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The Green Belt and Road Initiative was proposed by the Chinese government to address the environmental challenges related to the Belt and Road Initiative (BRI). The BRI International Green Development Coalition (BRIGC), a flagship initiative of the Green BRI, aims to promote the BRI's environmental performance through transnational governance measures. In this study, we analyzed the BRIGC from the perspective of orchestration theory. We developed a model of causal pathways to understand the micro-steps linking orchestrators, intermediaries, and targets. Furthermore, drawing on first-hand evidence collected through participatory observation, interviews, and focus groups, we identified four key pathways of green orchestration: green consumerism, green infrastructure, green finance, and green governance. We found that the orchestration processes were hampered by the lack of substantial input from the BRIGC, which undermined the intermediary-target relationship. We concluded with recommendations for the BRIGC to strengthen its orchestration capacity. [ABSTRACT FROM AUTHOR]

In the book "Ecological States: Politics of Science and Nature in Urbanizing China" by Jesse Rodenbiker, the concept of ecological civilization in China is examined as a political project that allows the state to shape nature, society, and space. The book explores how ecology has been used to consolidate state power and how ordinary individuals navigate within the state's vision of ecocivilization. It also delves into the relationship between aesthetics, science, and ecology in ecological civilization. The book provides insights into the politics of ecological civilization in China, including the displacement of rural populations and the contradictions of environmental governance. Overall, it is a valuable resource for understanding environmental politics in China. [Extracted from the article]

The burden of adverse cardiorenal outcomes among patients with the trifecta of diabetes, heart failure (HF) and chronic kidney disease (CKD) remains high. Steroidal mineralocorticoid receptor antagonists (MRAs) have been shown to improve clinical outcomes in patients with HF, however, there is significant underutilization of these agents, especially in patients with advanced CKD. Non-steroidal MRAs are an emerging therapeutic option for patients with diabetic kidney disease and are now guideline-supported in this population. Non-steroidal MRAs have a unique pharmacological profile distinct from their steroidal counterparts that retains the class-specific cardiorenal benefits but may help mitigate adverse effects, especially hyperkalaemia, in patients with CKD. In this review we summarize the current evidence on the use of non-steroidal MRAs for improving cardiorenal outcomes in patients with CKD and diabetes, as well as for combination use alongside other foundational medical therapies used in HF and CKD. [ABSTRACT FROM AUTHOR]

• Small molecules have been proposed as alternatives to regenerate bone tissue. • Small molecule drug dose can often be reduced while still achieving effective therapeutic. • The potential to improve bone repair by making it safer, easier, and more cost-effective with the use of a small molecule delivered in the short-term. Osteogenic small molecules have been adapted as one of the encouraging approaches to regenerate bone tissue. Small molecules used long term will usually result in adverse effects. A novel approach is short-term treatment with osteogenic small molecules. Demonstrating effectiveness for regenerating bone with a short-term treatment or a single-dose administration of osteogenic small molecules could enhance safety by reducing adverse effects. Over the past few years, many small molecules with the potential of regenerating bone tissue have been reported when used for short-term or single-dose administration. Here, I review the relevant literature, paying particular attention to prospects for small molecule-mediated bone regeneration with short-term exposure. [ABSTRACT FROM AUTHOR]

This paper develops a political perspective of just transition by linking the just transition concept with the concept of policy implementation, thereby drawing attention to the role of local policy implementers in the process and outcome of just transition. Focusing on the Chinese political context, it examines the degree of implementation flexibility in a broader context of authoritarian environmentalism. Implementation flexibility at the local level has been an enduring feature of Chinese environmental governance and can be considered as a key political process through which just transition can be achieved. However, recent studies suggest that the strengthening of top-down control over the environment means that the implementation process has become less flexible. Drawing on a case study of a logging town in the Greater Khingan Range transitioning under the National Forest Conservation Program, we found that while the strengthening of top-down control has resulted in an elevated level of compliance, flexibility remains an important dynamic in policy implementation. As such, local policy implementers still play an important role in just transition. This persistence of implementation flexibility is driven by a combination of local priorities, implementation difficulties, and top-down control. [ABSTRACT FROM AUTHOR]

Introduction: Venous thromboembolism (VTE) is reported in up to 27% of patients with COVID‐19 due to SARS‐CoV‐2 infection. Dysregulated systemic inflammation and various patient traits are presumed to underlie this anomaly. Optimal VTE prophylaxis in COVID‐19 patients has not been established due to a lack of validated models for predicting VTE in this population. Our study aims to address this deficiency by identifying demographic and clinical characteristics of COVID‐19 patients associated with increased VTE risk. Methods: This study is a retrospective analysis of all adult patients (final sample, n = 355) hospitalized with confirmed COVID‐19 at Einstein Medical Center Philadelphia between March 1 and April 24, 2020. Demographic and clinical patient data were collected and factors associated with VTE were identified and analyzed using t‐tests, multivariable logistic regression, and receiver operating characteristic (ROC) curves. Results: Thirty patients (8.5%) developed VTE. Patients with VTE had significantly higher D‐dimer levels on admission (P = 0.045) and peak D‐dimer levels (P < 0.0001), in addition to higher rates of vasopressor requirements (P = 0.038), intubation (P = 0.003), and death (P = 0.023). Age (OR 1.042), obstructive sleep apnea (OR 5.107), and need for intubation (OR 3.796) were associated with significantly increased odds of VTE. Peak D‐dimer level was a good predictor of VTE (AUC 0.806, P < 0.0001) and a D‐dimer cutoff of >6640 ng/mL had high (>70%) sensitivity and specificity for VTE. Conclusion: Peak D‐dimer level may be the most reliable clinical marker in COVID‐19 patients for predicting VTE and future prospective studies should attempt to further validate this. [ABSTRACT FROM AUTHOR]

