Global climate forcing of aerosols embodied in international trade

International trade separates regions consuming goods and services from regions where goods and related aerosol pollution are produced. Yet the role of trade in aerosol climate forcing attributed to different regions has never been quantified. Here, we contrast the direct radiative forcing of aerosols related to regions’ consumption of goods and services against the forcing due to emissions produced in each region. Aerosols assessed include black carbon, primary organic aerosol, and secondary inorganic aerosols, including sulfate, nitrate and ammonium. We find that global aerosol radiative forcing due to emissions produced in East Asia is much stronger than the forcing related to goods and services ultimately consumed in that region because of its large net export of emissions-intensive goods. The opposite is true for net importers such as Western Europe and North America: global radiative forcing related to consumption is much greater than the forcing due to emissions produced in these regions. Overall, trade is associated with a shift of radiative forcing from net importing to net exporting regions. Compared to greenhouse gases such as carbon dioxide, the short atmospheric lifetimes of aerosols cause large localized differences between consumption- and production-related radiative forcing. International efforts to reduce emissions in the exporting countries will help alleviate trade-related climate and health impacts of aerosols while lowering global emissions

Transboundary health impacts of transported global air pollution and international trade

Millions of people die every year from diseases caused by exposure to outdoor air pollution1, 2, 3, 4, 5. Some studies have estimated premature mortality related to local sources of air pollution6, 7, but local air quality can also be affected by atmospheric transport of pollution from distant sources8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18. International trade is contributing to the globalization of emission and pollution as a result of the production of goods (and their associated emissions) in one region for consumption in another region14, 19, 20, 21, 22. The effects of international trade on air pollutant emissions23, air quality14 and health24 have been investigated regionally, but a combined, global assessment of the health impacts related to international trade and the transport of atmospheric air pollution is lacking. Here we combine four global models to estimate premature mortality caused by fine particulate matter (PM2.5) pollution as a result of atmospheric transport and the production and consumption of goods and services in different world regions. We find that, of the 3.45 million premature deaths related to PM2.5 pollution in 2007 worldwide, about 12 per cent (411,100 deaths) were related to air pollutants emitted in a region of the world other than that in which the death occurred, and about 22 per cent (762,400 deaths) were associated with goods and services produced in one region for consumption in another. For example, PM2.5 pollution produced in China in 2007 is linked to more than 64,800 premature deaths in regions other than China, including more than 3,100 premature deaths in western Europe and the USA; on the other hand, consumption in western Europe and the USA is linked to more than 108,600 premature deaths in China. Our results reveal that the transboundary health impacts of PM2.5 pollution associated with international trade are greater than those associated with long-distance atmospheric pollutant transport

To what extent can China’s near-term air pollution control policy protect air quality and human health? A case study of the Pearl River Delta region

Following a series of extreme air pollution events, the Chinese government released the Air Pollution Prevention and Control Action Plan in 2013 (China's State Council 2013). The Action Plan sets clear goals for key regions (i.e. cities above the prefecture level, Beijing-Tianjin-Hebei Province, the Yangtze River Delta and the Pearl River Delta) and establishes near-term control efforts for the next five years. However, the extent to which the Action Plan can direct local governments' activities on air pollution control remains unknown. Here we seek to evaluate the air quality improvement and associated health benefits achievable under the Action Plan in the Pearl River Delta (PRD) area from 2012 to 2017. Measure-by-measure quantification results show that the Action Plan would promise effective emissions reductions of 34% of SO2, 28% of NOx, 26% of PM2.5 (particulate matter less than 2.5 μm in diameter), and 10% of VOCs (volatile organic compounds). These emissions abatements would lower the PM2.5 concentration by 17%, surpassing the 15% target established in the Action Plan, thereby avoiding more than 2900 deaths and 4300 hospital admissions annually. We expect the implementation of the Action Plan in the PRD would be productive; the anticipated impacts, however, fall short of the goal of protecting the health of local residents, as there are still more than 33 million people living in places where the annual mean ambient PM2.5 concentrations are greater than 35 μg m−3, the interim target-3 of the World Health Organization (WHO). We therefore propose the next steps for air pollution control that are important not only for the PRD but also for all other regions of China as they develop and implement effective air pollution control policies

Identification of metabolic biomarkers associated with nonalcoholic fatty liver disease

