Built Environment Exposure, Healthy Cities and Environmental Health

Large language models (LLMs) can generate advisory text on modifying built environments to support health. This study examined the ethical properties of a recent LLM generating text on built environments to support health. The prompts covered six health-related pathways in higher-income, lower-income, and mixed-income neighbourhoods. Overall, 180 answers were coded against four ethical criteria. Non-maleficence was satisfied in all answers. Lower-income contexts were rarely offered weaker proposals than higher-income contexts. Reference to collective participation and transparent oversight appeared in 70-90% of answers without a budget constraint, but only 30-50% under one. The LLM more consistently met minimum expectations for harm avoidance and distributive justice than for collective participation and transparent oversight. These findings suggest that current LLM outputs may reproduce some baseline ethical conventions in urban design discourse but are less reliable on procedural concerns. LLM-generated outputs should therefore be interpreted cautiously within existing built environment decision-making processes.

Background: The association between neighborhood commercial food environments and cognitive function in older adults remains unclear, particularly in high-density urban settings. This study aimed to investigate the relationship between the density of various types of retail food outlets and cognitive function in older adults within community settings. Methods: We analyzed data from the Beijing Community-based Cognitive Function Screening (CCFS) program, which included 61,842 older adults (mean age: 70.9 years; 60.5 % female) residing in 114 urban communities within the Fifth Ring Road of Beijing. Cognitive function was assessed using adapted versions of the Mini-Mental State Examination (Mini-MMSE; range: 0 – 13) and the Episodic Memory Test (EMT; range: 0 – 100). The primary exposure was total restaurant density, representing overall commercial food availability. Secondary exposures included the densities of fast-food restaurants, dessert/drink/pastry shops, and fruit and vegetable stores. Multilevel linear and logistic regression models were used to estimate associations, adjusting for sociodemo - graphic and environmental covariates. Results: The mean Mini-MMSE and EMT scores were 12.3 (SD 1.3) and 90.6 (SD 9.2), respectively. Each inter - quartile range (IQR) increase in total restaurant density was associated with lower Mini-MMSE ( β = 0.002, 95 % CI: 0.004 to 0.001) and EMT scores ( β = 0.004, 0.005 to 0.003). Fast-food restaurant density showed similar inverse associations; for Mini-MMSE, each IQR increase was associated with a 0.003-point decrease ( β = 0.003, 0.004 to 0.002), an effect comparable to the decline associated with one additional year of age. In contrast, higher density of fruit and vegetable stores was positively associated with Mini-MMSE scores ( β = 0.002, 0.001 to 0.003), and the ratio of fruit and vegetable stores to fast-food restaurants showed an even stronger association ( β = 0.003, 0.002 to 0.005). No significant associations were found between cognitive outcomes and the density of dessert, drink, or pastry shops. Conclusions: Our findings suggest that a more balanced neighborhood food environment, characterized by increased access to fruit and vegetable stores, particularly relative to fast-food outlets, may help attenuate the age-related decline in cognitive function among older adults.

Green spaces offer a passive yet impactful component of urban design, with the potential to enhance cognitive function and reduce the risk of dementia in older adults. While the cognitive benefits of green spaces are recognized, particularly in improving cognitive performance among older populations, this area remains a critical yet underexplored domain within urban health research. This study aimed to investigate the association of exposure to green spaces with cognitive function among older adults across urban Beijing. A total of 62,333 participants from 114 communities were included in a city-wide screening program, utilizing an adapted version of the Mini-Mental State Examination (MMSE) and the Episodic Memory Test (EMT) to assess cognitive function. Green space exposure was quantified at the community level through multiple metrics, including accessibility (distance to large green spaces and parks), availability (Normalized Difference Vegetation Index [NDVI] and proportion of green space), and visibility (green view ratio). Multilevel linear and logistic regression models, adjusted for demographic and environmental covariates, were applied to data from 324 community healthcare centers. The findings indicated that greater exposure to green spaces, across all measured metrics, was associated with better cognitive function scores. A significant threshold was identified at 500 m from parks, beyond which cognitive function scores declined progressively with increasing distance. These results have important impli - cations for urban planning, suggesting the need for accessible, community-level green spaces to support cognitive health for older adults in urban China.

