Life expectancy can reflect both health benefit and implementation cost of climate policy. Nevertheless, little research has quantified the relation between life expectancy and climate policy in literature. In this paper, we attempt to narrow the research gap by studying how life expectancy is related to the Chinese nationwide emission trading scheme (CNETS). To achieve this research target, a Computable General Equilibrium (CGE) model is employed to simulate the operation of the economic system and the policy shock from emission abatement. The CGE model results show that life expectancy is prolonged by GDP but shortened by emissions, and the GDP impact on life expectancy is larger than the emission impact. Climate policy has dual effects on life expectancy because it relieves both negative emission impacts and positive GDP impacts on lifespan; its net effect on life expectancy is positive. Life expectancy positively impacts GDP, and this impact is moderated by climate policy; specifically, climate policy reinforces the positive impact of life expectancy on GDP. Life expectancy minimally affects carbon emissions during climate policy implementation; in other words, it has minimal impacts on emission abatement. These findings imply that climate policy and life expectancy complement each other; the government could implement climate policy to increase lifespan or prolong life expectancy to facilitate policy implementation.

Due to rising temperatures and CO2 emissions, climate change has become one of the most important global issues. We described the relationship between extreme weather-related events and death, globally, from 1999 through 2018. We used data from the emergency events database of the Université Catholique de Louvain. We also categorized the countries\' income according to the World Bank GDP and we used the CO2 emission levels data from the Carbon Dioxide Information Analysis Center to link the GDP and CO2 emissions to years of extreme weather conditions in each country. We conducted descriptive and Poisson Regression analysis to analyze the data. A total of 77 countries reported 425 extreme weather-related events from1999 through 2018. Mortality related events were highest in middle-income countries due to severe winter conditions (N = 2,020) and cold-waves (N = 70,972). The total number of recorded deaths due to heat waves was highest in high-income countries (N = 84,344). Furthermore, the number of deaths in high-income countries, compared to low-income countries, was five-fold higher (IRR 5.18; 95%CI 4.58; 5.85, p < 0.001). The mortality rate in heat season was almost seven-fold higher than that in cold/severe winter (IRR 33.43; 95%CI 32.85; 34.02, p < 0.001). The number of deaths increased significantly with the repetition of extreme events (IRR 6.82; 95%CI 6.68; 6.96, p < 0.001). We found the number of deaths increased in high-income countries, and this was associated with an increase in the number of times extreme events occurred per year and with heat wave.

This study aimed to explore the association between the GDP of various countries and the progress of COVID-19 vaccinations; to explore how the global pattern holds in the continents, and investigate the spatial distribution pattern of COVID-19 vaccination progress for all countries. We have used consolidated data on COVID-19 vaccination and GDP from Our World in Data, an open-access data source. Data analysis and visualization were performed in R-Studio. There was a strong linear association between per capita income and the proportion of people vaccinated in countries with populations of one million or more. GDP per capita accounts for a 50% variation in the vaccination rate across the nations. Our assessments revealed that the global pattern holds in every continent. Rich European and North-American countries are most protected against COVID-19. Less developed African countries barely initiated a vaccination program. There is a significant disparity among Asian countries. The security of wealthier nations (vaccinated their citizens) cannot be guaranteed unless adequate vaccination covers the less affluent countries. Therefore, the global community should undertake initiatives to speed up the COVID-19 vaccination program in all countries of the world, irrespective of their wealth.

UNASSIGNED: Dermatoses contribute to a large burden of global disease, but the relationship between socioeconomic status and the effect of dermatologic conditions in Europe is not well understood.
UNASSIGNED: We selected Global Burden of Disease Study data sets to analyze disability-adjusted life-years (DALYs) and the annual rate of change of dermatoses between 1990 and 2017 in 43 European countries. The principal country-level economic factor used was gross domestic product per capita from the World Bank. Statistical analysis was performed with Spearman ρ correlation.
UNASSIGNED: Wealthier European countries had higher DALYs for melanoma, basal cell carcinoma, psoriasis, atopic dermatitis, acne, seborrheic dermatitis, alopecia, asthma, contact dermatitis, and viral skin disease. Poorer countries had higher DALYs of squamous cell carcinoma, urticaria, decubitus ulcers, pruritus, scabies, tuberculosis, and syphilis. Thirteen European countries were in the top 10th percentile globally for annual increase in skin and subcutaneous disease burden.
UNASSIGNED: The majority of European countries have experienced an increase in skin and subcutaneous diseases in recent decades relative to the rest of the world, but the burden of individual dermatoses in Europe varies by country and socioeconomic status. DALYs can potentially serve as a purposeful measure for directing resources to improve the burden of skin disease in Europe.

The construction industry of all countries in the world is facing the issue of sustainable development. How to make effective and accurate decision-making on the three pillars (Environment; Economy; Social influence) is the key factor. This manuscript is based on an accurate evaluation framework and theoretical modelling. Through a comprehensive evaluation of six cable-stayed highway bridges in the entire life cycle of five provinces in China (from cradle to grave), the research shows that life cycle impact assessment (LCIA), life cycle cost assessment (LCCA), and social impact life assessment (SILA) are under the influence of multi-factor change decisions. The manuscript focused on the analysis of the natural environment over 100 years, material replacement, waste recycling, traffic density, casualty costs, community benefits and other key factors. Based on the analysis data, the close connection between high pollution levels and high cost in the maintenance stage was deeply promoted, an innovative comprehensive evaluation discrete mathematical decision-making model was established, and a reasonable interval between gross domestic product (GDP) and sustainable development was determined.