Background COVID-19 is now a critical threat to global public health. Although the majority of patients present with respiratory illness, several studies have described multiorgan involvement. This study evaluated the prevailing patterns of liver enzymes in COVID-19 patients on admission and their association with clinical outcomes. Methods This was a single-center retrospective analysis of all inpatients with COVID-19. Demographic and clinical factors, and liver enzyme tests, including aspartate aminotransferase (AST) and alanine aminotransferase (ALT), were noted on admission. The association of liver enzyme elevation with outcomes such as inpatient death, need for intubation, and vasopressor use was determined using the chi-square test and multivariate regression analysis. Results Among 200 patients, AST and ALT elevation was seen in 55% and 20%, respectively. Alkaline phosphatase elevation was seen in 28%. AST elevation was associated with inpatient death (odds ratio [OR] 1.03, 95% confidence interval [CI] 1.01-1.05; P=0.035), need for vasopressors (OR 1.034, 95%CI 1.015-1.055; P=0.001), and intubation (OR 1.03, 95%CI 1.01-1.05; P=0.002). An AST/ALT ratio of 2 or more was seen in 34% of patients and was associated with need for intubation (OR 2.678, 95%CI 1.202-5.963; P=0.016), and need for vasopressors (OR 3.352, 95%CI 1.495-7.514; P=0.003). Conclusion Serum aminotransferase levels are useful markers of hepatocellular injury. Patients with elevated AST or AST/ALT ratio are at higher risk of severe disease, as evidenced by intubation, vasopressor use, and inpatient death. These patients should be monitored closely given their propensity for severe disease. [ABSTRACT FROM AUTHOR]

There is no current standardized approach to anticoagulation in patients with Coronavirus Disease 2019 (COVID-19) while potential bleeding risks remain. Our study characterizes the patterns of anticoagulation use in COVID-19 patients and the risk of related bleeding. This is a single center retrospective analysis of 355 adult patients with confirmed diagnosis of COVID-19 from March 1 to May 31, 2020. Chi-square was used to analyze the relationship between degree of anticoagulant dose and bleeding events by site. Multivariable logistic regression was used to look at factors associated with inpatient death. 61% of patients were being treated with prophylactic doses of anticoagulation, while 7% and 29% were being treated with sub-therapeutic and therapeutic anticoagulation (TA) doses respectively. In 44% of patients, we found that the decision to escalate the dose of anticoagulation was based on laboratory values characterizing the severity of COVID-19 such as rising D-dimer levels. There were significantly higher rates of bleeding from non-CNS/non-GI sites (p = 0.039) and from any bleeding site overall (p = 0.019) with TA. TA was associated with significantly higher rates of inpatient death (41.6% vs 15.3% p < 0.0001) compared to those without. All patients who developed CNS hemorrhage died p = 0.011. After multivariable logistic regression, only age OR 1.04 95% CI (1.01 to 1.07) p = 0.008 and therapeutic anticoagulation was associated with inpatient mortality OR 6.16 95% CI (2.96 to 12.83) p ≤ 0.0001. The use of TA was significantly associated with increased risk of bleeding. Bleeding in turn exhibited trends towards higher inpatient death among patients with COVID-19. These findings should be interpreted with caution and larger more controlled studies are needed to verify the net effects of anticoagulation in patients with COVID-19. • Major bleeding is associated with use of therapeutic anticoagulation in COVID-19. • Therapeutic anticoagulation has shown higher mortality and major bleeding trends. • Risks and benefits of anticoagulation in COVID-19 should be weighed cautiously. [ABSTRACT FROM AUTHOR]

Introduction: Chronic kidney disease is an independent risk factor for cardiovascular disease. Despite careful preoperative evaluation, there is a risk of acute coronary syndromes after kidney transplant. Methods: The National Inpatient Sample for the years 2004‐2013 was used for this retrospective cohort study. All adult patients undergoing kidney transplantation were identified using the appropriate ICD‐9‐CM codes. Multivariate logistic regression was used to identify predictors of acute coronary syndromes in the peri‐operative period after kidney transplantation. Results: A total of 147 431 kidney transplants were performed from 2004 through 2013 in the United States. The average peri‐operative in‐hospital mortality was 0.5%. Acute coronary syndrome occurred in 1.3% patients in the peri‐operative period. Half of patients with acute coronary syndromes had pre‐existing coronary artery disease. The strongest predictors of acute coronary syndromes included older age: 45‐64 years. OR 3.28 95% CI (1.85‐5.83), ≥65 years. OR 4.84 (2.59‐9.05), race: African American, OR 0.66 (0.47‐0.93) and pre‐existing coronary artery disease OR 3.83 (2.84‐5.15). The case fatality rates were 16.9% and 5.3% for STEMI and NSTEMI, respectively. The overall mortality for any ACS event was 7.1%. Conclusion: Acute coronary syndrome in the immediate peri‐operative period after kidney transplantation is rare but is associated with high rates of mortality. [ABSTRACT FROM AUTHOR]

