Disease Burden Attributable to PM2.5 Exposure in China from 2000 to 2016

Long-term exposure to ambient fine particulate matter (PM2.5) has slowly increased both the morbidity and mortality among Chinese people; becoming a leading problem for public health efforts. In this study, the exposure-response function was used to derive the spatial-temporal dynamics of disease burden attributable to PM2.5 pollution in China. It was found that the economic loss attributable to PM2.5 increased by 93% from 35 billion Chinese yuan to 536 billion Chinese yuan within the period of 16 years. Digging further, a substantiate level of regional differences was discovered with the disease burden being the most severe in East China and the least severe in Northwest China. This article can provide more insights for future air pollution control in China.

Purchasing Power Parity Approach to Exchange Rate Misalignment in Nigeria

This study examines the purchasing power parity (PPP) approach to the determination of exchange rate misalignment in Nigeria by using two variants of the PPP: the absolute PPP (aPPP) and the relative PPP (rPPP). Data on the Nigerian Naira to US Dollar ( N/$), British Pound ( N/£) and Chinese Yuan (N /¥) interbank exchange rates, Nigeria consumer price index and Inflation as well as the US, UK and China consumer price indices and inflation rates spanning 2008:M1 to 2018:M12 were utilized. A recently modified fractional cointegration framework was employed, taking care of smooth structural breaks and nonlinearity, while the unit root tests employed the fractional alternatives. The results confirmed that the aPPP approach to exchange rate determination is unrealistic but revealed empirical support for the rPPP approach. Furthermore, the exchange rates computed with the rPPP approach show that the interbank Naira to US Dollar, UK Pounds and Chinese Yuan exchange rates were overvalued in most of the period of this study. The period of undervaluation observed in June 2016 and April 2017 coincided with the periods when CBN introduced the investors and exporters window. The study recommends the use of rPPP for gauging the level of exchange rate misalignment in Nigeria and suggests the need to diversify the export base to appreciate the exchange rate.

Trends in Outpatient Prescribing Patterns for Ocular Topical Anti-Infectives in Six Major Areas of China, 2013–2019

Topical anti-infectives are important in the management of ocular infections, but little is known about their current status and trends in their use in China. Thus, we carried out a prescription-based, cross-sectional study using the database of Hospital Prescription Analysis Projection of China, and aimed to analyze the trend in the use of ocular topical anti-infectives for outpatients of the ophthalmology department from 2013 to 2019. A total of 2,341,719 prescriptions from 61 hospitals located in six major areas written by ophthalmologists for outpatients were identified, and 1,002,254 of the prescriptions contained at least one anti-infective. The yearly anti-infective prescriptions increased continuously from 126,828 prescriptions in 2013 to 163,434 prescriptions in 2019. The cost also increased from 4,503,711 Chinese Yuan (CNY) in 2013 to CNY 5,860,945 in 2019. However, the use rate of anti-infectives decreased slightly from 46.5% in 2013 to 41.1% in 2019. Patients aged between 19 and 45 years old had the highest anti-infective use rate. Levofloxacin was the most frequently used anti-infective and kept on increasing among all age groups, occupying 67.1% of the total cost at the end of the study. Tobramycin was more frequently used in pediatric patients than in adults, but the use still decreased. Ganciclovir was the preferred anti-viral drug over acyclovir. In conclusion, the prescriptions and cost of ocular topical anti-infectives for outpatients both increased progressively. The increasingly widespread use of levofloxacin raised concerns regarding safety in pediatrics and resistance development. The observed trends can lead to the more efficient management of ocular anti-topical anti-infectives in China.

Green Investment Changes in China: A Shift-Share Analysis

As China’s economic development has entered a new phase, China needs to seek a new path of green transformation development to coordinate the economic growth with environmental mitigation. From 2002 to 2017, green investment in China grew from 118.56 billion Chinese yuan to 950.86 billion Chinese yuan, increasing more than seven times. In this study, a homothetic shift-share analysis (HSSA) is used to understand how green investment changed and was used to decompose the change of provincial green investment in China from 2002 to 2017 into four driving factors: the national economic growth effect (NEG), national green investment structure effect (NIS), homothetic regional green investment competition effect (HRIC), and regional green investment allocation effect (RIA). The results indicate that these four factors had various regional and temporal characteristics, although green investment increased in all provinces during this period. More specifically, the NEG was more significant in the east than in other regions. The regional differences of NEG were relatively large in the first two periods (2002–2007 and 2007–2012) and began to shrink in the third period (2012–2017). The NIS shared the same characteristics as the NEG. In terms of HRIC, the central region was ahead of the eastern and western regions, and relatively many eastern provinces were with negative HRIC. The HRIC of most provinces showed a trend of “low/medium-medium/high-low”. The RIA inhibited green investment growth in most provinces and showed a “high-low-high” trend regarding the change from 2002 to 2017. Our study suggests that it is necessary to coordinate the growth of green investment across different regions and establish an ecological compensation mechanism.

