Effect modification of integrated neighborhood environment on associations of air pollution with mortality remained unclear. We analyzed data from UK biobank prospective study (n = 421,650, median 12.5 years follow-up) to examine disparities of mortality risk associated with air pollution among varied neighborhood settings. Fine particulate matter (PM2.5), PM10 and nitrogen dioxide (NO2) were measured and assigned to each participants\' address. Diverse ecological and societal settings of neighborhoods were integrated with principal component analysis and categorized into disadvantaged, intermediate and advantaged levels. We estimated mortality risk associated with air pollution across diverse neighborhoods using Cox regression. We calculated community-level proportions of mortality attributable to air pollutants. There was evidence of higher all-cause and respiratory disease mortality risk associated with PM2.5 and NO2 among those in disadvantaged neighborhoods. In disadvantaged communities, air pollutants explained larger proportions of deaths and such disparities persisted over past decades. Across 2010-2021, reducing PM2.5 and NO2 to 10 μg/m3 (World Health Organization limits) would save 87,000 (52,000-120,000) and 91,000 (37,000-145,000) deaths of populations aged ≥ 40 years, with 150 000 deaths occurred in disadvantaged neighborhood settings. These findings suggested that disadvantaged neighborhoods can exacerbate mortality risk associated with air pollution.

Rapid urbanisation in China has resulted in an increased demand for land in towns and cities. To upgrade and modernise, China has also moved many major industries from urban centres to less populated areas. With the high economic value of urban land, the transformation and utilisation of brownfield areas have become important economically and socially. The Chinese government has recognised the need for strong frameworks to safeguard soil and groundwater quality, with brownfield sites a key category for management. Strong scientific, regulatory and decision-making frameworks are needed and being adopted to ensure practical, careful and wise use of central and localised government resources, to manage the reuse and regeneration of these brownfield sites. This paper reviews the context, policies and management procedures of developing brownfield sites in countries with a history of brownfield management and discusses China\'s current situation and priorities for brownfield governance and redevelopment. These include (1) clarification of brownfield site soil contamination risk control standards and risk assessment procedures, (2) the responsibilities of different national and local agencies, (3) the establishment of a national expert committee to advise on best practices, policy and process, (4) the use of registered brownfield databases at national, provincial, municipal and county levels, and (5) the set up of soil pollution prevention fund at the provincial level.

Cost-effectiveness of atezolizumab, as a treatment for advanced non-small-cell lung cancer (NSCLC) patients who cannot receive a platinum-containing regimen,was still unknown. Our objective was to evaluate the cost-effectiveness of atezolizumab vs. chemotherapy in this indication from the perspective of UK healthcare system.
From the global, randomised, open-label, phase III IPSOS trial, clinical inputs and patient characteristics were obtained. A partitioned survival model with three health states was built: Progression-free survival, progressed disease and death. A lifetime time horizon was applied, with an annual discount rate of 3.5%. Additionally, the willingness-to-pay threshold of £50,000/QALY was utilized. Primary outcomes were quality-adjusted life-year (QALY), costs, and incremental cost-effectiveness ratio (ICER). Sensitivity, scenario, and subgroup analyses were used to assess the reliability of base-case results. Price simulations were carried out in order to provide information for the pricing strategy at specific willingness-to-pay threshold.
In the base-case analysis, atezolizumab resulted in a gain of 0.28 QALYs and an ICER of £94,873/QALY compared to chemotherapy, demonstrating no cost-effectiveness. Price simulation results revealed that atezolizumab would be preferred at a price lower than £2,215 (a reduction of 41.8%) at the willingness-to-pay threshold of £50,000. Sensitivity, scenario and subgroup analyses revealed these conclusions were generally robust, the model was most sensitive to the price of atezolizumab and subsequent medication. Furthermore, atezolizumab was found to be more cost-effective for patients displaying a positive PD-L1 expression, with an ICER of £72,098/QALY as compared to chemotherapy.
Atezolizumab is not cost-effective for patients with advanced NSCLC ineligible for platinum-containing regimen, potential price reduction is necessary.

