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Due to the transboundary nature of air pollutants, a province's efforts to improve air quality can reduce PM2.5 concentration in the surrounding area. The inter-provincial PM2.5 pollution transport could bring great challenges to related environmental management work, such as financial fund allocation and subsidy policy formulation. Herein, we examined the transport characteristics of PM2.5 pollution across provinces in 2013 and 2020 via chemical transport modeling and then monetized inter-provincial contributions of PM2.5 improvement based on pollutant emission control costs. We found that approximately 60% of the PM2.5 pollution was from local sources, while the remaining 40% originated from outside provinces. Furthermore, about 1011 billion RMB of provincial air pollutant abatement costs contributed to the PM2.5 concentration decline in other provinces during 2013-2020, accounting for 41.2% of the total abatement costs. Provinces with lower unit improvement costs for PM2.5, such as Jiangsu, Hebei, and Shandong, were major contributors, while Guangdong, Guangxi, and Fujian, bearing higher unit costs, were among the main beneficiaries. Our study identifies provinces that contribute to air quality improvement in other provinces, have high economic efficiency, and provide a quantitative framework for determining inter-provincial compensations. This study also reveals the uneven distribution of pollution abatement costs (PM2.5 improvement/abatement costs) due to transboundary PM2.5 transport, calling for adopting inter-provincial economic compensation policies. Such mechanisms ensure equitable cost-sharing and effective regional air quality management.
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China is confronting the dual challenges of air pollution and climate change, mandating the co-control of air pollutants and CO2 emissions from their shared sources. Here we identify key sources for co-control that prioritize the mitigation of PM2.5-related health burdens, given the homogeneous impacts of CO2 emissions from various sources. By applying an integrated analysis framework that consists of a detailed emission inventory, a chemical transport model, a multisource fused dataset, and epidemiological concentration-response functions, we systematically evaluate the contribution of emissions from 390 sources (30 provinces and 13 socioeconomic sectors) to PM2.5-related health impacts and CO2 emissions, as well as the marginal health benefits of CO2 abatement across China. The estimated source-specific contributions exhibit substantial disparities, with the marginal benefits varying by 3 orders of magnitude. The rural residential, transportation, metal, and power and heating sectors emerge as pivotal sources for co-control, with regard to their relatively large marginal benefits or the sectoral total benefits. In addition, populous and heavily industrialized provinces such as Shandong and Henan are identified as the key regions for co-control. Our study highlights the significance of incorporating health benefits into formulating air pollution and carbon co-control strategies for improving the overall social welfare.
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This preliminary study investigates hypoglossal nerve stimulator (HNS) amplitude changes and usage patterns during the initial HNS uptitration period to characterize when patients achieve their therapeutic amplitude. HNS therapy amplitudes, duration, and pause times were examined across the first 4 months of implant use. Average HNS therapy amplitude increased monthly from baseline (0.7 ± 0.3 V) to the first (1.1 ± 0.3 V), second (1.4 ± 0.4 V), third (1.7 ± 0.5 V), and fourth months (1.8 ± 0.5 V) (P < .001). After 4 months, 60% had reached a therapeutic amplitude. Average therapeutic amplitude was greater for patients who did not achieve therapeutic amplitude by month 4 than for those who did (2.6 vs 1.6 V; P < .05). Body mass index, baseline apnea-hypopnea index, respiratory disturbance index, and initial HNS amplitude did not differ between the 2 groups. Predictors for therapeutic amplitude and other usage patterns require further investigation.
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Colon adenocarcinoma (COAD) is a type of colon cancers with a high mortality rate. Its early symptoms are not obvious, and its late stage is accompanied by various complications that seriously endanger patients' lives. To assist in the early diagnosis of COAD and improve the detection efficiency of COAD, this paper proposes a multi-level threshold image segmentation (MIS) method based on an enhanced particle swarm algorithm for segmenting COAD images. Firstly, this paper proposes a multi-strategy fusion particle swarm optimization algorithm (DRPSO) with a replacement mechanism. The non-linear inertia weight and sine-cosine learning factors in DRPSO help balance the exploration and exploitation phases of the algorithm. The population reorganization strategy incorporating MGO enhances population diversity and effectively prevents the algorithm from stagnating prematurely. The mutation-based final replacement mechanism enhances the algorithm's ability to escape local optima and helps the algorithm to obtain highly accurate solutions. In addition, comparison experiments on the CEC2020 and CEC2022 test sets show that DRPSO outperforms other state-of-the-art algorithms in terms of convergence accuracy and speed. Secondly, by combining the non-local mean 2D histogram and 2D Renyi entropy, this paper proposes a DRPSO algorithm based MIS method, which is successfully applied to the segments the COAD pathology image problem. The results of segmentation experiments show that the above method obtains relatively higher quality segmented images with superior performance metrics: PSNR = 23.556, SSIM = 0.825, and FSIM = 0.922. In conclusion, the MIS method based on the DRPSO algorithm shows great potential in assisting COAD diagnosis and in pathology image segmentation.
