estimate the mortality from 1990 to 2020. Mortality with predicted interval from 2020 to 2080 was projected by Lee-Carter method extended with rotation. Cohort-component projection model was used to simulate the number of older population with different degrees of disability. Disability data of the older people is sourced from China Health and Retirement Longitudinal Study 2018. The balance of LTCI fund was simulated by dynamic financing actuarial model. RESULTS: Life expectancy of Zhejiang for male (female) is from 80.46 (84.66) years in 2020 to 89.39 [86.61, 91.74] (91.24 [88.90, 93.25]) years in 2080. The number of long-term care demand with severe disability in Zhejiang demonstrates an increasing trend from 285 [276, 295] thousand in 2023 to 1027 [634, 1657] thousand in 2080 under predicted mean of life expectancy. LTCI fund in Zhejiang will become accumulated surplus from 2024 to 2080 when annual premium growth rate is 5.25% [4.20%, 6.25%] under various disability scenarios, which is much higher than the annual growth of unit cost of long-term care services (2.25%). The accumulated balance of LTCI fund is sensitive with life expectancy. CONCLUSIONS: Dynamic growth of LTCI premium is essential in dealing with current deficit around 2050 and realizing Zhejiang's LTCI sustainability in the long-run. The importance of dynamic monitoring disability and mortality information is emphasized to respond immediately to the increase of premiums. LTCI should strike a balance between expanding coverage and controlling financing scale. This study provides implications for developing countries to establish or pilot LTCI schemes.

Study on the quality of Corydalis Rhizoma in Zhejiang based on multidimensional evaluation method.

ETHNOPHARMACOLOGICAL RELEVANCE: The quality requirements of Corydalis Rhizoma (CR) in different producing areas are uniform, resulting in uneven efficacy. As a genuine producing area, the effective quality control of CR in Zhejiang Province (ZJ) could provide a theoretical basis for the rational application of medicinal materials. AIM OF THE STUDY: The purpose of this study was to effectively distinguish the CR inside and outside ZJ, and provided a theoretical basis for the quality control and material basis research of ZJ CR. MATERIALS AND METHODS: The core components of ZJ CR could be identified by HPLC combined with chemometrics screening, and the quality of CR from different producing areas was evaluated by a genetic algorithm-back propagation (GA-BP) neural network. Chromaticity and near-infrared (NIR) spectroscopy were used to identify CR inside and outside ZJ, and rapid content prediction was realized. The analgesic effect of CR in different regions was compared by a zebrafish analgesic experiment. Analgesic experiments in rats and analysis of the research status of quality components were used to screen the quality control components of ZJ CR. RESULTS: The contents of palmatine hydrochloride (YSBMT), dehydrocorydaline (TQZJJ), tetrahydropalmatine (YHSYS), tetrahydroberberine (SQXBJ), corydaline (YHSJS), stylopine (SQHLJ), and isoimperatorin (YOQHS) in ZJ CR were higher than those in CR from outside ZJ, but the content of protopine (YAPJ) and berberine hydrochloride (YSXBJ) was lower than that in CR from outside ZJ. YHSJS and SQHLJ could be used as the core components to identify ZJ CR. The GA-BP neural network showed that the relative importance of ZJ CR was the strongest. Chroma-content correlation analysis and the NIR qualitative model could effectively distinguish CR from inside and outside of ZJ, and the NIR quantitative model could quickly predict the content of CR from inside and outside of ZJ. Zebrafish experiments showed that ZJ, Shaanxi (SX), Henan (HN), and Sichuan (SC) CR had significant analgesic effects, while Hebei (HB) CR had no significant analgesic effect. Overall comparison, the analgesic effect of ZJ CR was better than that of CR outside ZJ. The comprehensive score of the grey correlation degree between YAPJ, YSBMT, YSXBJ, TQZJJ, YHSYS, YHSJS, SQXBJ, and SQHLJ were higher than 0.9, and the research frequency were extremely high. CONCLUSIONS: The relative importance of the content and origin of most components of ZJ CR was higher than that of CR outside ZJ. The holistic analgesic effect of ZJ CR was better than that of CR outside ZJ, but slightly lower than that of SX CR. YHSJS and SQHLJ could be used as the core components to identify ZJ CR. YAPJ, YSBMT, YSXBJ, TQZJJ, YHSYS, SQXBJ, YHSJS, and SQHLJ could be used as the quality control components of ZJ CR. The multidimensional evaluation method used in this study provided a reference for the quality control and material basis research of ZJ CR.

Occurrence and Exposure Assessment of Nickel in Zhejiang Province, China.