This study analyses the relationship between vessel groups (small, medium and large) and casualty or loss type of UK fishing vehicles based on a summary of information concerning casualties and losses that occurred on fishing vessels in the UK from 2013 to 2020. The study establishes loss of control as the main cause of casualty occurrences for all fishing vessels. Further, flooding/foundering is the main contributor to the loss of fishing vessels smaller than 24 m in length, and grounding/stranding is the main contributor to the loss of fishing vessels 24 m or longer. Fishing vessels below 15 m in length comprise the majority of casualties and losses, while medium-size vessels (15 m or longer, but less than 24 m) make the highest average contribution per vessel to casualties.

Evidence on long-term associations between coronavirus disease 2019 (COVID-19) and risks of multi-organ complications and mortality in older population is limited. This study evaluates these associations.
The cohorts included patients aged ≥60 year diagnosed with COVID-19 infection (cases), between 16 March 2020 and 31 May 2021 from the UK Biobank; and between 01 April 2020 and 31 May 2022 from the electronic health records in Hong Kong. Each patient was randomly matched with individuals without COVID-19 infection based on year of birth and sex and were followed for up to 18 months until 31 August 2021 for UKB, and up to 28 months until 15 August 2022 for HK cohort. Patients with COVID-19 infection over 6 months after the date of last dose of vaccination and their corresponding controls were excluded from our study. Characteristics between cohorts were further adjusted with Inverse Probability Treatment Weighting. For evaluating long-term association of COVID-19 with multi-organ disease complications and mortality after 21-days of diagnosis, Cox regression was employed.
10,759 (UKB) and 165,259 (HK) older adults with COVID-19 infection with matched 291,077 (UKB) and 1,100,394 (HK) non-COVID-19-diagnosed older adults were recruited. Older adults with COVID-19 were associated with a significantly higher risk of cardiovascular outcomes [major cardiovascular disease (stroke, heart failure and coronary heart disease): hazard ratio(UKB): 1.4 (95% Confidence interval: 1.1,1.6), HK:1.2 (95% CI: 1.1,1.3)]; myocardial infarction: HR(UKB): 1.8 (95% CI: 1.3,2.4), HK:1.2 (95% CI: 1.0,1.4)]; respiratory outcomes [interstitial lung disease: HR(UKB: 3.4 (95% CI: 2.5,4.5), HK: 4.0 (95% CI: 1.3,12.8); chronic pulmonary disease: HR(UKB): 1.7 (95% CI: 1.3,2.2), HK:1.6 (95% CI: 1.3,2.1)]; neuropsychiatric outcomes [seizure: HR(UKB): 2.6 (95% CI: 1.7,4.1), HK: 1.6 (95% CI: 1.2,2.1)]; and renal outcomes [acute kidney disease: HR(UKB): 1.4 (95% CI: 1.1,1.6), HK:1.6 (95% CI: 1.3,2.1)]; and all-cause mortality [HR(UKB): 4.9 (95% CI: 4.4,5.4), HK:2.5 (95% CI: 2.5,2.6)].
COVID-19 is associated with long-term risks of multi-organ complications in older adults (aged ≥ 60). Infected patients in this age-group may benefit from appropriate monitoring of signs/symptoms for developing these complications.