Objectives: This study aimed to evaluate the effectiveness of educational health message and menu default options on a Meal Delivery App (MDA) in nudging consumers towards reduced-salt options in restaurants of China. Study design: We conducted a nudge-based intervention trial on an MDA named ELEME in China. Methods: Along with a control group, five intervention groups were formed utilizing different combinations of the three nudging treatments, including setting up a salt submenu for “ reduced salt ” default, a salt submenu for “ regular salt ” default, and a conventional educational health message on the ordering page. We recruited 903 restaurants from cities across different geographic regions and assigned them into either the control group or one of the five intervention groups. Results: After analyzing 870,942 meal orders, the results showed that the inclusion of a health message on the restaurants ’ ordering page was not effective to influence consumers to choose reduced-salt dishes (P > 0.1). A salt submenu that explicitly asked for consumers ’ preference for “ reduced salt ” or “ regular salt ” significantly increased consumers ’ likelihoods of choosing reduced-salt dishes in the unadjusted model (P < 0.1). Conclusions: Applying choice architecture changes as nudge-based interventions on MDAs were proven to be effective to promote consumers to order reduced salt dishes, and we consider these findings to have real-world implications for policymakers, researchers, and the private sectors.

Rapid urbanization and population aging have made equitable Emergency Medical Services (EMS) access for older adults a critical challenge in high-density cities. This study develops a deep learning framework to evaluate EMS accessibility, considering ambulance trafficability derived from street view images (SVIs). A Multi-Scale Vision Transformer (MSViT) model classifies SVIs into impassable, narrow, and passable categories to assess road conditions. Travel speeds are then assigned based on the classified trafficability and road hierarchy data. The framework measures the pre-hospital time through two-stage travel (emergency center-to-patient and patient-to-hospital), while evaluating accessibility through two complementary metrics: the inverse of the shortest total pre-hospital time, and a composite accessibility score with Gaussian time-decay weighting for all facilities within 15-minute service ranges. A case study in Beijing ’ s Old City demonstrated that considering ambulance trafficability reduces the estimated 15-minute coverage from 94.18 % to 83.14 %, revealing signif - icant overestimation when road conditions are neglected. Spatially, peripheral areas achieved better nearest- facility response times, whereas central regions dominated in comprehensive service coverage. Additionally, EMS accessibility patterns strongly correlated with older adults ’ distribution, showing limited income-based disparities. This study shifts the focus from supply-demand balancing to road system management in EMS accessibility, which can be integrated with existing methods to support more sustainable and targeted infra - structure optimization in aging cities.

数字平台已成为日常生活决策的关键场景，同时降低居民食盐摄入是重要的公共健康目标之一。本文以中国大型外卖平台“饿了么”为场景，从“需求—供给—干预”三个方面构建减盐助推研究框架，基于平台真实的订单数据、多家餐厅问卷以及菜品的钠含量检测，分析消费者在外卖中对减盐菜品的需求 ； 评估餐厅提供减盐菜品的意愿和实际行为 ； 并通过 A/B 测试实验验证数字界面设计对消费者选择减盐菜品的干预效果。研究发现，在主动留言的消费者中，40.6% 提出了减盐菜品需求 ； 超过 90% 的餐厅愿意响应减盐需求，并确实提供了减盐菜品 ； 在外卖平台数字界面为菜品增加“标准 / 少盐”子菜单，并将“少盐”设为默认选项，可以促进消费者对少盐菜品的选择。研究结果拓展了对改善人群饮食选择的干预措施的理解，证明了在真实商业平台中以最小界面变更撬动行为改变的可行性。本文将营养学检测、大数据分析和行为经济学的对照实验等跨学科方法结合，为健康饮食环境的构建提供了实证支撑与方法借鉴，也为基于数字界面的实验范式在更多设计场景中的应用奠定基础。

