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The deep seabed mining regime is composed of international legislation and domestic counterparts. International legislation emanates from the International Seabed Authority (ISA) under the mandate of UNCLOS, which is currently in the accelerated process of being drafted for exploitation activities to meet a deadline of July 2023. In contrast, the development of domestic law in ISA Member States has been relatively slow, and this risks failure to fulfill their obligation of “responsibility to ensure” concluded in the advisory opinion in 2011. This possible failure is partly due to States’ different understanding of their obligation to impose more stringent environmental conditions on contractors in their domestic laws than those specified in the Mining Code adopted by ISA. This paper argues that Annex III, article 21(3) of the UNCLOS requires States to adopt a two-tier approach in their national legislation—minimal and optimal levels. The minimal level requires a sponsoring State to comply with the Mining Code’s fundamental requirements while reaching the optimal level means that the sponsoring State tries its best to establish more stringent standards than the Mining Code. Adopting more stringent requirements may be realized by adopting higher or stricter standards or inserting more details in the national legislation. Moreover, all ISA Member States are, including developing States, obliged to meet the minimum line and encouraged to move towards the optimal one

Background. This study is aimed at evaluating the diagnostic efficacy of ultrasound-based risk stratification for thyroid nodules in the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) and the American Thyroid Association (ATA) risk stratification systems. Methods. 286 patients with thyroid cancer were included in the tumor group, with 259 nontumor cases included in the nontumor group. The ACR TI-RADS and ATA risk stratification systems assessed all thyroid nodules for malignant risks. The diagnostic effect of ACR and ATA risk stratification system for thyroid nodules was evaluated by receiver operating characteristic (ROC) analysis using postoperative pathological diagnosis as the gold standard. Results. The distributions and mean scores of ACR and ATA rating risk stratification were significantly different between the tumor and nontumor groups. The lesion diameter > 1 cm subgroup had higher malignant ultrasound feature rates detected and ACR and ATA scores. A significant difference was not found in the ACR and ATA scores between patients with or without Hashimoto’s disease. The area under the receiver operating curve (AUC) for the ACR TI-RADS and the ATA systems was 0.891 and 0.896, respectively. The ACR had better specificity (0.90) while the ATA system had higher sensitivity (0.92), with both scenarios having almost the same overall diagnostic accuracy (0.84). Conclusion. Both the ACR TI-RADS and the ATA risk stratification systems provide a clinically feasible thyroid malignant risk classification, with high thyroid nodule malignant risk diagnostic efficacy.

Description, China has made substantial progress towards global targets for conserving coastal habitats but less headway for deeper waters., China’s stature as the world’s major producer and consumer of seafood is legendary, but its long-standing tradition of protecting marine life domestically is virtually unknown. We present the most comprehensive database on area-based marine conservation in China including 326 sites that conserve 12.98% of China’s seas and address 142 conservation objectives. Twenty-two percent of shallow habitats (50 meters) are critical to protect, yet

Companies and legal persons intending to conduct activities in the Area must be sponsored by a State Party of the UNCLOS, which constitute a “dual-track mechanism” with ISA as a primary regulator and sponsoring state as a secondary regulator. This regime setting places companies and legal persons subject to international and national legislation simultaneously. The sponsoring state’s national legislation is thus an integrated part of the DSM regime. This resolves the defects that private entities in DSM are not subject to international law and weak enforcement of international organizations. However, UNCLOS neither draws a clear line of competence between the sponsoring state and the ISA nor provides compulsory components that national legislation should contain, resulting in the disparity between the objective of the establishment of sponsorship and the status quo of the sponsoring state’s role and its national legislation. This paper analyzes the competence of a sponsoring state and regulatory aspects it should focus on to assist the ISA and further proposes such components of the national legislation contributing to the DSM regime.

China has undergone massive economic development over the last several decades, but at the cost of serious environmental degradation, including to coastal and marine ecosystems. This paper describes the governance arrangements for management of coastal and marine areas of southern, mainland China and Hong Kong, especially marine protected areas (MPAs). Although not widely recognized internationally, there are 123 designated MPAs spread across the South China Sea coast. However, the effectiveness of these MPAs in conservation of ecosystem goods and services is seriously limited by a familiar range of pressures, including limited resources, insufficient enforcement and massive coastal development. Recent developments in national policy include integration of all protected areas (including marine) under a single agency, a range of limits on coastal development and water pollution, and the strategy of 'eco-civilization' to balance environmental management with economic development. If successfully implemented, these policies would profoundly change the course of marine environments in China, with globally significant consequences. Recommendations for improving MPA performance in China include: ensuring that marine systems are not overwhelmed within the new national jurisdiction, and maintaining and enhancing marine capacity; increased resourcing, supported by comprehensive and systematic economic valuations of ecosystem goods and services and natural capital; upgraded enforcement of existing environmental laws and regulations, combined with further refinement and development, especially around cumulative impact management; a particular focus on major reduction in water pollution in all forms; integration of marine management between Hong Kong SAR and surrounding Guangdong Province; and enhanced community engagement, participation and education. Finally, much greater, collaborative engagement by the international community with Chinese marine management and conservation would bring major, and very mutual, benefits.