Nickel (Ni) is a silver-white metal with high antioxidative properties, often existing in a bivalent form in the environment. Despite being the fifth most abundant metal on Earth, anthropogenic activities, including industrial processes, have elevated Ni levels in environmental media. This study investigated Ni contamination in various food groups in Zhejiang Province, China, mainly focusing on Ni levels in beans, vegetables, aquatic foods, meat products, cereal products, and fruits. A total of 2628 samples were collected and analyzed. Beans exhibited the highest Ni content in all samples. The overall detection rate of Ni was 86.5%, with variation among food categories. For plant-origin foods, legumes had the highest Ni concentration while for animal-origin foods, shellfish showed the highest median Ni concentration. The results indicate generally acceptable Ni exposure levels among Zhejiang residents, except for children aged 0-6. Beans were identified as the primary contributor to high Ni exposure risk. The paper suggests monitoring Ni contamination in food, especially for vulnerable populations, and provides insights into exposure risks in different age groups.

Spatial and temporal changes of social vulnerability of cities to natural hazards in Zhejiang province, China.

Understanding how social dynamics interact with natural hazards is one of the main challenges at global and local scales in the world for studying social vulnerability to natural hazards. In this study, we explore the spatial and temporal changes of social vulnerability of cities in Zhejiang province to natural hazards in China for the last decade. Based on the Zhejiang province's census data and the demographics and socioeconomic data during the period from 2009 to 2018, we have characterized social vulnerability through the Social Vulnerability Index (SoVI) for 11 cities throughout the province during 2009-2018 and examined spatial changes in social vulnerability using equal interval method. The results indicated that although the comprehensive vulnerability of Zhejiang province shows a declining trend at a county level, the social vulnerability of different city at the provincial level has obvious differences.

Land use carbon emissions estimation and carbon emissions control strategy effect scenario simulation in Zhejiang province.

Carbon emission control is an important aspect of regional sustainable development. However, there are few studies on predicting the impact of different socio-economic development strategies on carbon emissions under the premise of established government policy objectives, and then evaluating the degree of achievement of policy objectives. In order to research the effect of social and economic development strategies on carbon emissions, remote sensing land use data of Zhejiang Province from 2000 to 2020 were utilized in this paper to quantify carbon emissions, combined with Kaya identity and LMDI decomposition method, and multi-scenario carbon emissions simulation and prediction were carried out under the STIRPAT model framework. The results demonstrate that land use carbon emissions increased by four times in the last 20 years, and increased rapidly between 2000 and 2010, and became stable in recent years. Economic growth is the primary motivator; According to the existing economic development model, carbon emissions will peak and turn around in 2030; If appropriate economic transformation measures are taken to increase the proportion of low-carbon economic components, it is possible to achieve the development model of scenario 2 and scenario 3, and carbon emissions will reach the peak 2-5 years earlier. In general, this study offers a significant conclusion for the investigation of the connection between social and economic growth strategies and carbon emissions, and it can serve as a guide for the formation of government policy.

[Impact of COVID-19 pandemic on the management of imported malaria in China].

OBJECTIVE: To examine the impact of COVID-19 pandemic on the epidemic status of imported malaria and national malaria control program in China, so as to provide insights into post-elimination malaria surveillance. METHODS: All data pertaining to imported malaria cases were collected from Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region during the period from January 1, 2018 through December 31, 2021. The number of malaria cases, species of malaria parasites, country where malaria parasite were infected, diagnosis and treatment after returning to China, and response were compared before (from January 1, 2018 to January 22, 2020) and after the COVID-19 pandemic (from January 23, 2020 to December 31, 2021). RESULTS: A total of 2 054 imported malaria cases were reported in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region during the period from January 1, 2018 to December 31, 2021, and there were 1 722 cases and 332 cases reported before and after the COVID-19 pandemic, respectively. All cases were reported within one day after definitive diagnosis. The annual mean number of reported malaria cases reduced by 79.30% in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region after the COVID-19 pandemic (171 cases) than before the pandemic (826 cases), and the number of monthly reported malaria cases significantly reduced in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region since February 2020. There was a significant difference in the constituent ratio of species of malaria parasites among the imported malaria cases in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region before and after the COVID-19 pandemic (χ2 = 146.70, P < 0.05), and P. falciparum malaria was predominant before the COVID-19 pandemic (72.30%), while P. ovale malaria (44.28%) was predominant after the COVID-19 pandemic, followed by P. falciparum malaria (37.65%). There was a significant difference in the constituent ratio of country where malaria parasites were infected among imported malaria cases in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region before and after the COVID-19 pandemic (χ2 = 13.83, P < 0.05), and the proportion of malaria cases that acquired Plasmodium infections in western Africa reduced after the COVID-19 pandemic that before the pandemic (44.13% vs. 37.95%; χ2 = 4.34, P < 0.05), while the proportion of malaria cases that acquired Plasmodium infections in eastern Africa increased after the COVID-19 pandemic that before the pandemic (9.58% vs. 15.36%; χ2 = 9.88, P = 0.02). The proportion of completing case investigation within 3 days was significantly lower after the COVID-19 pandemic than before the pandemic (96.69% vs. 98.32%; χ2= 3.87, P < 0.05), while the proportion of finishing foci investigation and response within 7 days was significantly higher after the COVID-19 pandemic than before the pandemic (100.00% vs. 98.43%; χ2 = 3.95, P < 0.05). CONCLUSIONS: The number of imported malaria cases remarkably reduced in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region of China during the COVID-19 pandemic, with a decreased proportion of completing case investigations within 3 days. The sensitivity of the malaria surveillance-response system requires to be improved to prevent the risk of secondary transmission of malaria due to the sharp increase in the number of imported malaria cases following the change of the COVID-19 containment policy.