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Algoritmos , Neoplasias do Colo , Humanos , Neoplasias do Colo/diagnóstico por imagem , Neoplasias do Colo/patologia , Interpretação de Imagem Assistida por Computador/métodos , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Processamento de Imagem Assistida por Computador/métodosRESUMO
We demonstrate an optical fiber-based, multiple-access frequency transmission using two optical frequency combs. The experimental results using the Allan deviation analysis show that with the phase compensation technique, the frequency instabilities at the remote site are 8.7 × 10-15/1 s and 1.0 × 10-17/103 s, and at the accessing node along the fiber link, the frequency instabilities are 6.9 × 10-15/1 s and 1.1 × 10-17/103 s. Similarly, the power spectral density of phase noise was analyzed in the frequency domain. These experimental results demonstrate that the compensation scheme improved the performance by two to three orders of magnitude. Thus, the proposed frequency transmission technique has potential application for disseminating ultrastable frequency references in the optical fiber network.
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Acetaminophen (AC) can inhibit the synthesis of prostaglandins in the body, and has antipyretic and analgesic effects. In this paper, a two-step microwave impregnation method was used to prepare anthraquinone (AQ)-doped carbon composite, which were applied to the surface modification of glassy carbon electrodes (GCE) for the determination of acetaminophen (AC) using differential pulse voltammetry (DPV). The composites were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), Raman and Fourier infrared spectroscopy (FT-IR). The results showed that anthraquinone was successfully modified on the surface of activated carbon. The peak current of AC increased with its concentration in the range of 0.1 µM to 700 µM (R2 = 0.998) and a detection limit of 0.05 µM was obtained with 20%AQ doped carbon electrochemical sensor (20%AQ-C/GCE). Electrochemical Impedance Spectroscopy (EIS) test results indicated that the charge transfer resistance (Rct) of 20%AQ-C/GCE is only the one-fourth of that of bare GCE. The proposed 20%AQ-C/GCE sensor has good stability, reproducibility and selectivity for the detection of AC. The sensor is also suitable for the detection of real samples, indicating its good practicality.
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Acetaminofen , Antraquinonas , Técnicas Eletroquímicas , Eletrodos , Acetaminofen/análise , Antraquinonas/química , Carbono/química , Carvão Vegetal/química , Limite de Detecção , Eletroquímica , Propriedades de SuperfícieRESUMO
OBJECTIVES: Obstructive sleep apnea (OSA) is usually assessed at discrete and infrequent timepoints. Wearable consumer sleep technologies (CST) may allow for more granular and longitudinal assessments of OSA therapy responses and OSA-related symptoms. METHODS: In this case series, we enrolled hypoglossal nerve stimulator (HGNS) patients who had an effective treatment response for an 8-week study using a wearable CST. Participants started with "HGNS-on," were randomized to turn off HGNS therapy during either week 4 or 5 ("HGNS-off"), followed by a return to therapy, "HGNS-resume." Participants completed validated symptom questionnaires assessing sleepiness, insomnia symptoms, functional status, and overall sleep health (Satisfaction, Alertness, Timing, Efficiency, and Duration, SATED) each week. CST metrics and survey scores were compared between HGNS treatment phases. Associations between CST metrics and survey scores were assessed. RESULTS: Seven participants with a total of 304 nights of CST data showed no statistically significant changes in total sleep time (TST), wake time after sleep onset, or sleep efficiency (SE) across the study periods. During HGNS-off, survey scores indicated significantly worsened OSA-related symptom scores. Two participants had significantly higher heart rate variability (HRV) during HGNS-off (by 3.3 and 6.3 ms) when compared to HGNS active therapy periods. Amongst CST metrics, SATED scores correlated with TST (r = 0.434, p < 0.0001), HRV (r = -0.486, p < 0.0001), and SE (r = 0.320, = 0.0014). In addition, FOSQ-10 scores correlated with average HR during sleep (r = -0.489, p < 0.001). CONCLUSION: A 1-week HGNS therapy withdrawal period impacted OSA-related sleep symptoms. Sleep-related metrics measured by a wearable CST correlated with symptom scores indicating potential value in the use of CSTs for longitudinal sleep-tracking in OSA patients. LEVEL OF EVIDENCE: 4 Laryngoscope, 134:3406-3411, 2024.