Background: A lot remains unknown about the features and laboratory findings that may predict worse outcomes in patients with coronavirus disease 2019 (COVID‐19). The aim of this study was to evaluate the difference in complete blood count parameters and differential counts in patients hospitalized with COVID‐19 who survived compared to those who died. Design: We performed a single‐center retrospective study including 242 patients with confirmed COVID‐19. We described the characteristics of the complete blood count parameters in these patients. Mann‐Whitney U test was used to compare hematologic parameters of patients who died and those who survived; multivariate logistic regression was used to look for associations with mortality. Results: Patients with COVID‐19 who died had significantly lower median absolute monocyte count (AMC) (0.4 vs 0.5, P =.039) and median platelet count (169 vs 213, P =.009) compared to those who survived. Patients who died had a significantly higher neutrophil‐to‐lymphocyte ratio (6.4 vs 4.5, P =.001). The NLR was positively associated with death (OR = 1.038; 95% CI, 1.003‐1.074, P =.031), while AMC was inversely associated with death (OR = 0.200; 95% CI, 0.052‐0.761, P =.018). Conclusion: Among patients with COVID‐19, a lower AMC and higher NLR are associated with higher mortality. [ABSTRACT FROM AUTHOR]

Background: As health-care institutions mobilize resources to address the coronavirus disease 2019 (COVID-19) pandemic, palliative care may potentially be underutilized. It is important to assess the use of palliative care in response to the COVID-19 pandemic.Methods: This is a retrospective single-center study of patients with COVID-19 diagnosed via reverse transcriptase-polymerase chain reaction assay admitted between March 1, 2020, and April 24, 2020. An analysis of the utilization of palliative care in accordance with patient comorbidities and other characteristics was performed while considering clinical outcomes. Chi-square test was used to determine associations between categorical variables while t-tests were used to compare continuous variables.Results: The overall mortality rate was 21.5% (n = 52), and in 48% (n = 25) of these patients, palliative care was not involved. Fifty-nine percent (n = 24) of those who had palliative consults eventually elected for comfort measures and transitioned to hospice care. Among those classified as having severe COVID-19, only 40% (n = 31) had palliative care involvement. Of these patients with severe COVID-19, 68% (n = 52) died. Patients who got palliative care consults were of older age, had higher rates of intubation, a need for vasopressors, and were dead.Conclusion: There was a low utilization rate of palliative care in patients with COVID-19. Conscious utilization of palliative care is needed at the time of COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: In stereotactic body radiation therapy (SBRT) of solitary liver cancer, organ motion due to respiration is an important factor in the definition of planning target volume (PTV). This study evaluated the potential associations of target motion with gross tumour volume (GTV) size, tumour location, Child-Pugh score and intra-fraction treatment time in SBRT of liver cancer treated by CyberKnife.Methods: Translational motion data of 145 liver cancer patients, who were previously treated by CyberKnife with free breathing under tumour tracking, were recorded in the log files of the motion tracking system and analysed. The factors including target location based on liver segments, Child-Pugh score which was an indication of liver cirrhosis, GTV size and intra-fraction treatment time were recorded and their associations with the magnitude of target movement were evaluated.Results: Target location demonstrated significant association with the translational target motion in the supero-inferior (SI) and left-right (LR) directions but less in antero-posterior (AP) direction. Tumours located at the peripheral segments were more affected than the central segments. Child-Pugh score and GTV size were not significantly associated with target motion in any direction. Longer intra-fraction treatment time generally increased target motion in the SI and LR directions.Conclusion: In SBRT of liver cancer, the target motions in SI and LR directions were correlated with the location of target and treatment time, but not with Child-Pugh score and GTV size. These results should assist in deciding the GTV-PTV margin in SBRT treatment planning for solitary liver cancer. [ABSTRACT FROM AUTHOR]

Resource‐based cities (RBCs) whose economies depend primarily on exploiting and processing natural resources usually have rigid, singular, and low‐end industrial structures, which often cripples their ability to cope with external disturbances such as international resource price fluctuations and economic downturns. This paper quantitatively analyzes the economic resilience of RBCs in China in terms of resistance and recoverability during the Asian financial crisis and the global financial crisis. Furthermore, it identifies the main factors affecting resilience. There are four main findings: First, RBCs were quickly and negatively impacted by the Asian financial crisis, which suggests that economic resistance was generally low during this period. In the recovery period, while the rate of recovery was slow at the beginning, economic recoverability improved after 2002. Economic resistance and recoverability were found to have a strong negative correlation. Second, at the beginning of the global financial crisis, the economic resistance of RBCs was generally high. However, after 2012, the number of cities that were severely affected by the economic crisis increased rapidly. Third, economic resistance varied across different types of RBCs. Coal‐based and forestry‐based cities had lower economic resistance, while oil & gas‐based cities were more resistant. RBCs in the Eastern region generally had low economic resistance, while the economic resilience of recessionary cities was also low. Finally, while factors affecting the economic resilience varied across the two economic cycles, we found that economic development, labor conditions and, most of all, the industrial structure had a statistically significant negative effect on economic resilience. [ABSTRACT FROM AUTHOR]