[Simulation of land use and assessment of ecosystem service value in the eastern coastal cities of Zhejiang Province, China]. / 浙江东部沿海城市土地利用模拟及生态系统服务价值评估.

Simulating the change of ecosystem service values (ESV) caused by land use/cover change (LUCC) in the eastern coastal cities of Zhejiang Province is of great significance for regional sustainable development and ecological security. Based on remote sensing images of land use and Statistics Yearbook of 2000, 2010, and 2020, we analyzed the influence of LUCC on ESV in the study area during 2000-2020. We used the PLUS model to simulate land use change under three scenarios, including inertial development, ecological protection, and urban development in 2030, analyzed the spatial distribution and concentration degree of ESVs based on grid scale, and clarified the sensitivity characteristics of ESVs. The results showed that the construction land area showed an increasing trend during 2000-2020. The area of forest, cultivated land and water decreased significantly, resulting in a continuous downward trend of ESVs, which decreased by 160×108 yuan. Under the simulation of three scenarios of inertial development, ecological development, and urban development, the construction land area would increase by 93624, 54927, and 111966 hm2, respectively. The eastern plain would become the agglomeration area of construction land expansion. The ESVs of those three scenarios was 1693×108, 1729×108, and 1688×108 yuan, respectively, which were all lower than the ESVs of the study area in 2020. The decline rate of ESV in the ecological protection scenario slowed down. The spatial distribution of ESVs in the study area was high in the west and low in the east. Hot spots and cold spots of ESVs were distributed in a large range with strong agglomeration. Hot spots were mainly concentrated in the west, while cold spots were mainly distributed in the east and north.

Driving impact and spatial effect of the digital economy development on carbon emissions in typical cities: a case study of Zhejiang, China.

The digital economy (DE) not only drives economic innovation and development but also has significant environmental effects by promoting lower carbon emissions. To investigate the spatial effects of DE on urban carbon emissions, this study comprehensively measures the level of DE development based on the panel data from 11 typical cities in Zhejiang Province from 2011 to 2020, by comparing analysis using different regression models. The following conclusions are obtained: (1) The total carbon emissions (TC) of Zhejiang cities in general show a fluctuating change trend of first increasing and then slowly decreasing, while carbon emission intensity and carbon emission per capita in general show a fluctuating change trend of decreasing. Cities with high TC are primarily concentrated in the Hangzhou Bay city cluster, accounted for 62 ~ 65% of the province's carbon emissions. The development of the DE in Zhejiang cities shows steady growth, but there are large differences among cities, with Hangzhou and Ningbo standing out as particularly prominent. (2) There is a significant inverted U-shaped relationship between the DE and the level of carbon emissions in Zhejiang Province. The influence coefficient of the DE on the primary term of TC is 0.613, and the influence coefficient of the quadratic term of TC is - 1.008. (3) In terms of the spatial spillover effect of the DE on carbon emissions, the study finds that compared to the direct effect, the spatial spillover effect is not significant. However, the allocation of transport resources shows a positive spatial spillover effect (increasing carbon emissions, coefficient value is 0.138), while technological progress shows a somewhat negative spatial spillover effect (decreasing carbon emissions, coefficient value is - 0.035). (4) The study also finds that the smart city pilot policy significantly reduces urban carbon emissions. Moreover, the effect of the DE on carbon emissions is confirmed through the significance test of the quadratic term when replacing the geographical and economic distance weight matrices. This indicates that the empirical findings are robust to these tests. Finally, several countermeasures to reduce carbon emissions are proposed from the perspective of DE development.