Abstract Background Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease. Metabolism-related genes significantly influence the onset and progression of the disease. Hence, it is necessary to screen metabolism-related biomarkers for the diagnosis and treatment of NAFLD patients. Methods GSE48452, GSE63067, and GSE89632 datasets including nonalcoholic steatohepatitis (NASH) and healthy controls (HC) analyzed in this study were retrieved from the Gene Expression Omnibus (GEO) database. First, differentially expressed genes (DEGs) between NASH and HC samples were obtained. Next, metabolism-related DEGs (MR-DEGs) were identified by overlapping DEGs and metabolism-related genes (MRG). Further, a protein–protein interaction (PPI) network was developed to show the interaction among MR-DEGs. Subsequently, the “Least absolute shrinkage and selection operator regression” and “Random Forest” algorithms were used to screen metabolism-related genes (MRGs) in patients with NAFLD. Next, immune cell infiltration and gene set enrichment analyses (GSEA) were performed on these metabolism-related genes. Finally, the expression of metabolism-related gene was determined at the transcription level. Results First, 129 DEGs related to NAFLD development were identified among patients with nonalcoholic steatohepatitis (NASH) and healthy control. Next, 18 MR-DEGs were identified using the Venn diagram. Subsequently, four genes, including AMDHD1, FMO1, LPL, and P4HA1, were identified using machine learning algorithms. Moreover, a regulatory network consisting of four genes, 25 microRNAs (miRNAs), and 41 transcription factors (TFs) was constructed. Finally, a significant increase in FMO1 and LPL expression levels and a decrease in AMDHD1 and P4HA1 expression levels were observed in patients in the NASH group compared to the HC group. Conclusion Metabolism-related genes associated with NAFLD were identified, containing AMDHD1, FMO1, LPL, and P4HA1, which provide insights into diagnosing and treating patients with NAFLD

Assessment of socioeconomic costs to China’s air pollution

Particulate air pollution has had a significant impact on human health in China and it is associated with cardiovascular and respiratory diseases and high mortality and morbidity. These health impacts could be translated to reduced labor availability and time. This paper utilized a supply-driven input-output (I-O) model to estimate the monetary value of total output losses resulting from reduced working time caused by diseases related to air pollution across 30 Chinese provinces in 2007. Fine particulate matter (PM2.5) pollution was used as an indicator to assess impacts to health caused by air pollution. The developed I-O model is able to capture both direct economic costs and indirect cascading effects throughout inter-regional production supply chains and the indirect effects greatly outnumber the direct effects in most Chinese provinces. Our results show the total economic losses of 346.26 billion Yuan (approximately 1.1% of the national GDP) based on the number of affected Chinese employees (72 million out of a total labor population of 712 million) whose work time in years was reduced because of mortality, hospital admissions and outpatient visits due to diseases resulting from PM2.5 air pollution in 2007. The loss is almost the annual GDP of Vietnam in 2010. The proposed modelling approach provides an alternative method for health-cost measurement with additional insights on inter-industrial and inter-regional linkages along production supply chains

Efficacy and safety of SOXIRI mFOLFIRINOX in advanced pancreatic cancer

Background: Modified fluorouracil/leucovorin/irinotecan/oxaliplatin (FOLFIRINOX) regimen (mFOLFIRINOX), comprised of fluorouracil, leucovorin, irinotecan and oxaliplatin, is the first-line standard chemotherapy in patients with advanced pancreatic cancer. The S-1/oxaliplatin/irinotecan (SOXIRI) regimen has also been studied recently under similar conditions. This study compared its efficacy and safety. Methods: All cases of locally advanced or metastatic pancreatic cancer treated with the SOXIRI or mFOLFIRINOX regimen in Sun Yat-sen University Cancer Centre from July 2012 to June 2021 were reviewed retrospectively. The data of patients who satisfied the inclusion criteria were compared between two cohorts, including overall survival (OS), progression-free survival (PFS), objective response rate, disease control rate and safety. Results: A total of 198 patients were enrolled in the study, including 102 patients treated with SOXIRI and 96 patients treated with mFOLFIRINOX. There was no significant difference in OS [12.1 months versus 11.2 months, hazard ratio (HR) = 1.04, p  = 0.81] or PFS (6.5 months versus 6.8 months, HR = 0.99, p  = 0.96) between patients treated with SOXIRI and mFOLFIRINOX. In the subgroup analysis, patients with slightly elevated baseline total bilirubin (TBIL) or underweight patients before chemotherapy were more likely to have a longer OS or PFS from SOXIRI than from mFOLFIRINOX. In addition, the carbohydrate antigen (CA)19-9 decline was a good predictor for the efficacy and prognosis of both chemotherapy regimens. All grade adverse events were parallel in all kinds of toxicities except that anaemia was more common in the SOXIRI group than in the mFOLFIRINOX group (41.4% versus 24%, p  = 0.03). The occurrence of any grade 3 to 4 toxicity was similar in the two groups. Conclusions: For locally advanced or metastatic pancreatic cancer patients, the SOXIRI regimen had similar efficacy and controllable safety compared with the mFOLFIRINOX regimen