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Terapia por Estimulação Elétrica , Nervo Hipoglosso , Apneia Obstrutiva do Sono , Humanos , Apneia Obstrutiva do Sono/terapia , Apneia Obstrutiva do Sono/fisiopatologia , Masculino , Pessoa de Meia-Idade , Feminino , Terapia por Estimulação Elétrica/métodos , Terapia por Estimulação Elétrica/instrumentação , Adulto , Inquéritos e Questionários , Resultado do Tratamento , Dispositivos Eletrônicos Vestíveis , Idoso , Polissonografia , Sono/fisiologiaRESUMO
A transition away from coal power always maintains a high level of complexity as there are several overlapping considerations such as technical feasibility, economic costs, and environmental and health impacts. Here, we explore the cost-effectiveness uncertainty brought by policy implementation disturbances of different coal power phaseout and new-built strategies (i.e., the disruption of phaseout priority) in China based on a developed unit-level uncertainty assessment framework. We reveal the opportunity and risk of coal transition decisions by employing preference analysis. We find that, the uncertainty of a policy implementation might lead to potential delays in yielding the initial positive annual net benefits. For example, a delay of six years might occur when implementing the prior phaseout practice. A certain level of risk remains in the implementation of the phaseout policy, as not all strategies can guarantee the cumulative positive net benefits from 2018-2060. Since the unit-level heterogeneities shape diverse orientation of the phaseout, the decision-making preferences would remarkably alter the selection of a coal power transition strategy. More strikingly, the cost-effectiveness uncertainty might lead to missed opportunities in identifying an optimal strategy. Our results highlight the importance of minimizing the policy implementation disturbance, which helps mitigate the risk of negative benefits and strengthen the practicality of phaseout decisions.
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Chronic kidney disease (CKD) is a progressive disorder characterized by structural and functional changes in the kidneys, providing a global health challenge with significant impacts on mortality rates. Extracellular vesicles (EVs), are vital in the physiological and pathological processes associated with CKD. They have been shown to modulate key pathways involved in renal injury, including inflammation, fibrosis, apoptosis, and oxidative stress. Currently, the application research of EVs in the diagnosis and treatment of CKD is highly prevalent. However, there is currently a lack of standardized guidelines for their application, and various methodologies have advantages and limitations. Consequently, we present an comprehensive summary elucidating the multifaceted involvement of EVs in both physiological and pathological aspects in CKD. Furthermore, we explore their potential as biomarkers and diverse therapeutic roles in CKD. This review provides an overview of the current state of research on application of EVs in the diagnosis and therapeutic management of CKD.
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Finding effective therapeutic targets to treat NRAS-mutated melanoma remains a challenge. Long non-coding RNAs (lncRNAs) recently emerged as essential regulators of tumorigenesis. Using a discovery approach combining experimental models and unbiased computational analysis complemented by validation in patient biospecimens, we identified a nuclear-enriched lncRNA (AC004540.4) that is upregulated in NRAS/MAPK-dependent melanoma, and that we named T-RECS. Considering potential innovative treatment strategies, we designed antisense oligonucleotides (ASOs) to target T-RECS. T-RECS ASOs reduced the growth of melanoma cells and induced apoptotic cell death, while having minimal impact on normal primary melanocytes. Mechanistically, treatment with T-RECS ASOs downregulated the activity of pro-survival kinases and reduced the protein stability of hnRNPA2/B1, a pro-oncogenic regulator of MAPK signaling. Using patient- and cell line- derived tumor xenograft mouse models, we demonstrated that systemic treatment with T-RECS ASOs significantly suppressed the growth of melanoma tumors, with no noticeable toxicity. ASO-mediated T-RECS inhibition represents a promising RNA-targeting approach to improve the outcome of MAPK pathway-activated melanoma.