[Ecological Risk and Health Risk of Heavy Metal Pollution in Vegetable Production System of Zhejiang Province].

In order to understand the heavy metal contamination of soil and vegetables in the vegetable production system of Zhejiang Province and the health risks of vegetables consumed by residents, typical vegetable production bases in Zhejiang Province were selected as the study areas; 102 pairs of vegetable and soil samples were collected; the distribution characteristics of heavy metals Cd, Cu, Pb, Cr, As, Ni, and Hg in the vegetable production system of Zhejiang Province were analyzed, and the ecological health risks of the vegetable production system were systematically evaluated using the Nemerow composite pollution index, potential ecological risk index, and dietary exposure assessment model. The results showed that Cd in the soil seriously exceeded the standard, with an exceedance rate of 97.2%. The main risk of soil pollution was moderate and mild, and the highest risk was Cd, followed by Pb, Cu, and As. Among vegetables, only a small amount of bean and fruit vegetables exceeded the Cd content, with the exceedance rates of 12.5% and 8.7%, respectively. The BCF of different types of vegetables differed significantly and could be ranked accordingly:leafy vegetables>bean vegetables>melon vegetables>root vegetables. The non-carcinogenic and carcinogenic risks of Zhejiang residents consuming local vegetables were within acceptable limits, with children being more at risk than adults (P<0.01), and Cd and Pb contributing the most to health risks. The overall vegetables produced by the vegetable production system in Zhejiang Province were at a safe level, but there is a need to strengthen the control of Cd and Pb pollution sources.

[Pollution Characteristics of PM2.5 Chemical Composition in Zhejiang Province].

To investigate the seasonal and regional pollution characteristics of PM2.5 chemical composition in Zhejiang province, this study was based on manual sampling monitoring data from 11 sampling sites of four regions in Zhejiang province from October 1, 2019 to September 30, 2020. The results showed that during the observation period, the average ρ(PM2.5) of the four regions ranged from 34.3 µg·m-3 to 46.4 µg·m-3. The PM2.5 mass concentrations in the hinterland areas of western Zhejiang and northern Zhejiang were relatively high, 15.1% and 13.2% higher than the mean value, respectively. The PM2.5 mass concentrations in the coastal areas of eastern Zhejiang and southern Zhejiang were relatively low, 8.4% and 14.9% lower than the average, respectively. The seasonal characteristics showed a higher concentration in autumn and winter and lowest concentration in summer. The seasonal variation in PM2.5 mass concentration from autumn to spring was not obvious in southern Zhejiang, whereas in western Zhejiang, the PM2.5 mass concentration followed a descending sequence of autumn>winter>spring>summer. In northern Zhejiang and eastern Zhejiang, the trend was winter>autumn>spring>summer. During the observation period in the inland area, the ρ(PM2.5) of the scenic area, administrative area, residential area, and mixed area of commercial traffic and residents were (40.2±10.2), (46.3±9.6), (50.1±10.6), and (46.7±10.2) µg·m-3, respectively. The highest value of ρ(PM2.5) was in the residential area. During the sampling period in coastal areas, the ρ(PM2.5) of the cultural and entertainment area and mixed area of commercial traffic and residents were (27.4±5.8) µg·m-3and (37.2±5.6) µg·m-3, respectively. The contribution rates of organic matter (OM), NO3-, SO42-, NH4+, trace elements, and crustal matter in PM2.5were 26.4%, 15.4%, 12.4%, 9.0%, 7.1%, and 5.7%, respectively. The SNA, including SO42-, NO3-, and NH4+, contributed 36.8% in PM2.5. In terms of seasons, the contribution of OM to PM2.5 in autumn, spring, and summer was higher than that of other compositions, which accounted for 28.3%, 27.7%, and 26.3%, respectively. The contribution rate of NO3- in PM2.5 was the largest in winter, reaching 24.3%. In terms of spatial distribution, SNA contributed the most to PM2.5 in all regions, ranging from 32.8% to 39.7%, with the highest in northern Zhejiang and the lowest in southern Zhejiang. The SNA of all regions presented NO3->SO42->NH4+. Based on the backward trajectory clustering analysis, the main air sources of northern Zhejiang were the Yellow Sea-southern Jiangsu (autumn), northern Anhui (winter), East China Sea (spring), and western Jiangsu (summer) areas, with contribution rates of 38.11%, 35.28%, 37.46%, and 27.87%, respectively. The main air sources of western Zhejiang were the Yellow Sea-southern Jiangsu (autumn), southern Anhui (winter), eastern Zhejiang (spring), and northern Zhejiang (summer), with contribution rates of 38.11%, 37.50%, 46.55%, and 32.58%, respectively. The air of autumn, winter, spring, and summer in eastern Zhejiang were influenced by air masses from northern Hebei (36.07%), eastern Shandong (38.06%), East China Sea (30.17%), and southern Guangdong (34.43%), respectively. In autumn, winter, spring, and summer, southern Zhejiang was affected by air masses from the Yellow Sea (35.66%), northeast Anhui (34.44%), East China Sea (26.72%), and southern Fujian coast (35.00%), respectively. The regions in Zhejiang province showed large seasonal differences. The difference value between the maximum value of ρ(PM2.5) in the northwest and the lowest value in the southeast was 21.0 µg·m-3 and 20.5 µg·m-3 in autumn and winter, respectively; the difference values in spring and summer were 10.4 µg·m-3 and 6.1 µg·m-3. Thus, the northern air mass had a certain exogenous contribution to PM2.5 in autumn and winter in Zhejiang province. However, with the weakening of the northern air mass trajectory in spring and summer and the increasing contribution of the southern and east China Sea air mass to the air flow in Zhejiang province, PM2.5 pollution showed a trend of improvement.