The average salt intake of Chinese residents far exceeds the recommended standard. As food delivery becomes increasingly popular among the Chinese public, salt reduction for takeaways is important to reduce salt intake of Chinese residents. However, studies related to salt reduction of takeaways are still very few; especially, no study has explored consumers’ attitudes towards salt level in takeaway meals. The purpose of the study was to objectively measure consumers’ request for reduced-salt options when ordering meals online, from real takeaway orders. Consumer messages from 718 restaurants on a meal delivery app called ELEME in China were collected between July and December 2020. Reduced-salt messages from all consumer messages placed by consumers when ordering meals were extracted to determine the extent of customized salt reduction requests and to analyze the content of those requests. Feature words from messages identified through AI machine learning (Term Frequency and Term Frequency-Inverse Document Frequency method) were extracted and analyzed. Out of 25,982 consumer messages, 10,549 (40.6%) were reduced-salt messages. Consumers, in general, had the demand to customize dishes with less salt – “less salt” was the most frequently mentioned word for taste preference. Populations with special health and nutritional needs may have a higher demand for reduced-salt meals according to these messages. The study showed definite patterns of demand in a sizable minority of orders and identified the feature words and concepts that could feed into future efforts to create an effective choice architecture in online meal delivery platforms.

This output forms part of the Beijing City Lab research direction on Built Environment Exposure, Healthy Cities and Environmental Health. Download the publication below.

Clinical Research Nonoptimum Temperatures Are More Closely Associated With Fatal Myocardial Infarction Than With Nonfatal EventsQ1 Q6 Piaopiao Hu, MD, a,b,c,d Jie Chang, MD, a,b,c,d Yulin Huang, MD, a,b,c,d Moning Guo, MD, e,f Feng Lu, PhD,e,f Ying Long, PhD,g Huan Liu, PhD,h Xudong Yang, PhD,i Yue Qi, MD, PhD, a,b,c,d Jiayi Sun, MD, a,b,c,d Zhao Yang, PhD, a,b,c,d Qiuju Deng, MD, PhD, a,b,c,d and Jing Liu, MD, PhD a,b,c,d a Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing, China b Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China National Clinical Research Center of Cardiovascular Diseases, Beijing , China c Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China d Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China e Beijing Municipal Health Big Data and Policy Research Center, Beijing, China f Beijing Institute of Hospital Management, Beijing, ChinaQ 2 g XXX h State Key Joint Laboratory of ESPC, State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, School of Environ ment, Tsinghua University, Beijing, China i Departments of Building Science and Vanke School of Public Health, Tsinghua University, Beijing, China See editorial by Gagnon and Iglesies-Grau, pages XXX-XX of this issue.

Background The availability of physical activity (PA) facilities in neighborhoods is hypothesized to influence cardio- vascular disease (CVD), but evidence from individual-level long-term cohort studies is limited. We aimed to assess the association between neighborhood exposure to PA facilities and CVD incidence. Methods A total of 4658 participants from the Chinese Multi-provincial Cohort Study without CVD at baseline (2007–2008) were followed for the incidence of CVD, coronary heart disease (CHD), and stroke. Availability of PA facilities was defined as both the presence and the density of PA facilities within a 500-m buffer zone around the par- ticipants’ residential addresses. Time-dependent Cox regression models were performed to estimate the associations between the availability of PA facilities and risks of incident CVD, CHD, and stroke. Results During a median follow-up of 12.1 years, there were 518 CVD events, 188 CHD events, and 355 stroke events. Analyses with the presence indicator revealed significantly lower risks of CVD (hazard ratio [HR] 0.80, 95% confidence interval ([CI] 0.65–0.99) and stroke (HR 0.76, 95% CI 0.60–0.97) in participants with PA facilities in the 500-m buffer zone compared with participants with no nearby facilities in fully adjusted models. In analyses with the density indicator, exposure to 2 and ≥ 3 PA facilities was associated with 35% (HR 0.65, 95% CI 0.47–0.91) and 28% (HR 0.72, 95% CI 0.56– 0.92) lower risks of CVD and 40% (HR 0.60, 95% CI 0.40–0.90) and 38% (HR 0.62, 95% CI 0.46–0.84) lower risks of stroke compared with those without any PA facilities in 500-m buffer, respectively. Effect modifications between presence of PA facilities and a history of hypertension for incident stroke (P = 0.049), and a history of diabetes for incident CVD (P = 0.013) and stroke (P = 0.009) were noted. Conclusions Residing in neighborhoods with better availability of PA facilities was associated with a lower risk of inci- dent CVD. Urban planning intervention policies that increase the availability of PA facilities could contribute to CVD prevention.