Resource-dependent cities (RCs) are a vulnerable group of urban settlements that often face population shrinkage; however, population changes in RCs in China are not well understood. This study offers new insight into this matter through a robust analysis that features a longer time scale, a larger sample of RCs, and a finer unit of analysis. It finds new evidence that problems of population shrinkage in RCs are more serious than previous literature has suggested. Approximately 30% of the studied units have experienced either long-term or short-term population shrinkage, and many more are experiencing a slowing down of population growth. Problems are especially common among three types of RCs: the resource-depleted RCs, the forestry-based RCs, and RCs in Northeast China. These results underscore transition policy inadequacies in addressing population loss, and call for a more comprehensive and diversified population policy that tackles the multifaceted factors that contribute to population shrinkage, including lack of industrial support, maladjustment to market oriented reformation, poor urban environment and natural population decline. [ABSTRACT FROM AUTHOR]

The Low-Carbon Pilot (LCP) program in China is an important national initiative aiming to facilitate climate experimentation. Thus far, 87 local governments have become climate pilots and are tasked with developing innovative climate solutions with the hope that these innovations can be applied nationally. The LCP adopts a uniquely Chinese approach to policymaking that is characterized by both bottom-up experimentation and top-down control and has been described as a success in the official discourse. However, using two case studies from Guangdong and Jilin, we show that there could be significant variation in performance and willingness to conduct experimentation among the climate pilots. The presence of variation suggests that the top-down steering mechanisms of the LCP are not conducive to climate experimentation and have the unintended consequences of encouraging risk-averse behaviors. We further show that local factors – leadership support, communities of practice, and alignment of interests – are important factors enabling success. [ABSTRACT FROM AUTHOR]

Background: Recent guidelines have suggested avoiding beta-blockers in the setting of cocaine-associated acute coronary syndrome. However, the available evidence is both scarce and conflicted. The purpose of this systematic review and meta-analysis is to investigate the evidence pertaining to the use of beta-blockers in the setting of acute cocaine-related chest pain and its implication on clinical outcomes.Methods: Electronic databases were systematically searched to identify literature relevant to patients with cocaine-associated chest pain who were treated with or without beta-blockers. We examined the end-points of in-hospital all-cause mortality and myocardial infarction. Pooled risk ratios (RR) and their 95% confidence intervals (CI) were calculated for all outcomes using a random-effects model.Results: Five studies with a total of 1447 patients were included. Our analyses found no differences between patients treated with or without beta-blockers for either myocardial infarction (RR 1.08; 95% CI, 0.61-1.91) or all-cause mortality (RR 0.75; 95% CI, 0.46-1.24). Heterogeneity among included studies was low to moderate.Conclusion: This systematic review and meta-analysis suggests that beta-blocker use is not associated with adverse clinical outcomes in patients presenting with acute chest pain related to cocaine use. [ABSTRACT FROM AUTHOR]

This research examined the link between shopping mobility and travel CO2 emissions among suburban residents in Shenyang, China. We found suburban residents travelled 14.33 km and produced 1111.32 g of CO2 per shopping trip. The high emitters are mostly located at the urban fringe, travelling long distances and having a stronger dependency on cars. Furthermore, we used a binary logistic regression model to discover the main factors statistically significant in explaining private car usage. Evidence from this research indicates the need to formulate sustainable transport policies and reduce carbon emissions through compact urban forms and transit-oriented development. [ABSTRACT FROM AUTHOR]

Voluntary resettlement, typically framed by the principle of free, prior, and informed consent (FPIC), has emerged as a preferred alternative to the heavily criticized forced resettlement approach, but there are growing concerns over whether those “voluntary” programs are genuinely voluntary. In China, the government maintains that its poverty alleviation resettlement (PAR) program is a successful example of voluntary resettlement. Under this national anti-poverty initiative, millions of people living in the poorest parts of the country have been resettled “voluntarily”. However, few studies have critically examined this claim. In this study, we collected empirical evidence through a survey of PAR resettlers. Drawing on a large and representative household survey (1723 resettlers from 30 different PAR projects) and 142 qualitative interviews, we report inconclusive and conflicting findings. On the one hand, the respondents strongly expressed that they willingly participated in resettlement. The perception of willingness was especially high among those who were younger, wealthier, and had off-farm employment. Furthermore, the consent to relocate was mostly free and driven by a desire to improve the quality of life. On the other hand, we observed that consent was not fully informed due to inadequate consultation. The villagers were not given detailed information about the resettlement or time to consider the implications. To ensure genuinely voluntary resettlement and to enhance the effectiveness of the program in poverty alleviation, the government needs to improve the consultation process, offer more targeted assistance to poor households, and provide better post-resettlement support. [ABSTRACT FROM AUTHOR]