Pixel level spatial variability modeling using SHAP reveals the relative importance of factors influencing LST.

As an important indicator of the regional thermal environment, land surface temperature (LST) is closely related to community health and regional sustainability in general, and is influenced by multiple factors. Previous studies have paid scant attention to spatial heterogeneity in the relative contribution of factors underlying LST. In this study of Zhejiang Province, we investigated the key factors affecting daytime and nighttime annual mean LST and the spatial distribution of their respective contributions. The eXtreme Gradient Boosting tree (XGBoost) and Shapley Additive exPlanations algorithm (SHAP) approach were used in combination with three sampling strategies (Province-Urban Agglomeration -Gradients within Urban Agglomeration) to detect spatial variation. The results reveal heterogenous LST spatial distribution with lower LST in the southwestern mountainous region and higher temperatures in the urban center. Spatially explicit SHAP maps indicate that latitude and longitude (geographical locations) are the most important factors at the provincial level. In urban agglomerations, factors associated with elevation and nightlight are shown to positively impact daytime LST in lower altitude regions. In the urban centers, EVI and MNDWI are the most notable influencing factors on LST at night. Under different sampling strategies, EVI, MNDWI, NL, and NDBI affect LST more prominently at smaller spatial scales as compared to AOD, latitude and TOP. The SHAP method proposed in this paper offers a useful means for management authorities in addressing LST in a warming climate.

Influencing factors on ecological efficiency: Based on 11 cities in Zhejiang Province, China.

Ecological efficiency (eco-efficiency) is the effectiveness of ecological resources in meeting human needs and is a good representation of the quality of a region's development. The traditional concept of improving eco-efficiency refers to maximizing economic benefits by minimizing resource costs and environmental loads. This article argues that the goal of eco-efficiency evaluation is not only to maximize economic benefits but also to achieve high-quality and coordinated development in many aspects so that more people can enjoy the fruits of development. Therefore, in the evaluation system of eco-efficiency, the input indexes take into account the consumption of human, energy resources, and the environmental load caused by them in a region. The output indexes take into account the four dimensions of "economy, innovation, social harmony, and openness." This study first establishes the nonexpected output superefficiency slacks-based measure model under the assumption of variable returns to scale to measure eco-efficiency in 11 cities of Zhejiang Province, China. Second, the spatial and temporal trends of eco-efficiency are studied with the help of the Malmquist index model. Moreover, regression analysis was conducted using the panel Tobit method to discuss the influencing factors of eco-efficiency. Several key results were obtained in this study: (1) The overall eco-efficiency in Zhejiang Province is rising steadily, but there are serious regional imbalances. (2) The improvement of eco-efficiency mainly relied on the scale efficiency from 2008 to 2013, but on pure technical efficiency from 2013 to 2018. (3) The share of tertiary industry, the number of scientific researchers, and the foreign trade dependence positively affect the improvement of eco-efficiency, but highway transportation mileage has a negative impact on the improvement of eco-efficiency. Integr Environ Assess Manag 2023;19:139-151. © 2022 SETAC.

Study on the relationship among typhoon, climate change, and acute Stanford type A aortic dissection in southern of Zhejiang in China.