China’s public health initiatives for climate change adaptation John S. Ji,a,∗ Yanjie Xia,a Linxin Liu,a Weiju Zhou,a Renjie Chen,b Guanghui Dong,c Qinghua Hu,d Jingkun Jiang,e Haidong Kan,b Tiantian Li,f Yi Li,g Qiyong Liu,h Yanxiang Liu,g Ying Long,i Yuebin Lv,f Jian Ma,a Yue Ma,i Kinay Pelin,j Xiaoming Shi,f,k Shilu Tong,f,l Yang Xie,m Lei Xu,a Changzheng Yuan,n Huatang Zeng,o Bin Zhao,p Guangjie Zheng,e Wannian Liang,a Margaret Chan,a and Cunrui Huanga aVanke School of Public Health, Tsinghua University, Beijing, China bSchool of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National School of Public Health, Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China cDepartment of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China dShenzhen Center for Disease Control and Prevention, Shenzhen, China eState Key Joint Laboratory of Environment Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, China fNational Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China gPublic Meteorological Service Centre, China Meteorological Administration, Beijing, China hNational Institute of Infectious Diseases at China, Chinese Center for Disease Control and Prevention, Beijing, China iSchool of Architecture, Tsinghua University, Beijing, China jSchool of Climate Change and Adaptation, Univ...

Few previous studies have investigated the impacts of coexposure to multiple urban environmental factors on the prognosis of acute myocardial infarction (AMI) events. This study aimed to evaluate the associations between the urban exposome and AMI recurrence. We used data from 88,509 AMI patients from a large cohort obtained from the Beijing Cardiovascular Disease Surveillance System between 2013 and 2019. Twenty-six types of urban exposures were assessed within 300-m, 500-m, and 1000-m buffers of patients ’ home addresses in the baseline and cumulative average levels. We used the Cox proportional hazard model along with the Elastic Net (ENET) algorithm to estimate the hazard ratios (HRs) of recurrent AMI per interquartile range increase in each selected urban exposure. The increased risk of AMI recurrence was significantly associated with lower urban function diversity in the 500-m buffer, longer distance to subway stations and higher PM 2.5 for both baseline and cu - mulative average exposure. The cumulative averages of two urban factors, including the distance to parks, and the density of fruit and vegetable shops in the 1000-m buffer, were also identified as significant factors affecting the risk of AMI recurrence. These findings can help improve the urban design for promoting human cardio - vascular health.

Background: To examine the association between urban neighborhood disorder and the recurrence risk of patients with acute myocardial infarction (AMI) in central Beijing, China. Methods: Recurrent AMI was identified by the Beijing Monitoring System for Cardiovascular Diseases through the end of 2019 for patients discharged with AMI between 2007 and 2017. Cox proportional hazards models were performed to estimate associations between neighborhood disorder and AMI recurrence. Results: Of 66,238 AMI patients, 11,872 had a recurrent event, and 3117 died from AMI during a median follow- up of 5.92 years. After covariate adjustment, AMI patients living in the high tertile of neighborhood disorder had a higher recurrence risk (hazard ratio [HR] 1.08, 95 % confidence interval [CI], 1.03 – 1.14) compared with those in the low tertile. A stronger association was noted for fatal recurrent AMI (HR 1.21, 95 % CI 1.10 – 1.34). The association was mainly observed in females (HR 1.04, 95 % CI: 1.02 to 1.06). Conclusions: Serious neighborhood disorder may contribute to higher recurrence risk, particularly fatal recur - rence, among AMI patients. Policies to eliminate neighborhood disorders may play an important role in the secondary prevention of cardiovascular disease.

Online search queries have been used in various behaviour studies. As smoking has become a global health issue, studies that assess smoking-related behaviours using online search queries have faced limitations in data utilization and study design. This study conducts comparative analyses to investigate changes in smoking-related behaviours represented by online search volumes. Baidu search queries from 2013 to 2017 were used to examine the search volume containing four groups of smoking-related search keywords. A validation process was used to validate the proposed method by comparing changes in search queries with the observed tobacco consumption. The results show changes in smoking- related behaviours assessed by online search queries at the city level in China. The validation experiments illustrate the consistency between changes in search volumes and tobacco consumption. Thus, online search queries were verified to be an effective instrument for assessing smoking-related behaviours, and this study sheds light on broader behaviour studies and policy assessments.