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Melanoma , RNA Longo não Codificante , Humanos , Camundongos , Animais , Melanoma/patologia , RNA Longo não Codificante/genética , Apoptose/genética , Oligonucleotídeos Antissenso/genética , Oligonucleotídeos Antissenso/uso terapêutico , Linhagem Celular Tumoral , Proteínas de Membrana/genética , GTP Fosfo-Hidrolases/genética , GTP Fosfo-Hidrolases/metabolismoRESUMO
BACKGROUND: Dementia is associated with individual vision impairment (VI) and hearing impairment (HI). However, little is known about their associations with motoric cognitive risk syndrome (MCR), a pre-dementia stage. We investigated the association of VI, HI, and dual sensory impairment (DSI) with MCR and to further evaluate causal relationships using Mendelian randomization (MR) approach. METHODS: First, an observational study was conducted in the China Health and Retirement Longitudinal Study (CHARLS). Evaluate the cross-sectional and longitudinal associations of VI, HI, and DSI with MCR using the logistic regression models and Cox proportional hazard models, respectively. Second, evaluate the causal association between VI and HI with MCR using MR analysis. The GWAS data was used for genetic instruments, including 88,250 of European ancestry (43,877 cases and 44,373 controls) and 504,307 with "white British" ancestry (100,234 cases and 404,073 controls), respectively; MCR information was obtained from the GWAS with 22,593 individuals. Inverse variance weighted was the primary method and sensitivity analysis was used to evaluate the robustness of MR methods. RESULTS: In the observational study, VI (HR: 1.767, 95%CI: 1.331-2.346; p < 0.001), HI (HR: 1.461, 95%CI: 1.196-1.783; p < 0.001), and DSI (HR: 1.507, 95%CI: 1.245-1.823; p < 0.001) were significantly associated with increased risk of MCR. For the MR, no causal relationship between VI (OR: 0.902, 95% CI: 0.593-1.372; p = 0.631) and HI (OR: 1.016, 95% CI: 0.989-1.043; p = 0.248) with MCR risk, which is consistent with the sensitivity analysis. CONCLUSION: VI, HI, and DSI were significantly associated with MCR, but MR analysis failed to provide evidence of their causal relationship. Emphasized the importance of sensory impairment screening in identifying high-risk populations for dementia.
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Demência , Análise da Randomização Mendeliana , Humanos , Estudos Transversais , Estudos Longitudinais , Audição , Síndrome , CogniçãoRESUMO
Cities are increasingly vital in global carbon mitigation efforts, yet few have specifically tailored carbon neutrality pathways. Furthermore, out-of-boundary indirect greenhouse gas (GHG) emissions, aside from those related to electricity and heat imports, are often overlooked in existing pathways, despite their significance in comprehensive carbon mitigation strategies. Addressing this gap, here we introduce an integrated analysis framework focusing on both production and consumption-related GHG emissions. Applied to Wuyishan, a service-oriented city in Southern China, this framework provides a holistic view of a city's carbon neutrality pathway, from a full-scope GHG emission perspective. The findings reveal the equal importance of carbon reduction within and outside the city's boundaries, with out-of-boundary emissions accounting for 42% of Wuyishan's present total GHG emissions. This insight highlights the necessity of including these external factors in GHG accounting and mitigation strategy development. This framework serves as a practical tool for cities, particularly in developing countries, to craft effective carbon neutrality roadmaps that encompass the full spectrum of GHG emissions.
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Selenium nanoparticles (SeNPs) have gained significant attention in the fields of medicine and healthcare products due to their various biological activities and low toxicity. In this study, we focused on genetically modifying the Saccharomyces cerevisiae strain YW16 (CICC 1406), which has the ability to efficiently reduce sodium selenite and produce red SeNPs. By overexpressing genes involved in glutathione production, we successfully increased the glutathione titer of the modified strain YJ003 from 41.0 mg/L to 212.0 mg/L. Moreover, we improved the conversion rate of 2.0 g/L sodium selenite from 49.3% to 59.6%. Furthermore, we identified three surface proteins of SeNPs, and found that overexpression of Act1, one of the identified proteins, led to increased stability of SeNPs across different acid-base and temperature conditions. Through a 135-h feed fermentation process using 5.0 g/L sodium selenite, we achieved an impressive conversion rate of 88.7% for sodium selenite, and each gram of SeNPs contained 195.7 mg of selenium. Overall, our findings present an efficient method for yeast to synthesize SeNPs with high stability. These SeNPs hold great potential for applications in nanomedicine or as nutritional supplements to address selenium deficiency.