The African swine fever virus (ASFV) has caused a devastating pandemic in domestic and wild swine, causing economic losses to the global swine industry. Recombinant live attenuated vaccines are an attractive option for ASFV treatment. However, safe and effective vaccines against ASFV are still scarce, and more high-quality experimental vaccine strains need to be developed. In this study, we revealed that deletion of the ASFV genes DP148R, DP71L, and DP96R from the highly virulent isolate ASFV CN/GS/2018 (ASFV-GS) substantially attenuated virulence in swine. Pigs infected with 104 50% hemadsorbing doses of the virus with these gene deletions remained healthy during the 19-day observation period. No ASFV infection was detected in contact pigs under the experimental conditions. Importantly, the inoculated pigs were protected against homologous challenges. Additionally, RNA sequence analysis showed that deletion of these viral genes induced significant upregulation of the host histone H3.1 gene (H3.1) and downregulation of the ASFV MGF110-7L gene. Knocking down the expression of H3.1 resulted in high levels of ASFV replication in primary porcine macrophages in vitro. These findings indicate that the deletion mutant virus ASFV-GS-Δ18R/NL/UK is a novel potential live attenuated vaccine candidate and one of the few experimental vaccine strains reported to induce full protection against the highly virulent ASFV-GS virus strain. IMPORTANCE Ongoing outbreaks of African swine fever (ASF) have considerably damaged the pig industry in affected countries. Thus, a safe and effective vaccine is important to control African swine fever spread. Here, an ASFV strain with three gene deletions was developed by knocking out the viral genes DP148R (MGF360-18R), NL (DP71L), and UK (DP96R). The results showed that the recombinant virus was completely attenuated in pigs and provided strong protection against parental virus challenge. Additionally, no viral genomes were detected in the sera of pigs housed with animals infected with the deletion mutant. Furthermore, transcriptome sequencing (RNA-seq) analysis revealed significant upregulation of histone H3.1 in virus-infected macrophage cultures and downregulation of the ASFV MGF110-7L gene after viral DP148R, UK, and NL deletion. Our study provides a valuable live attenuated vaccine candidate and potential gene targets for developing strategies for anti-ASFV treatment.

The spread of the COVID-19 pandemic since the end of 2019 has forced an unprecedented lockdown worldwide, and environmental quality was significantly affected by the pandemic and its induced lockdown. The objective of this study is to examine the role of renewable energy, non-renewable energy and COVID-19 case on CO2 emission in the context of United Kingdom. Several non-linear techniques such as Fourier ADL cointegration test, Non-Linear ARDL, Markov switching regression, and Breitung and Candelon (BC) causality test are employed to attain this objective. The result reveals that there is long run cointegration among the variables in this study. The results demonstrate that positive (negative) shift in renewable energy development decrease (increase) CO2 emissions while positive (negative) shocks in fossil fuel energy increase CO2 emissions. Moreover, negative (positive) variation in COVID case leads to a decrease (increase) in CO2 emissions. Moreover, an uni-directional causal impact was found to run from all the variables - renewable energy, fossil fuel, and COVID-19 case to CO2 emissions. Finally, several policy recommendations are provided.

The dawn of the Sino-US peer competition has broken, denoting a new status quo of instability as Beijing and Washington vie for influence. As leader of the rules-based international order (RIO), Washington under the Trump administration nevertheless adopted an \"America first\" posture, which triggered a transatlantic discord. Simultaneously, Beijing, having signalled discontent with existing settlements, has sought to alter international arrangements to cement its leadership role. Europe has been identified as a significant theatre for the emerging competition, with Germany and the UK recognized as essential target states for Beijing\'s efforts, yet are simultaneously major stakeholders in the US-led RIO. As such, this article sets out to operationalize a European narrative of hedging. The article poses the questions, how does the transatlantic discord and Beijing\'s leadership ambitions impact the hedging strategies of Germany and the UK, and why do such coping behaviors differ in various indices? Utilizing key signals from policy practitioners, policy elites\' rhetoric and national strategies, it is contended that while the UK is struggling to formulate a coherent foreign policy and now finds itself aligned with US foreign policy narratives, Germany is unlikely to signal its wishes to become strategically independent, if the US and EU foreign policy imperatives accord with Berlin\'s political and economic interests. These two case studies reveal that both European powers are decidedly wary about Beijing\'s signals and intentions, and are likely to retain closer alignment with Washington, foregoing strategic independence and illustrating the temporary nature of the transatlantic discord. Both will not, however, wish to relinquish Beijing, so long as attractive economic benefits can be attained, resulting in an inexplicit strategic hedge.