建成环境暴露与急性心肌梗死复发的关联识别及规划应对 (申请清华大学工学硕士学位论文) 培养单位 ： 建筑学院学科 ： 城乡规划学研究生 ： 刘宁睿指导教师 : 龙瀛副教授二○二三年五月建成环境暴露与急性心肌梗死复发的关联识别及规划应对刘宁睿 Associations Between Urban Exposome and Recurrence of Acute Myocardial Infarction and Planning Responses Thesis submitted to Tsinghua University in partial fulfillment of the requirement for the degree of Master of Science in Urban and Rural Planning by Liu Ningrui Thesis Supervisor: Long Yin g, Associate Professor May, 2023 学位论文公开评阅人和答辩委员会名单公开评阅人名单党安荣教授清华大学刘佳燕副教授清华大学答辩委员会名单主席武廷海清华大学委员王崇烈北京市城市规划设计研究院王英清华大学刘佳燕清华大学龙瀛清华大学梁思思清华大学孙诗萌清华大学郑筱津北京清华同衡规划设计研究院秘书耿丹教授教授级高级工程师副教授副教授副教授副教授助理研究员教授级高级工程师清华大学关于学位论文使用授权的说明本人完全了解清华大学有关保留、使用学位论文的规定，即： 清华大学拥有在著作权法规定范围内学位论文的使用权，其中包括：（1）已获学位的研究生必须按学校规定提交学位论文，学校可以采用影印、缩印或其他复制手段保存研究生上交的学位论文；（2）为教学和科研目的，学校可以将公开的学位论文作为资料在图书馆、资料室等场所供校内师生阅读，或在校园网上供校内师生浏览部分内容； （3）按照上级教育主管部门督导、抽查等要求，报送相应的学位论文。 本人保证遵守上述规定。 作者签名： 导师签名： 日期： 日期：

ICS 91.020 CCS P50 团体标准 T/UPSC 0010-2023 社区生活圈防疫应急规划指南 Emergency planning guide for epidemic prevention in community life circle 2023-01-04 发布 2023-01-04 实施中国城市规划学会发布 T/UPSC 0010-2023 IV 前言本文件按照 GB/1.1-2020《标准化工作导则第 1 部分：标准化文件的结构和起草规则》的规定起草。 本文件由中国城市规划学会城市规划新技术应用学术委员会提出。 本文件由中国城市规划学会标准化工作委员会归口。 本文件由黑龙江省城市规划勘测设计研究院负责具体技术内容的解释。 本文件主编单位：黑龙江省城市规划勘测设计研究院（地址：哈尔滨市香坊区和平路 83 号；邮政编码：150040） 本文件参编单位：武汉大学、河南省城乡建筑设计院、福建工程学院、清华大学、哈尔滨工业大学、武汉市规划研究院、 同济大学、重庆大学本文件主要起草人：刘东亮、王艳秋、魏文琪、张蕾、张宝武、陆彤、张远景、高春义、孙英博、李艳杰、邵凯、穆伟东、原帅、张宇、刘春阳、孙云飞、张霞、刘润乾、孙敏、龙瀛、黄焕、赫磊、董慰、黄瓴、林建伟、高晓昱、夏巍、戴锏、 邹志翀、王月本文件主要审查人（按姓氏笔画排序）：王承慧、刘奇志、 刘佳燕 T/UPSC 0010-2023 1 社区生活圈防疫应急规划指南 1 范围本文件规定了社区生活圈防疫应急规划工作的基础调研、 风险评估、设施配置、防疫隔离、应急救治、资源供应、应急保障、城市支撑，以及实施和成果要求等技术指引内容。 本文件适用于全国城市（含县城）社区生活圈传染病疫情防控应急规划的编制，乡镇社区生活圈防疫应急规划的编制可参照执行。 2 规范性引用文件下列文件中的内容通过文中的规范性引用而构成本文件必不可少的条款。其中，注日期的引用文件，仅该日期对应的版本适用于本文件；不注日期的引用文件，其最新版本（包括所有的修改单）适用于本文件。 GB 50180-2018 城市居住区规划设计标准 GB/T5 1327 城市综合防灾规划标准 T/UPSC 0001 应急传染病医院的选址、设计、建设和运行管理导则 3 术语和定义 3.1 社区 community T/UPSC 0010-2023 2 聚居在一定地域范围内的人们所组成的社会生活共同体， 是社会治理的基本单元。 3.2 社区生活圈 community life circle 在适宜的日常步行范围内，满足居民全生命周期工作与生活等各类需求的基本单元，融合“宜业、宜居、宜游、宜养、 宜学”多元功能，引领面向未来、健康低碳的美好生活方式。 3.3 15 分钟社区生活圈 15-minute community life circle 以居民步行 15 分钟可达范围内有完善的教育、商业、交通、 文体、养老等公共设施的基本单元；一般由城市干路或用地边界线所围合，以 800~1000 m 为服务半径，居住人口规模为 50000 ~100000 人，配套设施完善的社区生活圈。 3.4 10 分钟社区生活圈 10-minute community life circle 以居民步行 10 分钟可满足其基本物质与生活文化需求为原则划分的基本单元；一般由城市干路、支路或用地边界线所围合，以 500 m 为服务半径，居住人口规模为 15000 ~25000 人， 配套设施齐全的生活圈。