Extranodal natural killer/T cell lymphoma, nasal type (ENKL) is a highly aggressive tumor with relatively poor prognosis. In this prospective study, we investigated the efficacy and toxicity of a novel GDP-ML regimen (combined gemcitabine, cisplatin, dexamethasone, methotrexate, and pegaspargase) as front-line treatment in newly diagnosed ENKL. Eligible newly diagnosed stage I/II ENKL patients received sandwich chemoradiation therapy. Patients with stage III/IV disease received an initial 4 cycles of GDP-ML regimen. After 4 cycles, responding patients continued to receive either autologous transplantation or additional two courses of GDP-ML. A total of 44 patients were enrolled with a median follow-up of 26 months. The overall response rate (ORR) were 78.6% for the whole cohort, 84.6% for stage I/II, and 66.7% for stage III/IV, and corresponding complete remission (CR) rates were 61.9%, 76.9%, and 33.3%. The 1- year and 2- year progression-free survival (PFS) rates were 69.3% and 62.9%, and 1- year and 2-year overall survival (OS) rates were 76.5% and 67.4%, respectively. Patients with stage I/II disease showed better 2-year OS rate compared with stage III/IV patients (88.1% vs. 33.2%, p < 0.001). Patients who achieved CR had significantly better 2-year OS rate compared with non-CR patients (90.8% vs. 24.5%, p < 0.001). The main adverse event was hematologic toxicity. Grade 3/4 neutropenia occurred in 59.1% of patients. These results indicate that GDP-ML is an effective and well-tolerated induction regimen with newly diagnosed ENKL patients. This clinical trial was registered on www.chictr.org.cn (ChiCTR-ONC-12002055).

Peripheral T cell lymphomas (PTCL) are less responsive to anthracycline-containing regimen such as CHOP and carry a poor prognosis. In this prospective study, we investigated gemcitabine, cisplatin, and dexamethasone (GDP) combined with methotrexate (MTX) and pegaspargase (PEG-L) as front-line treatment in PTCL. Eligible newly diagnosed PTCL patients received 4 cycles of the GDP-ML chemotherapy every 28 days. After 4 cycles, responding patients continued to receive either autologous stem cell transplantation or the MTX/cytarabine (MA) regimen for consolidation. This trial is registered with www.chictr.org.cn (ChiCTR-ONC-12002055). A total of 65 patients were enrolled with a median follow-up of 38.5 months. The overall response rate (ORR) was 55.4%, and complete remission rate (CR) was 33.8%. The median overall survival (OS) was 16 months, and the 1-year and 2-year OS were 59.1% and 38.2%, respectively. The median PFS was only 8 months. The main adverse event was hematologic toxicity: 50% patients showed grade III/IV neutropenia. GDP-ML for the first-line treatment of PTCL patients is an effective induction regimen compared with standard CHOP, and the toxicity was more significant but acceptable. However, future studies exploring new drug combinations are warranted to overcome relapse after remission. ClinicalTrials.gov Identifier: NCT02987244.

Determinants of universal healthcare (UHC) are poorly empirically understood. We undertook a comprehensive study of UHC development using a novel Evidenced Formal Coverage (EFC) index that combines three key UHC elements: legal framework, population coverage, and accessibility. Applying the EFC index measures (legislation, ≥90% skilled birth attendance, ≥85% formal coverage) to 194 countries, aggregating time-varying data from 1880-2008, this study investigates which macro-economic, political, and social indicators are major longitudinal predictors of developing EFC globally, and in middle-income countries. Overall, 75 of 194 countries implemented legal-text UHC legislation, of which 51 achieved EFC. In a country-year prospective longitudinal analysis of EFC prediction, higher GDP-per-capita (per GDP-per-capita doubling, relative risk [RR]=1.77, 95% CI: 1.49-2.10), higher primary school completion (per +20% completion, RR=2.30, 1.65-3.21), and higher adult literacy were significantly associated with achieving EFC. Results also identify a GDP-per-capita of I$5000 as a minimum level for development of EFC. GDP-per-capita and education were each robust predictors in middle-income countries, and education remained significant even controlling for time-varying GDP growth. For income-inequality, the GINI coefficient was suggestive in its role in predicting EFC (p=0.024). For social and political indicators, a greater degree of ethnic fractionalization (per +25%, RR=0.51, 0.38-0.70), proportional electoral system (RR=2.80, 1.22-6.40), and dictatorships (RR=0.10, 0.05-0.27) were further associated with EFC. The novel EFC index and this longitudinal prospective study together indicate that investment in both economic growth and education should be seen of equal importance for development of UHC. Our findings help in understanding the social and political drivers of universal healthcare, especially for transitioning countries.

OBJECTIVE: To study the change of surgical treatments for breast cancer in China over the recent 10 years and the relationship between such a changes and social economical development.
METHODS: The data were extracted from the 10-year database of female primary breast cancer at 7 tertiary hospitals from various geographic areas in China. The Chi-square Cochran-Armitage trend test was used to measure the difference.
RESULTS: Over the 10 year period, mastectomy showed a decline trend while breast conserving surgeries increased. The modified radical mastectomy was the primarily surgical treatment. Among various types of mastectomies, modified radical mastectomy was increasing while Halsted radical mastectomy had shown a decrease trend; no significant changes were observed for the simple mastectomy. Halsted radical mastectomy and breast conserving surgery were used in a higher proportion in high economic areas than low economic areas, while the modified radical mastectomy has been underused in hospitals from high economic areas.
CONCLUSIONS: Modified radical mastectomy was the overall most common choice of operation in China. Breast conserving surgery has been less popular but had been showing an increasing trend. Halsted radical mastectomy has still been in use but showing a decrease these years. Surgeries were not adherent to guidelines completely and needed further effective training.