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Nanopartículas , Selênio , Selênio/metabolismo , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/metabolismo , Selenito de Sódio , Nanopartículas/metabolismo , Glutationa/metabolismoRESUMO
Longitudinal snoring changes can be captured using a mobile phone application. During hypoglossal nerve stimulator (HNS) therapy up-titration, increasing stimulation voltage was associated with reduced snoring frequency and intensity in this case series of six patients. Laryngoscope, 134:987-992, 2024.
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Telefone Celular , Terapia por Estimulação Elétrica , Apneia Obstrutiva do Sono , Humanos , Apneia Obstrutiva do Sono/terapia , Ronco/terapia , Nervo HipoglossoRESUMO
Co-controlling the emissions of air pollutants and CO2 from automobiles is crucial for addressing the intertwined challenges of air pollution and climate change in China. Here, we analyze the synergetic characteristics of air pollutant and CO2 emissions from China's on-road transportation and identify the co-drivers influencing these trends. Using detailed emission inventories and employing index decomposition analysis, we found that despite notable progress in pollution control, minimizing on-road CO2 emissions remains a formidable task. Over 2010-2020, the estimated sectoral emissions of VOCs, NOx, PM2.5, and CO declined by 49.9%, 25.9%, 75.2%, and 63.5%, respectively, while CO2 emissions increased by 46.1%. Light-duty passenger vehicles and heavy-duty trucks have been identified as the primary contributors to carbon-pollution co-emissions, highlighting the need for tailored policies. The driver analysis indicates that socioeconomic changes are primary drivers of emission growth, while policy controls, particularly advances in emission efficiency, can facilitate co-reductions. Regional disparities emphasize the need for policy refinement, including reducing dependency on fuel vehicles in the passenger subsector and prioritizing co-reduction strategies in high-emission provinces in the freight subsector. Overall, our study confirms the effectiveness of China's on-road control policies and provides valuable insights for future policy makers in China and other similarly positioned developing countries.
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Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Dióxido de Carbono/análise , Emissões de Veículos/análise , Poluição do Ar/análise , China , Meios de Transporte , Monitoramento AmbientalRESUMO
BACKGROUND: The interaction between microorganisms and medicinal plants is a popular topic. Previous studies consistently reported that microorganisms were mainly considered pathogens or contaminants. However, with the development of microbial detection technology, it has been demonstrated that fungi and bacteria affect beneficially the medicinal plant production chain. AIM OF REVIEW: Microorganisms greatly affect medicinal plants, with microbial biosynthesis a high regarded topic in medicinal plant-microbial interactions. However, it lacks a systematic review discussing this relationship. Current microbial detection technologies also have certain advantages and disadvantages, it is essential to compare the characteristics of various technologies. KEY SCIENTIFIC CONCEPTS OF REVIEW: This review first illustrates the role of fungi and bacteria in various medicinal plant production procedures, discusses the development of microbial detection and identification technologies in recent years, and concludes with microbial biosynthesis of natural products. The relationship between fungi, bacteria, and medicinal plants is discussed comprehensively. We also propose a future research model and direction for further studies.
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Finding effective therapeutic targets to treat NRAS-mutated melanoma remains a challenge. Long non-coding RNAs (lncRNAs) recently emerged as essential regulators of tumorigenesis. Using a discovery approach combining experimental models and unbiased computational analysis complemented by validation in patient biospecimens, we identified a nuclear-enriched lncRNA (AC004540.4) that is upregulated in NRAS/MAPK-dependent melanoma, and that we named T-RECS. Considering potential innovative treatment strategies, we designed antisense oligonucleotides (ASOs) to target T-RECS. T-RECS ASOs reduced the growth of melanoma cells and induced apoptotic cell death, while having minimal impacton normal primary melanocytes. Mechanistically, treatment with T-RECS ASOs downregulated the activity of pro-survival kinases and reduced the protein stability of hnRNPA2/B1, a pro-oncogenic regulator of MAPK signaling. Using patient- and cell line- derived tumor xenograft mouse models, we demonstrated that systemic treatment with T-RECS ASOs significantly suppressed the growth of melanoma tumors, with no noticeable toxicity. ASO-mediated T-RECS inhibition represents a promising RNA-targeting approach to improve the outcome of MAPK pathway-activated melanoma.