急性心肌梗死是心血管病中的危重类型， 送医不及时死亡风险将大大提高。 科学测度就医可达性能准确评价医疗设施的空间布局， 助力疾病救治和健康城市建设。 以急性心肌梗死患者就医为例， 首先基于网络应用接口和人口大数据精准测度了一天中不同时段下的北京市居住小区就医可达性， 然后基于社会经济地位和地理探测器分析了就医公平性。 研究发现空间上北京市西南部和北部边缘就医可达性较差； 时间上早高峰的就医可达性最差； 昌平区、 通州区可达性受交通拥堵影响严重。 研究还发现受教育年限越短 ，收入越低以及蓝领工作占比越高的人群就医时间更长， 存在一定的就医不公平现象。 研究利用新技术新数据从疾病防控角度为医疗资源的合理布局提供了参考。

In history, the development o f technologies constantly reshaped and promote d the evolution of human urban civilization. A t present, the Fourth Industrial Revolution is also changing and sha ping the future of cities with a series of disruptive technologies. A growing number of studies are focusing on the evolving trends and construction methods of future cities, but those different stud ies are isolated from each other, and there is still a lack of sufficien t communication and discussion from all walks o f life to form a consensus. To this end, this pape r invited seven experts fro m academia and industr y to discuss and ex amine six core issues from the perspective of historical evolution, production and life, urban-rural relations, social sustainable development, engineering practice and urban operation. Experts have offered insights based o n their own research and practical experience, and generally agree on the profound im pact of technologies on the current urban space and industrial lifestyle. It has also become the 作者简介龙瀛（通讯作者），清华大学建筑学院，清华大学恒隆房地产研究中心，清华大学生态规划与绿色建筑教育部重点实验室； 李伟健、张恩嘉、王鹏，清华大学建筑学院。 摘要回顾历史，技术的发展不断重塑并推动着人类城市文明的演进，当下第四次工业革命同样以一系列颠覆性技术改变并影响着城市的未来。越来越多的研究开始关注未来城市的演化趋势及建设方法，但不同研究间大多彼此孤立，社会各界仍缺乏充分的交流探讨以达成共识。为此， 文章邀请了七位来自学界、业界不同方向的领域专家，围绕历史演进、生产生活、城乡关系、社会可持续发展、工程实践以及城市运营视角下的六个核心议题依次进行讨论与展望。专家基于各自的研究与实践经验提出见解，并普遍认同技术给当下城市空间及生产生活方式带来深刻影响。面向未来，充分理解城市本体的变化，以问题为导向、 以人为本，明晰适合我国的价值取向与城市发展路径成为专家们的共识。 关键词第四次工业革命；数字化；未来城市；智慧技术； 专家访谈技术发展对城市演进的影响可以追溯至城市文明诞生之初，其后技术在不同层面、不同维度对城市生产生活以及人类社会文化发展产生深远影响。当下，全面数字化发展改变城市的资源连接与供给，元宇宙的出现重塑人与空间的关系，碳中和发展愿景推动能源体系升级，物联网、 无人驾驶及机器人的发展促进工业数字化转型与智能运输。面对城市这一日益复杂的巨系统，技术对其影响路径也愈加错综复杂。然而，相关的城市研究仍大多聚焦单一未来城市的冷热思考——张宇星、刘泓志、沈振江、吕斌、周榕、尹稚、武廷海访谈纪实 | 235 consensus of the expert s that we should full y understand the changes of the urban ontology, take a problem-oriented and people-oriente d approach, and clarify the values and urba n development paths suitable for China.