Bitcoin and Fiat Currency Interactions: Surprising Results from Asian Giants

This study examines the interaction of Bitcoin with fiat currencies of three developed (euro, pound sterling and yen) and three emerging (yuan, rupee and ruble) market economies. Empirical investigations are executed through symmetric, asymmetric and non-linear causality tests, and Markov regime-switching regression (MRSR) analysis. Results show that Bitcoin has a causal nexus with Chinese yuan and Indian rupee for price and various return components. The MRSR analysis justifies these findings by demonstrating the presence of interaction in contractionary regimes. Accordingly, it can be stated that when markets display a downward trend, appreciation of the Chinese yuan and Indian rupee positively and strongly affects the value of Bitcoin, possibly due to the market timing. The MRSR analysis also exhibits a transition from a tranquil to a crisis regime in March 2020 because of the pandemic. However, a shorter duration spent in the crisis regime in 2020 indicates the limited and relatively less harmful effect of the pandemic on the cryptocurrency market when compared to the turmoil that occurred in 2018.

Anti-seizure Medication Prescription in Adult Outpatients With Epilepsy in China, 2013–2018

This study aimed to assess the national trends in anti-seizure medication (ASM) prescription in Chinese adult outpatients with epilepsy over a 6-year period from 2013 to 2018. Prescriptions for adult outpatients with epilepsy from hospitals in six major cities were extracted from the database of the Hospital Prescription Analysis Cooperative Project. Trends in the annual prescriptions and expenditure of ASM were analyzed. Prescription patterns (monotherapy or combination therapy) were also assessed. A total of 225,767 prescriptions from 60 hospitals were eligible and extracted for analysis. The number of ASM prescriptions increased from 28,360 in 2013 to 44,110 in 2018, and the corresponding cost increased from 9,452,990 Chinese Yuan (CNY) in 2013 to 14,627,865 CNY in 2018. The share of newer ASM use increased continuously, accounting for 56.75% of prescriptions and 85.03% of expenditure in 2018. The most frequently prescribed ASMs were sodium valproate and levetiracetam. The proportion of sodium valproate use decreased, while the proportion of levetiracetam use increased dramatically in terms of both ASM prescriptions and expenditure. Monotherapy was more frequent than combination therapy. The three most common combination therapies were sodium valproate/lamotrigine, levetiracetam/oxcarbazepine, and sodium valproate/levetiracetam. In summary, ASM use increased rapidly in terms of the number of ASM prescriptions and cost during the 6-year period, which raises concern regarding the rational use and pharma-economic profiles of ASMs. In place of valproate, levetiracetam became the most frequently used ASM. The development of ASM prescription is in line with therapy guidelines and reflects the current state of research in China.

Spatial-Temporal Dynamics of Disease Burden Attributable to Pm2.5 Exposure in China From 2000 to 2016

In recent years, long-term exposure to ambient fine particulate matter (PM2.5) has slowly increased both morbidity and mortality for Chinese people, becoming a leading problem for public health efforts. However, spatial-temporal dynamics of disease burden attributable to PM2.5 exposure still lacks a comprehensive evaluation so as to provide inadequate supports for policy making and improvement. Here, we used the exposure-response function to derive the spatial-temporal dynamics of disease burden attributable to PM2.5 pollution in China. We found the fact that economic loss attributable to PM2.5 increased by 93% from 35 billion Chinese Yuan (95% CI: 14-52) to 536 billion Chinese Yuan (95%CI: 236-753) during the period of 16 years. Digging further, we discovered a substantiate level of regional differences, with the disease burden being the most severe in East China and the least severe in the Northwest China. Other than that, there existed a spatial aggregation of health-related economic losses among Chinese cities. Our paper made an evaluation on the spatial-temporal dynamics of health effects attributed to PM2.5, an evaluation that could provide more insights to future policy making of the air pollution control for China and other developing countries.

Dependence Structure Between Renminbi Movements and Volatility of Foreign Exchange Rate Returns

This article investigates the linkages of the movements in Renminbi (RMB) to volatility of exchange rate returns of other currencies before and after the yuan devaluation on 11 August 2015. A comparison between the onshore Chinese yuan (CNY) and the offshore Chinese yuan (CNH) is made. Standard regression methods underestimate the tail dependence between yuan and other exchange rate volatility, as financial data are non-normally distributed, especially when extreme event occurs. We apply Gumbel copulas to capture the presence of tail dependence between RMB returns and the volatility of exchange rate returns for 13 selected currencies, and found dependencies not revealed by the standard ARCH models. The tail dependence has increased after the RMB devaluation, suggesting that RMB depreciation is associated with higher downside risks in these currencies. This is most obvious in the currencies of Asian and ASEAN-5 countries that have strong trade and financial linkages with China. The dependence structure has shifted away from the dominance of onshore CNY rates before the devaluation to the growing importance of more volatile offshore CNH rates after the devaluation. Hence, any large depreciation in CNH will lead to a higher volatility in the other exchange rate returns, and the corresponding downside currency risks are higher than those of the CNY.