Fusing Observational, Satellite Remote Sensing and Air Quality Model Simulated Data to Estimate Spatiotemporal Variations of PM2.5 Exposure in China

Estimating ground surface PM2.5 with fine spatiotemporal resolution is a critical technique for exposure assessments in epidemiological studies of its health risks. Previous studies have utilized monitoring, satellite remote sensing or air quality modeling data to evaluate the spatiotemporal variations of PM2.5 concentrations, but such studies rarely combined these data simultaneously. Through assembling techniques, including linear mixed effect regressions with a spatial-varying coefficient, a maximum likelihood estimator and the spatiotemporal Kriging together, we develop a three-stage model to fuse PM2.5 monitoring data, satellite-derived aerosol optical depth (AOD) and community multi-scale air quality (CMAQ) simulations together and apply it to estimate daily PM2.5 at a spatial resolution of 0.1° over China. Performance of the three-stage model is evaluated using a cross-validation (CV) method step by step. CV results show that the finally fused estimator of PM2.5 is in good agreement with the observational data (RMSE = 23.0 μg/m3 and R2 = 0.72) and outperforms either AOD-derived PM2.5 (R2 = 0.62) or CMAQ simulations (R2 = 0.51). According to step-specific CVs, in data fusion, AOD-derived PM2.5 plays a key role to reduce mean bias, whereas CMAQ provides spatiotemporally complete predictions, which avoids sampling bias caused by non-random incompleteness in satellite-derived AOD. Our fused products are more capable than either CMAQ simulations or AOD-based estimates in characterizing the polluting procedure during haze episodes and thus can support both chronic and acute exposure assessments of ambient PM2.5. Based on the products, averaged concentration of annual exposure to PM2.5 was 55.7 μg/m3, while averaged count of polluted days (PM2.5 > 75 μg/m3) was 81 across China during 2014. Fused estimates will be publicly available for future health-related studies

Inflammatory bowel disease increases the risk of hepatobiliary pancreatic cancer: A two‐sample Mendelian randomization analysis of European and East Asian populations

Abstract Background Both inflammatory bowel disease (IBD) and hepato‐pancreato‐biliary cancers (HPBC) have been established to cause a huge socioeconomic burden. Epidemiological studies have revealed a close association between IBD and HPBC. Methods Herein, we utilized inverse‐variance weighting to conduct a two‐sample Mendelian randomization analysis. We sought to investigate the link between various subtypes of IBD and HPBC. To ensure the accuracy and consistency of our findings, we conducted heterogeneity tests, gene pleiotropy tests, and sensitivity analyses. Results Compared to the general population, IBD patients in Europe exhibited a 1.22‐fold increased incidence of pancreatic cancer (PC) with a 95% confidence interval (CI) of 1.0022–1.4888 (p = 0.0475). We also found a 1.14‐fold increased incidence of PC in Crohn's disease (CD) patients with (95% CI: 1.0017–1.3073, p = 0.0472). In the East Asian population, the incidence of hepatocellular carcinoma (HCC) was 1.28‐fold higher (95% CI = 1.0709–1.5244, p = 0.0065) in IBD patients than in the general population. Additionally, ulcerative colitis (UC) patients displayed 1.12‐fold (95% CI: 1.1466–1.3334, p < 0.0001) and 1.31‐fold (95% CI: 1.0983–1.5641, p = 0.0027) increased incidences of HCC and cholangiocarcinoma (CCA), respectively. Finally, the incidence of PC was 1.19‐fold higher in CD patients than in the general population (95% CI = 1.0741–1.3132, p = 0.0008). Conclusion Our study validated that IBD is a risk factor for HPBC. This causal relationship exhibited significant heterogeneity in different European and East Asian populations

Revealing the hidden health costs embodied in Chinese exports

China emits a considerable amount of air pollutants when producing goods for export. Previous efforts have emphasized the magnitude of export-related emissions; however, their health consequences on the Chinese population have not been quantified. Here, we present an interdisciplinary study to estimate the health impact of export-related air pollution. The results show that export-related emissions elevated the annual mean population weighted PM2.5 by 8.3 μg/m3 (15% of the total) in 2007, causing 157,000 deaths and accounting for 12% of the total mortality attributable to PM2.5-related air pollution. Compared to the eastern coastal provinces, the inner regions experience much larger export-related health losses relative to their economic production gains, owing to huge inter-regional disparities in export structures and technology levels. A shift away from emission-intensive production structure and export patterns, especially in inner regions, could significantly help improve national exports while alleviating the inter-regional cost-benefit inequality. Our results provide the first quantification of health consequences from air pollution related to Chinese exports. The proposed policy recommendations, based on health burden, economic production gains, and emission analysis, would be helpful to develop more sustainable and effective national and regional export strategies