Objectives T o assess overall and gender- specific associa tions between marital status and out- of- hospital coronar y death (OHCD) compared with patients surviving to hospital admission. Design A cross- sectional stud y based on linkage of administrative health databases. Setting Beijing, China. Participants F rom 2007 to 2019, 378 883 patients with acute coronary event were identified in the Beijing Monitoring System for Cardiovascular Diseases, a validated city- wide registra tion system based on individual linkage of vital registration and hospital discharge data. Outcome measures OHCD was defined as coronar y death occurring before admission. Multilevel modified Poisson regression models were used to calculate the prevalence ratios (PR) and 95% CIs. Results Among 378 883 acute coronar y events, OHCD accounted for 33.8%, with a higher proportion in women compared with men (41.5% vs 28.7%, p<0.001). Not being married was associated with a higher proportion of OHCD in both genders, with a stronger association in women (PR 2.18, 95% CI 2.10 to 2.26) than in men (PR 1.97, 95% CI 1.91 to 2.02; p for interaction <0.001). The associations of OHCD with never being married (PR 1.98, 95% CI 1.88 to 2.08) and being divorced (PR 2.54, 95% CI 2.42 to 2.67) were stronger in men than in women (never married: PR 0.98, 95% CI 0.82 to 1.16; divorced: PR 1.47, 95% CI 1.34 to 1.61) (p for interaction <0.001 for both). Being widowed was associated with a higher proportion of OHCD in both genders, with a stronger association in women (PR 2.26, 95% CI 2.17 to 2.35) compared with men (PR 1.89, 95% CI 1.84 to 1.95) (p for interaction <0.001). Conclusions Not being married was independently associa ted with a higher proportion of OHCD and the associations differed by gender. Our study may aid the development of gender- specific public health inter ventions in high- risk popula tions characterised by marital status to reduce OHCD burden.

Several methods have been applied to measure healthcare accessibility, ie, the Euclidean distance, the network distance, and the transport time based on speed limits. However, these methods generally produce less accurate estimates than actual measurements. This research proposed a method to estimate historical healthcare accessibility more accurately by using taxi Global Positioning System (GPS) traces. The proposed method’s advantages were evaluated vis a case study using acute myocardial infarction (AMI) cases in Beijing in 2008. Comparative analyses of the new measure and three conventionally used measures suggested that the median estimated transport time to the closest hospital with percutaneous coronary intervention (PCI) capability for AMI patients was 5.72 minutes by the taxi GPS trace-based measure, 2.42 minutes by the network distance-based measure, 2.28 minutes by the speed limit-based measure, 1.73 minutes by the Euclidean distance-based measure; and the estimated proportion of patients who lived within 5 minutes of a PCI-capable hospital was 38.17%, 89.20%, 92.52%, 95.05%, respectively. The three conventionally used measures underestimated the travel time cost and overestimated the percentage of patients with timely access to healthcare facilities. In addition, the new measure more accurately identifies the areas with low or high access to healthcare facilities. The taxi GPS trace-based accessibility measure provides a promising start for more accurately estimating accessibility to healthcare facilities, increasing the use of medical records in studying the effects of historical healthcare accessibility on health outcomes, and evaluating how accessibility to healthcare changes over time.

Acute myocardial infarction (AMI) poses a serious disease burden in China, but studies on small-area characteristics of AMI incidence are lacking. We therefore examined temporal trends and geographic variations in AMI incidence at the township level in Beijing. In this cross-sectional analysis, 259,830 AMI events during 2007–2018 from the Beijing Cardiovascular Disease Surveillance System were included. We estimated AMI incidence for 307 consistent townships during consecutive 3-year periods with a Bayesian spatial model. From 2007 to 2018, the median AMI incidence in townships increased from 216.3 to 231.6 per 100,000, with a greater relative increase in young and middle-aged males (35–49 years: 54.2%; 50–64 years: 33.2%). The most pronounced increases in the relative inequalities was observed among young residents (2.1 to 2.8 for males and 2.8 to 3.4 for females). Townships with high rates and larger relative increases were primarily located in Beijing’s northeastern and southwestern peri-urban areas. However, large increases among young and middle- aged males were observed throughout peri-urban areas. AMI incidence and their changes over time varied substantially at the township level in Beijing, especially among young adults. Targeted mitigation strategies are required for high-risk populations and areas to reduce health disparities across Beijing.