Aim This study aimed to investigate the current situation of the spiritual health of maintenance haemodialysis (MHD) patients in China and analyse the influencing factors. Methods A total of 418 patients who underwent maintenance haemodialysis in three grade A tertiary hospitals were selected. The influencing factors were evaluated with demographic questionnaire, the Functional Assessment of Chronic Illness Therapy‐Spiritual Well‐Being (FACIT‐Sp‐12), Family APGAR Index, Herth Hope Index (HHI) and Acceptance of Illness Scale (AIS). Results Spiritual health was positively correlated with the HHI, Family APGAR and AIS scores. Nationality, HHI score, Family APGAR score and AIS score were independent influencing factors of spiritual health. MHD patients had a moderate level of spiritual health. Nationality, hope, family function and acceptance of illness were significant predictors of spiritual health. Patients who have higher hope levels, better family functioning and better illness acceptance may maintain better spiritual health.

China’s 13th Five-Year Plan, launched in March 2016, provides a sound policy platform for the protection of marine ecosystems and the restoration of capture fisheries within China’s exclusive economic zone. What distinguishes China among many other countries striving for marine fisheries reform is its size—accounting for almost one-fifth of global catch volume—and the unique cultural context of its economic and resource management. In this paper, we trace the history of Chinese government priorities, policies, and outcomes related to marine fisheries since the 1978 Economic Reform, and examine how the current leadership’s agenda for “ecological civilization” could successfully transform marine resource management in the coming years. We show how China, like many other countries, has experienced a decline in the average trophic level of its capture fisheries during the past few decades, and how its policy design, implementation, and enforcement have influenced the status of its wild fish stocks. To reverse the trend in declining fish stocks, the government is introducing a series of new programs for sustainable fisheries and aquaculture, with greater traceability and accountability in marine resource management and area controls on coastal development. As impressive as these new plans are on paper, we conclude that serious institutional reforms will be needed to achieve a true paradigm shift in marine fisheries management in China. In particular, we recommend new institutions for science-based fisheries management, secure fishing access, policy consistency across provinces, educational programs for fisheries managers, and increasing public access to scientific data.

AIM AND OBJECTIVE We investigated the correlation between the frailty status of maintenance haemodialysis (MHD) patients and psychosocial factors. BACKGROUND Varying degrees of frailty have been reported in MHD patients, which affect their quality of life. DESIGN We adopted a cross-sectional design in this study. METHODS Clinical data of 187 patients at our centre were collected from December 2017-June 2018 using a cross-sectional survey. Psychosocial factors were measured using the Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale, 10-item Connor-Davidson Resilience Scale (CD-RISC), Chronic Disease Self-Efficacy Scales and Perceived Social Support Scale. Frailty status was estimated using the fatigue, resistance, ambulation, illnesses and loss of weight (FRAIL) scale. Spearman's correlation and multiple logistic regression analysis were conducted to identify the risk factors for frailty. This study complied with the STROBE checklist. RESULTS Of 187 patients, 11 cases (5.9%) of frailty were identified. Patient's age, comorbidities, parathyroid hormone level, sleep quality and depression were positively correlated with frailty (p

PURPOSE We conducted a cross-sectional investigation of health-related quality of life (HRQOL) among maintenance haemodialysis (MHD) patients, and determined important predictive factors of HRQOL in these patients. METHODS Psychological factors were evaluated with the Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI) and the General Self-Efficacy Scale (GSES). HRQOL was evaluated with the EQ-5D. Laboratory data (albumin, haemoglobin and C-reactive protein) were collected for medical evaluation. We also collected participants' demographic data, including gender, age, et al. This study was in compliance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. RESULTS The mean EQ-5D score was 0.86 ± 0.12, mean HADS-anxiety score was 5.27 ± 3.41, mean HADS-depression score was 5.29 ± 3.58, mean PSQI score was 7.00 ± 4.23 and mean GSES score was 6.86 ± 2.03. Participants' mean haemoglobin was 108.18 ± 16.45 g/L, mean albumin was 41.80 ± 4.61 g/L and mean C-reactive protein was 8.88 ± 18.50 mg/L. HRQOL was negatively correlated with HADS-anxiety (r = -0.390, p

This paper discusses fisheries co-operation between China and Vietnam for the Gulf of Tonkin. It first reviews their fisheries relations to illustrate how their overall political relations affected the management of their shared stocks and resulted in a negative impact on the progress that led to the conclusion of the Sino-Vietnamese Fisheries Agreement. It then analyses the management measures pertaining to the Agreed Zones under this Agreement, and emphasises the improvement of its co-operation mechanism for the long-term utilisation of shared resources. The paper highlights the achievements of the Agreement and pinpoints the crucial role of implementation to the success of the fisheries co-operation.