Prostate cancer displays a wide spectrum of clinical behaviour from biological indolence to rapidly lethal disease, but we remain unable to accurately predict an individual tumor’s future clinical course at an early curable stage. Beyond basic dimensions and volume calculations, tumor morphometry is an area that has received little attention, as it requires the analysis of the prostate gland and tumor foci in three-dimensions. Previous efforts to generate three-dimensional prostate models have required specialised graphics units and focused on the spatial distribution of tumors for optimisation of biopsy strategies rather than to generate novel morphometric variables such as tumor surface area. Here, we aimed to develop a method of creating three-dimensional models of a prostate’s pathological state post radical prostatectomy that allowed the derivation of surface areas and volumes of both prostate and tumors, to assess the method’s accuracy to known clinical data, and to perform initial investigation into the utility of morphometric variables in prostate cancer prognostication. Serial histology slides from 21 prostatectomy specimens covering a range of tumor sizes and pathologies were digitised. Computer generated three-dimensional models of tumor and prostate space filling models were reconstructed from these scanned images using Rhinoceros 4.0 spatial reconstruction software. Analysis of three-dimensional modelled prostate volume correlated only moderately with weak concordance to that from the clinical data (r = 0.552, θ = 0.405), but tumor volume correlated well with strong concordance (r = 0.949, θ = 0.876). We divided the cohort of 21 patients into those with features of aggressive tumor versus those without and found that larger tumor surface area (32.7 vs 3.4cc, p = 0.008) and a lower tumor surface area to volume ratio (4.7 vs 15.4, p = 0.008) were associated with aggressive tumor biology. [ABSTRACT FROM AUTHOR]

Promoting active travel behavior and decreasing transport-related carbon dioxide (CO) emissions have become a priority in many Chinese cities experiencing rapid urban sprawl and greater automobile dependence. However, there are few studies that holistically examine the physical and social factors associated with travel CO emissions. Using a survey of 1525 shoppers conducted in Shenyang, China, this study estimated shopping-related travel CO emissions and examined how the built environment and individual socioeconomic characteristics contribute to shopping travel behavior and associated CO emissions. We found that, firstly, private car trips generate nearly eight times more carbon emissions than shopping trips using public transport, on average. Second, there was significant spatial autocorrelation with CO emissions per trip, and the highest carbon emissions were clustered in the inner suburbs and between the first and second circumferential roads. Third, shopping travel CO emissions per trip were negatively correlated with several built environment features including population density, the quantity of public transport stations, road density, and shop density. They were also found to be significantly related to the individual socio-economic characteristics of car ownership, employment status, and education level using a multinomial logistic regression model. These empirical findings have important policy implications, assisting in the development of measures that contribute to the sustainability of urban transportation and meet carbon mitigation targets. [ABSTRACT FROM AUTHOR]

Using data from the Economic Advisory Center of the State Information Center (SIC), we examined the spatial patterns of car sales in China at the prefectural level in 2012. We first analyzed the spatial distributions of car sales of different kinds of automakers (foreign automakers, Sino-foreign joint automakers, and Chinese automakers), and then identified spatial clusters using the local Moran's indexes. Location quotient analysis was applied to examine the relative advantage of each type of automaker in the local markets. To explain the variations of car sales across cities, we collected several socioeconomic variables and conducted regression analyses. Further, factor analysis was used to extract independent variables to avoid the problem of multicollinearity. By incorporating a spatial lag or spatial error in the models, we calibrated our spatial regression models to address the spatial dependence problem. The analytical results show that car sales varied significantly across cities in China, and most of the cities with higher car sales were the developed cities. Different automakers exhibit diverse spatial patterns in terms of car sales volume, spatial clusters, and location quotients. The scale and incomes factor were extracted and verified as the two most significant and positive factors that shape the spatial distributions of car sales, and together with the spatial effect, explained most of the variations of car sales across cities. [ABSTRACT FROM AUTHOR]

Rural electrification is a crucial process of enhancing the modern energy access of rural communities which is an important global development goal. Electric cooperatives have played an important role as drivers of rural electrification worldwide, both historically and contemporaneously. The emerging role of cooperatives in rural electrification is yet to be examined in the context of East Africa, a region that experiences serious infrastructure deficits alongside widespread rural poverty. This study adopts a political economy perspective to explore the roles and challenges of cooperatives in rural electrification in Uganda. Through a high-level case study of two electric cooperatives, we show that while the cooperatives can deliver rural electrification, they face a series of political and economic challenges in fulfilling their mission. To enhance rural electrification through cooperatives, the challenges should be addressed by policy solutions: (1) providing more support to rural households that cannot afford electricity; (2) providing further support to cooperatives to avoid overburdening the community; (3) enhancing investment to upgrade the grid and extend its geographical coverage; and (4) exploring new financial and technological options for rural electrification. We expect the findings of this study to be useful to policymakers, implementers, cooperatives, and international donors currently working in rural electrification in Africa and beyond. [ABSTRACT FROM AUTHOR]

The effective use of land in Northeast China is of great significance for ensuring national food security and regional rural revitalization. In this study, based on the survey data collected from Jilin Province, Northeast China, we analyzed the vacancy rates of rural homesteads in suburban, outer suburban, and remote villages, as well as the withdrawal intention of rural-settled farmers, urban-settled farmers, and farmers with urban and rural dual residency from vacant homesteads. From the perspective of farmers' perceptions, this study constructed a theoretical framework of the influence mechanism of their withdrawal intention and analyzed such mechanism by constructing a structural equation model. The results indicated that: 1) rural homestead vacancy rates increased with distance from the village to the city. 2) rural-settled farmers showed a low withdrawal intention for vacant rural homesteads, followed by urban and rural dual-residence farmers, and urban-settled farmers showed the highest withdrawal intention. 3) the relative importance of the factors influencing withdrawal intention is in the following order: policy awareness > interest perception > living environment perception > family characteristics. Finally, this study discussed the reformation of the homestead system and rural homestead transition in Northeast China, which can provide policy support to increase the potential of cultivated land and promote sustainable rural development and urban-rural coordination. [ABSTRACT FROM AUTHOR]