Background: Chinese people on average consume almost twice as much salt as recommended by the World Health Organization. In recent years, dining out and ordering food online are increasingly popular, especially for urban residents. The aim of this study is to evaluate the effectiveness of different settings on a digital food delivery App in nudging consumers towards reduced salt options through a randomized controlled trial in China. Methods and Analysis: This is a randomized controlled trial with matched restaurants randomized to five parallel intervention groups plus a control group. Participating restaurants are recruited via open invitation and targeted invitation on a voluntary basis and are free t o withdraw from the study at anytime. Each enrolled restaurant can select 1 -3 of their most popular dishes to participate in this study. The recruitment ends at the end of June 2021. As o f June 30, 285 restaurants enrolled for intervention groups and successfully completed interface set-up requirements. The primary outcome of this study is to investigate the differences in customer ordering behaviors regarding salt preference that result from changing the default settings and/or in combination with health me ssages before placing the order. The primary outcome will be measured by the difference between the number of regular salt orders and the number of reduced salt orders amongst the five intervention groups, and between each intervention group and the control group. We will collect order data at the end of the 2-month study period from the food delivery App. The secondary outcome is to measure if reduced the salt version of the participating dishes has less salt content than the regular version. The secondary outcome will be measured by lab testing salt content of randomly sampled dishes during the study period. In addition, we will also conduct pre - and post - intervention surveys with participating restaurants to assess their knowledge, attitude, and pra ctice regarding salt reduction, and their perceptions on how such intervention affects their business, if at all. We will not include findings from the pre- and post-intervention interviews as an outcome but will use them to inform future restaurant- based salt reduction promotions. Discussion: The study will test whether changing in the choice architecture on the digital food ordering platform will promote healthier ordering behavior among consumers.

个体建成环境暴露对健康的影响是健康城市研究领域的关键问题。 对于建成环境暴露的测度方法 ，近年相关研究多用 GIS数据测度建成环境特征， 基于5D理论指标来衡量建成环境暴露情况 ，以居住地附近作为个体全天建成环境暴露的测度范围。 现有方法存在两方面的问题： 一是在暴露的测度指标和测度数据方面， 较少关注影像数据评估所能反映的人本尺度建成环境特征； 二是暴露的测度空间方面 ，由于较少考虑人的移动性而存在显著的暴露估计误差 。而基于影像数据的建成环境暴露研究还没有考虑人的移动性 。随着科学技术的发展 ，建成环境暴露测度可用的工具方法越来越丰富， 呼吁今后的建成环境暴露研究中，在测度数据建成环境暴露测度的方法转变* — —从基于固定居住地和GIS数据到基于个体移动性和影像数据李文越龙瀛 Li Wenyue, Long Ying Revolution in Approaches of Assessing Exposure to Built Environment: From Static Residence Based Approach and GIS Data to Individual Mobility Based Approach and Image Data

Fine-particulate pollution is a major public health concern in China. Accurate assessment of the population exposed to PM 2.5 requires high-resolution pollution and population information. This paper assesses China’s potential population exposure to PM 2.5, maps its spatiotemporal variability, and simulates the effects of the recent air pollution control policy. We relate satellite-based Aerosol Optical Depth (AOD) retrievals to ground-based PM 2.5 observations. We employ block cokriging (BCK) to improve the spatial interpolation of PM2.5 distribution. We use the subdistrict level population data to estimate and map the potential population exposure to PM2.5 pollution in China at the subdistrict level, the smallest administrative unit with public demographic information. During 8 April 2013 and 7 April 2014, China’s population-weighted annual average PM 2.5 concentration was nearly 7 times the annual average level suggested by the World Health Organization (WHO). About 1322 million people, or 98.6% of the total population, were exposed to PM2.5 at levels above WHO’s daily guideline for longer than half a year. If China can achieve its Action Plan on Prevention and Control of Air Pollution targets by 2017, the population exposed to PM2.5 above China’s daily standard for longer than half a year will be reduced by 85%.