BACKGROUND: The aim of this study was to investigate the relationship between typhoon, climate change, and acute Stanford type A aortic dissection (TAAD) in southern of Zhejiang Province in China. METHOD: 371 patients with TAAD were admitted to three hospitals (the aortic dissection center) in southern of Zhejiang Province, China from January 2015 to December 2020, and data were retrospectively collected, the data included (1) the number of patients admitted in different months and seasons, (2) daily meteorological data in southern of Zhejiang Province, and (3) typhoon information were retrospectively analyzed. RESULTS: The number of TAAD occurred in winter was the highest and in summer was the lowest. The incidence of TAAD was correlated with minimum temperature, maximum wind speed, mean wind speed, and water vapor pressure (P < 0.05). Maximum wind speed (RR 0.37; 95% CI 0.17 to 0.80, P = 0.01) and water vapor pressure (RR 0.96; 95% CI 0.92 to 1, P = 0.03) were the protective factor. The occurrence incidence of TAAD under the influence of typhoon climate was less than that during the period not affected by typhoon (P < 0.05). CONCLUSION: There was a correlation between typhoon, climate change, and the occurrence of TAAD in southern Zhejiang Province. Wind speed, vapor pressure, and typhoon may be protective factors.

Spatial-temporal characteristics and influencing factors of county-level carbon emissions in Zhejiang Province, China.

Zhejiang Province is a "demonstration area for high-quality development and construction of common prosperity" in China. Moreover, the county is the basic unit and power source for the economic development of Zhejiang Province. Therefore, the research on the spatial-temporal characteristics and influencing factors of county-level carbon emissions is of great significance for Zhejiang Province to achieve the strategic goal of carbon peak and carbon neutrality. Based on the carbon emissions and socio-economic data of 62 counties in Zhejiang Province from 2014 to 2020, the spatial dependence and agglomeration of county-level carbon emissions are analyzed through the spatial autocorrelation test and local spatial autocorrelation test respectively. According to the spatial-temporal characteristics of county-level carbon emissions revealed by the index of Moran's I and local Moran's I, the spatial error STIRPAT model is used to study the influencing factors of county-level carbon emissions in Zhejiang Province, China. The main results are as follows: (1) The total amount of county-level carbon emissions of 62 counties fluctuates from 259.69 to 326.28 million tons and shows a growth trend. (2) Moran's I index is between 0.369 and 0.399. The county-level carbon emissions have a significant spatial correlation, and the spatial agglomeration trend is relatively stable, which is consistent with the hypothesis of the geographical polarization effect. (3) High-high agglomeration counties are concentrated in the northeast of Zhejiang Province, while low-low agglomeration counties are mainly in the southwest. (4) The relationship between county per capita GDP and carbon emissions has not been "decoupled," because when other variables remain unchanged, the county's total carbon emissions will increase by 2.866% for every 1% increase in the county's per capita GDP; the increase of the proportion of secondary industry contributes to the decline of carbon emissions, and the low-carbon effect brought by large-scale industrial development as well as scientific and technological innovation has not yet appeared. (5) The estimate of the spatial coefficient λ was 0.324, which illustrates that the carbon emission of a single county is positively affected by the carbon emission of the neighboring counties, and other socio-economic factors affecting carbon emission among counties also have a spatial correlation. Therefore, the policy of realizing regional coordinated development as well as the carbon peaking and carbon neutrality goals should not only focus on industrial layout, but also take a dynamic and comprehensive consideration from a spatial perspective.

Epidemiological characteristics of influenza outbreaks in Zhejiang Province from 2013 to 2022 / 预防医学

Objective@#To investigate the epidemiological characteristics of influenza outbreaks in Zhejiang Province from 2013 to 2022, so as to provide insights into influenza prevention and control. @*Methods@#Data pertaining to influenza outbreaks reported in Zhejiang Province from 2013 to 2022 were collected from National Influenza Surveillance System in China, including time, region, cases and pathogen types of influenza outbreaks. The temporal, spatial and pathogen distribution of influenza outbreaks were analyzed using a descriptive epidemiological method. @*Results@#A total of 577 influenza outbreaks involving 448 698 individuals were reported in Zhejiang Province from 2013 to 2022, and the overall attack rate was 5.34% (23 974 cases), with no death reported. The lowest attack rate of influenza was 0.26%, and the highest was 80.00%, with a median attack rate of 10.89% (interquartile range, 24.26%). The outbreak had the shortest duration of 1.00 day, and the longest duration of 59.00 days, with a median duration of 9.00 (interquartile range, 11.00) days. There were 387 influenza outbreaks that occurred between November and January of the following year (67.07%), and the three highest numbers of outbreaks were reported in Hangzhou City (310 outbreaks), Wenzhou City (51 outbreaks) and Jinhua City (46 outbreaks). There were 395 outbreaks reported in urban regions (68.46%), 93 in counties and townships (16.12%) and 89 in rural regions (15.42%), and influenza outbreaks predominantly occurred in primary schools (487 outbreaks, 84.40%). In addition, the types of pathogens were alternately prevalent, with influenza B virus (241 outbreaks, 41.77%) and A/H3N2 virus (232 outbreaks, 40.21%) as predominant subtypes. @* Conclusions@#Influenza outbreaks mainly occurred in winter in Zhejiang Province from 2013 to 2022, and primary schools were main places of influenza outbreaks, while influenza B virus and A/H3N2 virus were predominant subtypes. It is necessary to reinforce the surveillance and report of influenza-like illness in schools and improve the coverage of influenza vaccination to prevent influenza outbreaks.