Environmental justice is a key concept for understanding the contested relationship between pastoralism and conservation. Our study adopted a political approach to examine conservation, pastoralism, and justice in the context of the grazing ban policy in China. Employing a qualitative, in-depth case study, we investigated the local political actors and processes that lead to environmental (in)justice. The evidence shows how injustice is perpetuated by both centralized and decentralized political processes and how herders use their knowledge and strategies in resistance to the injustice. In addition, the study contributed to a pluralistic understanding of justice by examining the different notions of justice held by the herders. We found that herders perceive injustices through different lenses, namely economic, ecological, and cultural aspects. Further, the similarities and differences between Han and Mongolian herders are discussed in terms of their notions of environmental justice and counteractions. [ABSTRACT FROM AUTHOR]

Valacyclovir neurotoxicity is commonly seen in the elderly and those with impaired renal function. Differential diagnosis can be challenging as a myriad of medical conditions, including herpes zoster virus associated encephalitis, may present in a similar fashion. We present a case of a 71-year-old male who presented with altered mental status in the setting of recent herpes zoster eruption. His condition was attributed to valacyclovir neurotoxicity, and initiation of appropriate supportive therapy was met with complete resolution of symptoms and normalization of cognitive function. [ABSTRACT FROM AUTHOR]

The microgrid is a new concept in China and may potentially play an important role in enhancing the resilience and sustainability of electricity generation and distribution. However, the development of microgrids faces many challenges. This study examines the barriers to microgrid development using a case study of a pilot zone in Qingdao. Drawing on the theories of multi-level perspective and multi-actor perspective, we presented new empirical evidence on how the pilot microgrid projects were rendered difficult by the resistance from the existing industrial regime and the challenging economic and socio-political environments. The monopoly of state-owned grid operators in electricity transmission and distribution is difficult to break at a local level. The findings deepen our understanding of the challenges encountered by innovators in China's microgrid development and hold implications for policymakers in making more targeted policy mixes to support energy transition activities. [ABSTRACT FROM AUTHOR]

Urban expansion is a controversial process where territorial conflicts of differing interests and objectives become manifest. The existing interpretations of urban expansion pay insufficient attention to the strategies deployed by municipal governments to resolve the territorial conflicts arising out of urban expansion. This paper identifies two key bargaining arenas through which municipal governments mitigate the territorial complications of urban expansion. First, administrative annexation not only involves municipal governments to gain control over more territory, but also entails strategies adopted to reconcile conflicts created by administrative restructuration, such as offering preferential fiscal and job arrangements. Second, land acquisition is not only about livelihood restoration of landless farmers but is also about converting them into citizens constituting new urban communities and integrating them into the urban mode of production. These bargaining arenas are the sites where the benefits and concessions of urban expansion are negotiated, and they play a key role in ensuring the smooth operation of urban expansion by resolving potential conflicts among stakeholders. • Territorial conflicts are common in urban expansion projects. • Territorial conflicts arising from administrative annexation and land acquisition • Territorial conflicts can be resolved through bargaining and compromises. [ABSTRACT FROM AUTHOR]

Lithium is widely used as a treatment of bipolar disorder, a neuropsychiatric disorder associated with disrupted circadian rhythms. Lithium is known to lengthen period and increase amplitude of circadian rhythms. One possible pathway for these effects involves inhibition of glycogen synthase kinase-3β (GSK-3β), which regulates degradation of CRY2, a canonical clock protein determining circadian period. CRY1 is also known to play important roles in regulating circadian period and phase, although there is no evidence that it is similarly phosphorylated by GSK-3β. In this paper, we tested the hypothesis that lithium affects circadian rhythms through CRYs. We cultured fibroblasts and slices of the suprachiasmatic nucleus (SCN), the master circadian pacemaker of the brain, from Cry1 -/-, Cry2 -/-, or wild-type (WT) mice bearing the PER2:LUC circadian reporter. Lithium was applied in the culture medium, and circadian rhythms of PER2 expression were measured. In WT and Cry2-/- fibroblasts, 10 mM lithium increased PER2 expression and rhythm amplitude but not period, and 1 mM lithium did not affect either period or amplitude. In non-rhythmic Cry1 -/- fibroblasts, 10 mM lithium increased PER2 expression. In SCN slices, 1 mM lithium lengthened period ∼1 h in all genotypes, but did not affect amplitude except in Cry2-/- SCN. Thus, the amplitude-enhancing effect of lithium in WT fibroblasts was unaffected by Cry2 knockout and occurred in the absence of period-lengthening, whereas the period-lengthening effect of lithium in WT SCN was unaffected by Cry1 or Cry2 knockout and occurred in the absence of rhythm amplification, suggesting that these two effects of lithium on circadian rhythms are independent of CRYs and of each other. [ABSTRACT FROM AUTHOR]

