No nationwide studies have examined the associations between mortality risk and PM 1 (PM with an aerodynamic diameter of <1 μm) due to the scarcity of monitoring data of PM 1 . On the basis of newly released national scale PM 1 data, we performed a time series analysis to elucidate the cause-specific mortality risk caused by PM 1 exposure in China. During the period from January 2014 to December 2017, the PM 1 levels in 65 cities of China were on average 37 ± 32 μg/m 3 . Pooled results indicated a 10 μg/m 3 increase in the PM 1 level was associated with a 0.19% [95% confidence interval (CI) of 0.09−0.28%] increased risk in nonaccidental mortality, which was almost the same as that for PM 2.5 (0.18%, 95% CI of 0.08−0.27%) and PM 10 (0.17%, 95% CI of 0.01−0.24%). By comparison, the magnitude increased to 0.29% (0.12−0.47%) in cardiovascular disease for each 10 μg/m 3 uptick in PM 1 , which was significantly higher than that related to PM 2.5 and PM 10 exposure. This nationwide study supported the notion that PM 1 may be a higher risk factor for cardiovascular disease, which suggests rapid action is warranted to put more effort into mitigating the emissions of finer particulate matters.

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OBJECTIVE Previous reports of the annual incidence of type 1 diabetes (T1D) in China were conducted using retrospective hospital cases, which may not reflect the reality. This longitudinal study estimated T1D incidence in a Chinese population of 21.7 million from 2007 to 2017. RESEARCH DESIGN AND METHODS A population-based registry of T1D was performed by the Beijing Municipal Health Commission Information Center. Annual incidence and 95% CIs were calculated by age group and sex. The association of sex with T1D incidence and predicted new cases of T1D were assessed using Poisson regression models. Annual percentage change and average annual percentage of change were assessed using Joinpoint regression. RESULTS Overall, there were 6,875 individuals who developed T1D from 2007 to 2017 in this population. T1D incidence (/100,000 persons) (95% CI) significantly increased from 2.72 (2.51, 2.93) in 2007 to 3.60 (3.38, 3.78) in 2017 (P &lt; 0.001). The T1D onset peak was in the 10–14-year-old age group. While no significant trend was found in the 0–14- and 15–29-year-old age groups, T1D incidence markedly increased from 1.87 to 3.52 in the ≥30-year-old age group (P &lt; 0.05). The prevalence of diabetic ketoacidosis at diagnosis was highest in the 0–4-year-old age group. We predicted new cases of T1D will increase 1.57-fold over the next decade. CONCLUSIONS T1D incidence in this large Chinese population is higher than has been reported previously. From 2007 to 2017, although the incidence peak was in the 10–14-year age group, the T1D incidence increased sharply in adults but not in youth.

Background The relationship between temperature and mental disorders is still unclear. This study aims to assess the short-term effect of apparent temperature (AT) on daily emergency visits of mental and behavioral disorders (MDs) in Beijing, China. Methods Daily counts of emergency visits related to MDs in Beijing from 2016 to 2018 were obtained. A quasi-Poisson generalized additive model combined with a distributed lag non-linear model (DLNM) was applied to analyze the lag-exposure-response relationship between AT and emergency admissions related to MDs. Sunshine duration, precipitation, PM 2.5 , SO 2 , O 3 , time trend, day of week and holiday were adjusted in the model. Results Total daily emergency visits for MDs during the study period were 16,606. With the reference of −2.4 °C (temperature with the minimum emergency visit risk), the single day effects of low AT (−8.6 °C, 10th percentile) and high AT (9.2 °C, 90th percentile) on MDs emergency visits reached a relative risk peak of 1.043 (95%CI: 1.017–1.069) on lag day 4 and 1.105 (95%CI: 1.006–1.215) on lag day 1, respectively. The greatest cumulative effect of high AT emerged on lag 0–5 days and reached a relative risk of 1.435 (95%CI: 1.048–1.965), while no significant cumulative effect of low AT was observed. There was a significant effect of high AT on emergency visits of MDs due to psychoactive substance use and male patients. Conclusions Both low and high AT are demonstrated to be the significant risk factors of MDs, which highlights the need of strengthening the health interventions, patient medical services and early warning for patients.

Background: Psychiatric readmissions negatively impact patients and their families while increasing healthcare costs. This study aimed at investigating factors associated with psychiatric readmissions within 30 days and 1 year of the index admissions and exploring the possibilities of monitoring and improving psychiatric care quality in China. Methods: Data on index admission, subsequent admission(s), clinical and hospital-related factors were extracted in the inpatient medical record database covering 10 secondary and tertiary psychiatric hospitals in Beijing, China. Logistic regressions were used to examine the associations between 30-day and 1-year readmissions plus frequent readmissions (≥3 times/year), and clinical variables as well as hospital characteristics. Results: The 30-day and 1-year psychiatric readmission rates were 16.69% (1289/7724) and 33.79% (2492/7374) respectively. 746/2492 patients (29.34%) were readmitted 3 times or more within a year (frequent readmissions). Factors significantly associated with the risk of both 30-day and 1-year readmission were residing in an urban area, having medical comorbidities, previous psychiatric admission(s), length of stay > 60 days in the index admission and being treated in tertiary hospitals (p < 0.001). Male patients were more likely to have frequent readmissions (OR 1.30, 95%CI 1.04-1.64). Receiving electroconvulsive therapy (ECT) was significantly associated with a lower risk of 30-day readmission (OR 0.72, 95%CI 0.56-0.91) and frequent readmissions (OR 0.60, 95%CI 0.40-0.91). Conclusion: More than 30% of the psychiatric inpatients were readmitted within 1 year. Urban residents, those with medical comorbidities and previous psychiatric admission(s) or a longer length of stay were more likely to be readmitted, and men are more likely to be frequently readmitted. ECT treatment may reduce the likelihood of 30day readmission and frequent admissions. Targeted interventions should be designed and piloted to effectively monitor and reduce psychiatric readmissions.