Over the past few decades, a series of major challenges to global health have successively emerged, which call for China\'s deeper engagement in global health governance. In this context, the China-UK Global Health Support Programme (GHSP) was launched in 2012 with about 12 million pounds funded by the United Kingdom.
The GHSP was expected to explore a new type of China-UK partnership to strengthen the cooperation in global health, and enhance China\'s capacity to engage in global health governance and provide effective development assistance in health (DAH), in order to jointly improve global health outcomes.
The GHSP was programmed to support capacity building activities in Chinese experience distillation, DAH, global health governance and pilot partnership at national and institutional levels between October 2012 and March 2019. These activities were assigned to different project implementing agencies (PIAs) and their project cooperative agencies (PCAs) or pilot areas, and were then implemented under the guidance and management by the strategic oversight committee and the project management office of GHSP respectively.
At the national level, the GHSP held five rounds of China-UK high-level dialogues, conducted studies on China Global Health Strategies to provide robust evidence for developing and issuing relevant national policies, and supported the establishment of the China Global Health Network. At the institutional level, the GHSP funded a series of activities in research, training, international exchange and pilots etc., produced a large number of high-quality research outputs and policy briefings, cultivated a group of PIAs and individual researchers, facilitated the partnership building between the PIAs and PCAs, enhanced the practical ability of Chinese institutions to conduct overseas DAH, and improved the health service delivery and outcomes in pilot areas of three Asian and African countries.
In the GHSP, China and UK have established a good model for North-South Cooperation and the programme facilitated the 2030 Agenda for Sustainable Development by building a new type of bilateral partnership and carrying out triangular cooperation practices. This model has demonstrated huge potential for cooperation through partnership and can also be referred to by other countries to develop bilateral partnerships.

China and the UK use different risk-based approaches to derive soil screening or guideline values (SSVs; SGVs) for contaminants. Here we compare the approaches and the derived values for 6 illustrative contaminants. China\'s SSVs are derived using an approach developed in the US as follows: for carcinogens, acceptable level of risk (ACR) is set at 10-6 and the SSVs calculated as 10-6 divided by the soil exposure and toxicity data; for non-carcinogens, the hazard quotient is 1 and the SSV is calculated as 1 divided by the soil exposure and toxicity data. The UK\'s SGVs are calculated by the CLEA model, for which the Average Daily Exposure (ADE) from soil sources by a specific exposure route equals the health criteria values (HCVs) for that route, whether for carcinogens or a non-carcinogens. The UK\'s CLEA model is also used here to derive SSVs with Chinese input parameters. China\'s SSVs, the UK\'s SGVs and values for Chinese conditions derived using the UK approach were as follows (mg/kg): As, <1, 35, 20; Cd, 20, 18, 11; Cr (VI), <1, 14, 29; benzene, 1, 1, 2; toluene, 1200, 3005, 3800; ethyl-benzene, 7, 930, 1200. By comparing the differences in toxicity assessment and risk characterization, exposure assessment and parameter types in the methodologies to obtain SSVs in China and the UK, and by combining the CLEA model with Chinese parameterisation, these comparisons highlight that the difference in toxicity assessment and risk characterization methods of carcinogens results in the biggest difference in SSVs between the 2 countries. However, for non-carcinogenic substances, the difference of SSVs calculation method and SSVs is small. The difference in SSVs for carcinogenic substances is also related to the route of exposure. For volatile organic compounds, the presence of indoor respiratory exposure pathways greatly reduces the differences caused by toxicity assessment and risk characterization methods. For non-volatile substances such as heavy metals, the effects of toxicity assessment and risk characterization methods are significant. The SSV of As obtained by the CLEA model with Chinese parameters is closer to the background value of soil in China. In the management of non-volatile contaminated sites such as heavy metals in China, the CLEA model can be used for risk assessment and calculation of site specific SSVs. In the future, China can use the UK method to strengthen its toxicity assessment and risk characterization methods for carcinogenic substances, to reduce the uncertainty in the risk assessment of contaminated sites and improve the scientific management of contaminated sites.