All mining cities need to address the problems associated with resource depletion. However, there are crucial differences between mining cities in transition economies and those in market economies. Through a case study from Daqing, which is also known as the oil capital of China, this article sheds light on how mining cities in transition economies transform economically in anticipation of the eventual decline in mining prosperity. With rich empirical evidence gathered through extensive fieldwork, this article argues that mining cities in transition economies are faced not only with problems stemming from the boom-and-bust economic cycles of the dominant mining industry and the inevitable exhaustion of resources, but also with issues associated with the legacy of planned economies. Therefore, the transformation of mining cities in transition economies is often situated in a multi-level governance framework. In contrast, the transformation of mining cities in market economies is mainly a local process in the sense that the key actors are local governments and community-based organisations. This case study contributes to the theorisation of mining cities in transition economies and the practical knowledge of those engaged in similar economic transformation. [ABSTRACT FROM AUTHOR]

Rumors are an important yet poorly understood dynamic in environmental politics, particularly regarding their role in environmental activism. Drawing on theories of rumors, environmental information governance, and environmental activism, we analyzed the eco-politics of rumors in a Chinese village that experienced rumor-fueled protests against the construction and operation of a limestone quarry. We make three arguments regarding the condition, control, and content of rumors. First, poor environmental information governance, driven by a development-first and prejudice-rich official narrative and the strategic behaviors of blame and accountability avoidance, provides an important condition for rumor formulation and circulation. Second, the generation and circulation of rumors can be understood as a collective sense-making process driven by the informal communication between external and internal sources of information. The ephemeral nature of communication and group sanctions on government supporters make it difficult for authorities to control rumors. Third, by conceptualizing rumors as information warfare against official narratives, we show that rumors can foster a sense of collective urgency, reframe a land-right protest into an environmental protest that is politically more likely to succeed, and undermine public trust in local authorities. The findings suggest that rumors are an important part of environmental politics in China because of their role in environmental activism. [ABSTRACT FROM AUTHOR]

Our study looked at the relationship between insulin use and clinical outcomes in COVID-19. A response to our article, written by Dr. Chia Sing Kow and Dr. Syed Shahzad Hasan raised a few questions. They mentioned our use of hemoglobin A1c may be inaccurate as the patients in our study had high rates of CKD or ESRD which could alter the hemoglobin A1c levels. However due to the limitations of our patient population and perhaps in a lot of other sample populations in the real-world setting, it was the most feasible way to represent glucose control.The writers also suggested that the use of metformin, a potential confounder, was also not adjusted for. This should be considered in future research but addition of too many variables in a regression model may lead to less reliability of results for our study.The letter writers also suggested that the results of our paper may lead to misinterpretation by readers and may influence providers to not use insulin therapy for their patients when necessary due to fear of worse outcomes in the setting of COVID-19. We reiterated that it is very important that the data not be misinterpreted, and that nowhere in our paper did we imply or suggest that patients who need insulin therapy to treat their diabetes should not receive proper therapy due to the association we delineated in our paper. Instead, more careful surveillance of patients with advanced diabetes is needed especially when admitted with COVID-19. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to examine the focuses, motivations and challenges of achieving campus sustainability in Chinese higher education institutions (HEIs). Design/methodology/approach -- A multisite case study was conducted in Changchun City, Jilin, where eight HEIs of various types were examined. Structured interviews with school managers, students and government officials were accompanied with analysis of relevant documents. Findings -- The focuses of sustainability among the studied HEIs were on water and energy conservation and on non-technical initiatives. The focuses can be explained by motivations and challenges. The HEIs are motivated by government and financial pressures and face challenges in limited accessibility to funding. The reliance of non-technical initiatives has negatively impacted student welfare and has become unpopular among students. Practical implications -- The government is advised to increase funding to HEIs in relation to sustainability and to make the funding more equitable. The HEIs are advised to modify sustainability practices that severely affect the daily lives of students, to share the benefits of water and energy conservation with their students and to involve students in sustainability governance. Originality/value -- This paper adds to the existing literature in two ways. First, it expands the geographical reach of the literature to developing countries, in general, and to China, in particular. Second, it adopts the multisite case study research approach to study the whole spectrum of Chinese HEIs and highlights the differences among these HEIs when it comes to sustainability. [ABSTRACT FROM AUTHOR]

Service-learning is an experiential pedagogy that encourages students to understand academic content through performing direct service at a community organization. While research supports the benefits of service-learning pedagogy for students, there are fewer articles or guidance to faculty on how to teach service-learning, especially to faculty who have no prior experience. As guided reflection is a central component to service-learning pedagogy, this article shares both professorial reflection on the author's learning trajectory as well as reflections ideas from the author's service-learning class geared towards incorporating a more reflection oriented methodology for students. Even in a class that is not service-learning based, these exercises might be incorporated into a class for the purposes of enhancing student learning. [ABSTRACT FROM AUTHOR]