Impact of COVID-19 pandemic on the management of imported malaria in China / 中国血吸虫病防治杂志

Objective To examine the impact of COVID-19 pandemic on the epidemic status of imported malaria and national malaria control program in China, so as to provide insights into post-elimination malaria surveillance. Methods All data pertaining to imported malaria cases were collected from Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region during the period from January 1, 2018 through December 31, 2021. The number of malaria cases, species of malaria parasites, country where malaria parasite were infected, diagnosis and treatment after returning to China, and response were compared before (from January 1, 2018 to January 22, 2020) and after the COVID-19 pandemic (from January 23, 2020 to December 31, 2021). Results A total of 2 054 imported malaria cases were reported in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region during the period from January 1, 2018 to December 31, 2021, and there were 1 722 cases and 332 cases reported before and after the COVID-19 pandemic, respectively. All cases were reported within one day after definitive diagnosis. The annual mean number of reported malaria cases reduced by 79.30% in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region after the COVID-19 pandemic (171 cases) than before the pandemic (826 cases), and the number of monthly reported malaria cases significantly reduced in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region since February 2020. There was a significant difference in the constituent ratio of species of malaria parasites among the imported malaria cases in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region before and after the COVID-19 pandemic (χ2 = 146.70, P < 0.05), and P. falciparum malaria was predominant before the COVID-19 pandemic (72.30%), while P. ovale malaria (44.28%) was predominant after the COVID-19 pandemic, followed by P. falciparum malaria (37.65%). There was a significant difference in the constituent ratio of country where malaria parasites were infected among imported malaria cases in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region before and after the COVID-19 pandemic (χ2 = 13.83, P < 0.05), and the proportion of malaria cases that acquired Plasmodium infections in western Africa reduced after the COVID-19 pandemic that before the pandemic (44.13% vs. 37.95%; χ2 = 4.34, P < 0.05), while the proportion of malaria cases that acquired Plasmodium infections in eastern Africa increased after the COVID-19 pandemic that before the pandemic (9.58% vs. 15.36%; χ2 = 9.88, P = 0.02). The proportion of completing case investigation within 3 days was significantly lower after the COVID-19 pandemic than before the pandemic (96.69% vs. 98.32%; χ2= 3.87, P < 0.05), while the proportion of finishing foci investigation and response within 7 days was significantly higher after the COVID-19 pandemic than before the pandemic (100.00% vs. 98.43%; χ2 = 3.95, P < 0.05). Conclusions The number of imported malaria cases remarkably reduced in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region of China during the COVID-19 pandemic, with a decreased proportion of completing case investigations within 3 days. The sensitivity of the malaria surveillance-response system requires to be improved to prevent the risk of secondary transmission of malaria due to the sharp increase in the number of imported malaria cases following the change of the COVID-19 containment policy.

Analyzing the Spatio-Temporal Dynamics of Urban Land Use Expansion and Its Influencing Factors in Zhejiang Province, China.

