Large scale planted forests (PF) have been given a higher priority in China for improving the environment and mitigating climate change relative to natural forests (NF). However, the ecological consequences of these PF on water resource security have been less considered in the national scale. Moreover, a critically-needed comparison on key ecological effects between PF and NF under climate change has rarely been conducted. Here we compare carbon sequestration and water consumption in PF and NF across China using combination of remote sensing and field inventory. We found that, on average, NF consumed 6.8% (37.5 mm growing season-1 ) less water but sequestered 1.1% (12.5 gC m-2 growing season-1 ) more carbon than PF in the period of 2000-2012. While there was no significant difference in water consumption (p = 0.6) between PF and NF in energy-limited areas (dryness index < 1), water consumption was significantly (p < 0.001) higher in PF than that in NF in water-limited regions (dryness index > 1). Moreover, a distinct and larger shift of water yield was identified in PF than in NF from the 1980s to the 2000s, indicating that PF were more sensitive to climate change, leading to a higher water consumption when compared with NF. Our results suggest NF should be properly valued in terms of maximizing the benefits of carbon sequestration and water yield. Future forest plantation projects should be planned with caution, particularly in water-limited regions where they might have less positive effect on carbon sequestration but lead to significant water yield reduction. This article is protected by copyright. All rights reserved.

Afatinib is an effective therapy for metastatic non-small cell lung cancer (NSCLC) but it is associated with a relatively high incidence of severe diarrhea. The association between pre-treatment candidate predictors (age, sex, race, performance status, renal function, hemoglobin, and measures of body mass) and severe (grade ≥ 3) diarrhea was evaluated using logistic regression with pooled individual participant data from seven clinical studies. A risk score was developed based on the count of major risk factors. Overall, 184 of 1151 participants (16%) experienced severe diarrhea with use of afatinib. Body weight, body mass index, and body surface area all exhibited a prominent non-linear association where risk increased markedly at the lower range (p < 0.005). Low weight (<45 kg), female sex, and older age (≥60 years) were identified as major independent risk factors (p < 0.01). Each risk factor was associated with a two-fold increase in the odds of severe diarrhea, and this was consistent between individuals commenced on 40 mg or 50 mg afatinib. A simple risk score based on the count of these risk factors identifies individuals at lowest and highest risk (C-statistic of 0.65). Risk of severe diarrhea for individuals commenced on 40 mg afatinib ranged from 6% for individuals with no risk factors to 33% for individuals with all three risk factors.