This study seeks to examine and analyze the spatial and temporal patterns of 2019 novel coronavirus disease (COVID‐19) outbreaks and identify the spatiotemporal distribution characteristics and changing trends of cases. Hence, local outlier analysis and emerging spatiotemporal hot spot analysis were performed to analyze the spatiotemporal clustering pattern and cold/hot spot trends of COVID‐19 cases based on space‐time cube during the period from 23 January 2020 to 24 February 2020. The main findings are as follows: (1) The outbreak had spread rapidly throughout the country within a short time and the current totality incidence rate has decreased. (2) The spatiotemporal distribution of cases was uneven. In terms of the spatiotemporal clustering pattern, Wuhan and Shiyan city were the center as both cities had high‐high clustering pattern with a surrounding unstable multiple‐type pattern in partial areas of Henan, Anhui, Jiangxi, and Hunan provinces, and Chongqing city. Those regions are continuously in the hot spot on the spatiotemporal tendency. (3) The spatiotemporal analysis technology based on the space‐time cube can analyze comprehensively the spatiotemporal pattern of epidemiological data and produce a visual output of the consequences, which can reflect intuitively the distribution and trend of data in space‐time. Therefore, the Chinese government should strengthen the prevention and control efforts in a targeted manner to cope with a highly changeable situation.

Physicians have a key role to play in combating tobacco use and reducing the tobacco induced harm to health. However, there is a paucity of information about tobacco-use and cessation among physicians in developing countries. To assess the need for and nature of smoking cessation services among physicians in developing countries, a detailed literature review of studies published in English, between 1987 and 2010 was carried out. The electronic databases Medline and Pub Med were searched for published studies. The findings show that there are regional variations in the current smoking prevalence, quitting intentions, and cessation services among physicians. Smoking prevalence (median) was highest in Central/Eastern Europe (37%), followed by Africa (29%), Central and South America (25%) and Asia (17.5%). There were significant gender differences in smoking prevalence across studies, with higher prevalence among males than females. Smoking at work or in front of patients was commonly practiced by physicians in some countries. Asking about smoking status or advising patients to quit smoking was not common practice among the physicians, especially among smoker physicians. Organized smoking cessation programs for physicians did not exist in all of these regions. This review suggests that while smoking of physicians varies across different developing regions; prevalence rates tend to be higher than among physicians in developed countries. Quitting rates were low among the physicians, and the delivery of advice on quitting smoking was not common across the studies. To promote tobacco control and increase cessation in populations, there is a need to build physicians’ capacity so that they can engage in tobacco use prevention and cessation activities.

Heavy metals may play an important role as environmental risk factors in diabetes mellitus. This study aimed to explore the association of HbA1c with As, Cd, Cu, Ni, Pb, and Zn in single-metal exposure and multi-metal co-exposure models. A cross-sectional study involving 3472 participants was conducted. Plasma concentrations of heavy metals were determined by inductively coupled plasma mass spectrometry. We estimated the association of each metal with HbA1c by linear regression. Potential heterogeneities by sex, age, and smoking were investigated, and metal mixtures and interactions were assessed by the Bayesian kernel machine regression (BKMR). In linear regression, Cu (β = 0.324, p < 0.05) and Ni (β = -0.19, p < 0.05) showed significant association with HbA1c in all participants. In BKMR analyses, all exposure-response relationships were approximately linear. Cu was significantly and positively associated with HbA1c levels in overall participants, women, participants aged 60 years old and above, and nonsmokers. Ni was significantly and negatively associated with HbA1c levels in overall participants. We did not observe the overall effect of plasma metal mixtures on HbA1c or the interaction effect of the metals on HbA1c. Cu was positively correlated with HbA1c, whereas Ni was negatively correlated with HbA1c, when evaluated individually or in a metal mixture. Additional studies are necessary to confirm these correlations and to control for exposure to different metals in the general population.