State-owned forestry enterprises (SOFEs) in China, established during the Maoist era for forest exploitation, have undergone significant reorganization under the Natural Forest Conservation Program (NFCP). In this study, drawing on the perspectives of political ecology and a case study from a SOFE in the Greater Khingan Range in northeast China, we develop an eco-socialist perspective to understand this particular approach to forest conservation. The concept of eco-socialism is mobilized to describe how, as a form of all-encompassing social organization with overwhelming political, social, and economic power in the forestry regions, the eco-restructuring of SOFEs is key to the success of forest conservation. Four eco-restructuring processes have been identified: (1) declining timber sales and increasing central subsidies; (2) restructuring of work-units; (3) creating redundancies; and (4) developing new sustainable economic activities. Furthermore, these eco-restructuring processes, both mandated and supported by the central government, have a significant impact on state-society relationship. While the resources given by the central government allow SOFEs to maintain a stable relationship with some workers by providing them a relatively stable livelihood, the laid-off workers are the major victims of the process, as they suffer from loss of income, economic stability, and social self-esteem. This study enriches the literature by incorporating eco-socialist governmentality into the political ecology of forest conservation and illustrating how the political ecology perspective can be a powerful tool in the collective effort to craft sustainable and socially just futures in China. [ABSTRACT FROM AUTHOR]

This paper reviews the literature on urban carbon governance, which has become a burgeoning area of research. Since the early 1990s, the field has grown and diversified geographically, theoretically and methodologically, and now encompasses a wide range of topics, including governing techniques, limitations and challenges, central-local relations, municipal networks, network governance and grassroots initiatives. Given the increasingly global nature of low-carbon urbanism and governance, these studies have expanded our knowledge on the complexity and plurality of the role of cities in addressing climate change. This review serves as a consolidated guide for researchers, policymakers and students in this field. [ABSTRACT FROM PUBLISHER]

Abstract: The Chinese government has promulgated a wide variety of low-carbon initiatives to control the rapid growth of energy consumption and carbon emissions in the cities. Past records, however, show that the central government's policies are often poorly implemented or distorted by local officials. Using a case study from the city of Changchun, this paper examines how and why the issue of poor implementation persists despite the establishment of the Energy Conservation Target Responsibility System (ECTRS). As a key institutional mechanism providing local officials with political incentives to implement low-carbon policies, the ECTRS has been constrained by a number of problems, including a poorly designed scoring system, weak targets, the use of energy intensity instead of absolute energy consumption as a policy objective, and the lack of reliable local energy statistics. [Copyright &y& Elsevier]

Highlights: [•] Regenerative engineering has been recently proposed to regenerate complex tissue. [•] Therapeutic proteins have many limitations for their use in regenerating tissues. [•] Small-molecule-based therapeutics is emerging as an alternative strategy. [•] Small molecules may represent the next generation in musculoskeletal regenerative medicine. [ABSTRACT FROM AUTHOR]

Abstract: Renewable energy and energy efficiency (REEE) policies have far-reaching implications for energy security, climate change, economic competitiveness, pollution, and human livelihood. For these reasons, REEE has become a national priority for the Chinese government, particularly since 2005. This paper aims to critically review China's REEE policies in six sectors: electricity, industry, transportation, buildings, and local government. In addition to examining the progress China has made in the development and implementation of REEE policies, this review also identifies limitations and room for improvement. Finally, five policy recommendations are presented. [Copyright &y& Elsevier]

Efforts to commercialize green vehicles by the Chinese government have been met with surprisingly subdued consumer responses and with sales targets that fall far short to targets. This paper examines the barriers to the adoption of green vehicles in China from a consumer perspective, focusing on battery-only vehicles (BEVs). A web-based survey was conducted to solicit views from Chinese residents in November 2012. The results indicated that although the majority of respondents expressed interests in BEVs and agreed that BEVs were good for the environment and were cheaper to run, many respondents expressed concerns over them being inconvenient to charge, long charging times, limited battery longevity, limited vehicle range and high price. The greatest barrier was inconvenience to charge. The results also show that the level of interest, perception, and demands are significantly influenced by gender, age, income, education, and car ownership status. [ABSTRACT FROM AUTHOR]

Ethylene glycol (EG) is a toxic alcohol that causes central nervous system depression and multiple metabolic abnormalities including a high anion gap metabolic acidosis (HAGMA), elevated osmolal gap (OG), and acute kidney injury. Few case reports of EG intoxication report brain MRI findings. We describe an elderly female who was brought to the hospital because of altered mentation. We diagnosed her with EG toxicity and treated with fomepizole based on metabolic abnormalities and presence of urine calcium oxalate crystals. Our patient's brain MRI showed T2-hyperintense signals located in the midbrain, hippocampi, basal nuclei, and thalami consistent with previous MRI reports with confirmed EG toxicity. As in this case, a clear history of poisoning is not always available. However, antidote therapy with alcohol dehydrogenase blockade should be initiated if clinical data suggests EG intoxication. Our patient's EG concentration returned elevated two days after admission blood draw confirming the initial diagnosis. MRI of the brain may add diagnostic support to laboratory findings while awaiting a definitive EG concentration. [ABSTRACT FROM AUTHOR]

Abstract: The release of the Twelfth Five-Year Guideline for National Economic and Social Development in March 2011 marked the beginning of China’s Twelfth Five-Year Plan (12th FYP) period (2011–2015). Energy conservation continues to be a national priority. Since the release, new energy conservation policies and programs have been announced by many central ministries in accordance with the 12th FYP. Is this the beginning of a new paradigm or merely a continuation of the 11th FYP model? This paper describes and analyzes key changes in energy conservation since 2011, including a more conservative national energy conservation target, a more logical way of breaking down the target, new sectoral targets, the introduction of new programs, and the expansion of existing programs. However, one key problem of the 11th FYP period remains unresolved, namely the inability to shift the economy away from heavy industry. [Copyright &y& Elsevier]