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BACKGROUND: Long-term exposure to ambient fine particulate matter (PM2.5) has been linked to an increased risk of stroke. However, the effect of long-term exposure to PM2.5 and its major components on the functional disability of stroke patients remains unclear. METHODS: Based on China National Stroke Screening Survey data obtained from 2013 to 2019, we conducted a national multicenter longitudinal study of the associations of long-term exposure to PM2.5 and its components with the risk of disability after stroke in China. Post-stroke disability was assessed using the modified Rankin scale (mRS), which ranges from 0 to 5, with higher scores indicating greater disability. Long-term exposure to PM2.5 and its five components [sulfate (SO42-), nitrate (NO3-), ammonium salt (NH4+), organic matter (OM), and black carbon (BC)] was determined based on average concentrations during the 3 years preceding mRS administration according to the geographic coordinates of residential communities, using state-of-the-art estimates from multiple sources. We used a fixed-effect model to evaluate the associations between mRS scores and PM2.5 exposure, with adjustment for multiple covariates. RESULTS: Every 10 µg/m3 increase in PM2.5 was associated with a 0.019 (95% confidence interval, 0.003, 0.036) increase in mRS score, but the effect was not significant after adjusting for all covariates [0.016 (95% CI, -0.003, 0.032)]. For PM2.5 components, each IQR (7.92 µg/m3) increment in OM exposure was associated significantly with 0.062 (95% CI, 0.013, 0.111) increment in the mRS score. A significant association was observed between SO42- exposure and the mRS score [0.057 (95% CI, 0.003, 0.112), per IQR: 6.28⯵g/m3]. However, no significant association was found with BC, NO3-, or NH4+ exposure. Furthermore, the nonlinear curves were observed for the exposure-response relationship between PM2.5 exposure and the mRS score. CONCLUSION: Greater PM2.5 exposure increased the mRS score and was associated with post-stroke functional disability among stroke patients. However, different chemical components showed unequal neurotoxic effects, and long-term exposure to OM and SO42- may play a more important role. SYNOPSIS: This study reports fine particulate matter at higher concentrations damages the functional ability among specific stroke patients, and PM2.5 components have different neurotoxicities.
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Síndromes Neurotóxicas , Humanos , Estudos Longitudinais , China/epidemiologia , Nitratos , Material Particulado , FuligemRESUMO
Due to global warming, an increased number of open fires is becoming a major contributor to PM2.5 pollution and thus a threat to public health. However, the burden of stillbirths attributable to fire-sourced PM2.5 is unknown. In low- and middle-income countries (LMICs), there is a co-occurrence of high baseline stillbirth rates and frequent firestorms, which may lead to a geographic disparity. Across 54 LMICs, we conducted a self-matched case-control study, making stillbirths comparable to the corresponding livebirths in terms of time-invariant characteristics (e.g., genetics) and duration of gestational exposure. We established a joint-exposure-response function (JERF) by simultaneously associating stillbirth with fire- and non-fire-sourced PM2.5 concentrations, which were estimated by fusing multi-source data, such as chemical transport model simulations and satellite observations. During 2000-2014, 35,590 pregnancies were selected from multiple Demographic and Health Surveys. In each mother, a case of stillbirth was compared to her livebirth(s) based on gestational exposure to fire-sourced PM2.5. We further applied the JERF to assess stillbirths attributable to fire-sourced PM2.5 in 136 non-Western countries. The disparity was evaluated using the Gini index. The risk of stillbirth increased by 17.4% (95% confidence interval [CI]: 1.6-35.7%) per 10 µg/m3 increase in fire-sourced PM2.5. In 2014, referring to a minimum-risk exposure level of 10 µg/m3, total and fire-sourced PM2.5 contributed to 922,860 (95% CI: 578,451-1,183,720) and 49,951 (95% CI: 3,634-92,629) stillbirths, of which 10% were clustered within the 6.4% and 0.6% highest-exposure pregnancies, respectively. The Gini index of stillbirths attributable to fire-sourced PM2.5 was 0.65, much higher than for total PM2.5 (0.28). Protecting pregnant women against PM2.5 exposure during wildfires is critical to avoid stillbirths, as the burden of fire-associated stillbirths leads to a geographic disparity in maternal health.