The 21st century expansion of built-up areas due to rapid urbanization has recently been at the forefront of global land use/land cover research. Knowledge of the changing dynamics of urban land use is crucial for the monitoring of urbanization and the promotion of sustainable urban development. In this paper, Zhejiang Province was selected as the study area. It is a region with rapid urban growth located along the southeastern coast of China, with a highly developed economy but with a shortage of land resources. We employed remotely sensed and socio-economic panel data for the period between 1990 and 2020 to monitor urban land use changes and utilized the spatial Durbin model (SDM) to examine the urbanization process and the various driving factors of rapid urban expansion in Zhejiang Province, China, from 1990 to 2020. The study's results revealed substantial urban growth of about 6899.59 km2, i.e., 6.6%, whereas agricultural land decreased by 4320.68 km2, i.e., 4.19%. The rapid urban development was primarily attributed to the transformation of farmlands, forestlands, and water bodies into built-up areas by nearly 86.9%, 6.94%, and 6.06%, respectively. The built-up areas revealed features of spatial clustering. The study showed that the expansion hotspots were mainly distributed within the urban fabric of cities such as Hangzhou, Ningbo, Jinhua-Yiwu, and Wenzhou-Taizhou. The results further revealed the substantial influence of urban growth on the local areas of the province. As the core explanatory variables, population and economic development significantly promoted local urban expansion. The study's findings indicated a positive spatial spillover effect as regards the influence of economic development on the study area's urban growth, whereas the spatial spillover effect of the population was negative. Therefore, economic development was a major driving factor contributing immensely to the expansion of urban areas in Zhejiang Province, especially in the 26 mountainous counties of the province. The study enriches our understanding of the transformation of LULC and the changing dynamics of urban areas in China and provides the necessary research data that are vital for urban land-use planners and decision-makers to overcome the negative consequences of the expansion of urban areas due to the continuous economic growth of China.

[Inventory and Distribution Characteristics of Anthropogenic Ammonia Emissions in Zhejiang Province from 2008 to 2018].

As ammonia is the main component of PM2.5, long time series of ammonia emission characteristics are an important basis for studying the historical causes of PM2.5 pollution. In this study, the activity data of various anthropogenic ammonia emissions from 11 cities were collected in Zhejiang. The anthropogenic ammonia emissions inventory in Zhejiang was established using emission factors, and then a 1 km×1 km spatial grid distribution was carried out using ArcGIS software. The results showed that from 2008 to 2018, the ammonia emissions from anthropogenic sources in Zhejiang exhibited a downward trend, with an average annual decline rate of approximately 3.97%. The ammonia emissions were 108.52 kt in 2018, and the emission intensity was 1.03 t·km-2, in which there was 90.02 kt from agricultural sources and 18.50 kt from non-agricultural sources. The ammonia emissions of Hangzhou, Jiaxing, and Wenzhou were higher than those of the other cities, accounting for 14.72%, 11.86%, and 11.80% of the total ammonia emissions, respectively. The spatial distribution characteristics showed that ammonia emissions were mainly distributed in the northern part of Zhejiang, showing an emission trend of "high in the north and low in the south." Uncertainty analysis showed that the simulated average value of ammonia emissions was 108.37 kt, and the uncertainty range in the 95% confidence interval was -5.40%-5.60%.

Spatio-temporal variation on syphilis from 2005 to 2018 in Zhejiang Province, China.

Background: Syphilis has spread throughout China, especially in Zhejiang Province which endangers the health and lives of people. However, the spatial and temporal epidemiological studies of syphilis in Zhejiang are not thorough enough. The temporal and spatial variation and the relevant factors of syphilis incidence should be analyzed for more effective prevention and control in Zhejiang, China. Methods: Data on confirmed cases of syphilis in Zhejiang Province from 2005 to 2018 was used and the spatio-temporal distributions were described. The spatial autocorrelation analysis and SaTScan analysis were performed to identify spatio-temporal clusters. A Bayesian spatial Conditional Autoregression (CAR) model was constructed to explore the relationships between syphilis incidence and common social and natural indicators. Results: 474,980 confirmed cases of syphilis were reported between 2005 and 2018 with a large peak in 2010. Farmers and unemployed people accounted for the largest proportion of confirmed cases. And the significant spatial clusters of syphilis were concentrated in the north of Zhejiang Province, especially in more economically developed regions. Seven spatio-temporal clusters were identified and the main three high-risk areas were located in Hangzhou (RR = 1.62, P < 0.05), Zhoushan and Ningbo (RR = 1.99, P < 0.05), and Lishui (RR = 1.68, P < 0.05). The findings showed that the morbidity of syphilis was positively correlated with the Gross Domestic Product (GDP) per capita, the number of health technicians per 10,000 people, the proportion of the elderly and air temperature were negatively correlated with the proportion of the urban population, the proportion of men and precipitation. Conclusions: The spatio-temporal analysis revealed that the prevalence of syphilis was still serious in Zhejiang Province. Syphilis high-risk areas were mainly located in the more developed coastal regions where more targeted intervention measures were required to be implemented. The study highlighted the need to strengthen Sexually Transmitted Diseases (STD) screening and health education for high-risk groups and improve the coverage of syphilis testing to reduce hidden syphilis cases.