Search Results (553)

This study evaluates how environmental regulation influences enterprise management practices in the YREB of China, which faces a dilemma between economic growth and ecological conservation. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines, a qualitative systematic review of empirical studies published between 2015 and 2025 was conducted. The data were retrieved via Web of Science and Scopus, supplemented by Google Scholar and ScienceDirect. Subsequently, thematic analysis and data visualization were conducted by MAXQDA 2024. The findings synthesize evidence across key themes, environmental information disclosure (EID), green innovation, governance adaptation, and regional disparity themes to synthesize key empirical findings. From the perspectives of Institutional Theory and Stakeholder Theory, the findings suggest that environmental regulation is not only a compliance burden, but also a force for enterprise change, driving EID practices and innovation-oriented competitive advantages. The results further suggest that when institutions are more developed or policy implementation is more stable, enterprises are better able to adjust, implying that downstream regions are more flexible than upstream regions. Other instruments to close the implementation gap and support sustainable development are multi-level governance, context-specific policy instruments, and Integrated Water Resource Management. Also, it may be highlighted that effectiveness in environmental governance relies on governance quality, institutional capacities, and regionally differentiated aspects. Future research should better identify causal mechanisms and improve cross-region learning to improve equitable and effective environmental governance in China’s evolving socio-ecological context. Full article

Background: Prostate cancer is a heterogeneous disease with variable clinical outcomes. If localized, the patient may be cured. However, prostate cancer is lethal if recurrence/progression to metastatic castrate resistant disease occurs. Thus, there is an unmet need to further understand the molecular underpinnings of this progression. Epidemiologic studies show that increased risk of developing and dying from prostate cancer has been associated with elevated serum IGF-1 levels, hyperinsulinemia and metabolic syndrome. Alterations in insulin pathway genes, such as PTEN, FOXO, and PIK3CA, are mutated in up to 32%, 15%, and 11% of localized prostate tumors, respectively. We aimed to further characterize expression of insulin pathway genes in localized prostate cancers in an effort to (1) provide insights into potential mechanisms of progression to metastatic disease and (2) try to further enrich for those prostate tumors that portend worse survival outcomes. Methods: Using the multi-institutional Oncology Research Information Exchange Network (ORIEN) database, gene expression data was analyzed from localized prostate cancer tumors. The raw counts were first normalized, and 176 genes related to the insulin receptor and its downstream pathways were then subset and used for clustering using the non-negative matrix factorization (NMF). The NMF cluster analysis was performed in an attempt to separate gene expression into two groups. Gene Set Enrichment Analysis (GSEA) was then performed between the two groups that had been separated by cluster analysis to determine homology between other GSEA sets. Kaplan–Meier curves were used to assess median overall survival. Cox analysis was performed to generate the adjusted KM curve. Mediation analysis was conducted to determine the relationship between cluster status, TN stage, and survival. Results: Cluster analysis revealed two distinct groups of insulin gene expression, cluster 1 (n = 96) and cluster 2 (n = 337). Compared with cluster 2, cluster 1 consisted of decreased expression of PTEN (p < 0.001) and PIK3R1 (p < 0.001), along with increases in the expression of AKT1 (p < 0.001), IRS1/2 (p < 0.001), FASN (p < 0.001), IGFBP2 (p < 0.001), and MTOR (p < 0.001). GSEA analysis revealed changes in lipid metabolism and WNT secretion pathways in cluster 1. Cluster 2 GSEA showed pathway changes related to DNA damage repair and testosterone. Patient characteristics between clusters differed significantly in the T and N stages of tumor but not in other ways. In unadjusted analysis, median overall survival was estimated at 117 months and 232 months for cluster 1 and cluster 2, respectively (p < 0.05). The proportion of patients who went on to develop metastases (p < 0.05) or need chemotherapy (p < 0.05) was increased in cluster 1 compared to cluster 2. Repeat survival analysis adjusted for confounders (T stage, N stage, age at diagnosis, pathologic grade) showed no difference in survival between clusters. Mediation analysis showed that the contribution of cluster status to survival was independent of T or N stage. Conclusions: A subset of localized prostate cancer patients demonstrated linked insulin pathway changes that are consistent with prior studies describing a pattern of insulin dysregulation. Though the group characterized by insulin dysregulation initially showed worse survival outcomes, this difference disappeared when controlling for confounders. Though baseline differences in tumor stage seemed to most readily explain the difference in survival between clusters, mediation analysis showed that the effect of cluster status on survival was independent of tumor stage. This suggests that other confounders, such as pathologic grade or baseline age, may explain the survival difference. Full article

Improving the climate adaptability of farmers is crucial to ensuring agricultural production and achieving the goal of sustainable development in agriculture. Against the background of climate change aggravating agricultural risks, how do farmers’ own risk attitudes affect their adaptive behavior? Based on the micro-survey data of 480 grape growers in the Turpan-Hami Basin in 2025, we used the least squares method (OLS) to explore the impact of risk appetite on the climate adaptation behavior of farmers and its mechanism. The study found that risk appetite significantly promoted the adoption of adaptive behaviors by farmers. For every 1 unit increase in the risk preference score, the number of climate-adaptive behaviors adopted by farmers increased by an average of 0.322. Mechanism testing shows that both formal credit and informal credit play a partial intermediary role. The intermediary effect accounts for 18.3% and 36.3% respectively, and the transmission effect of informal credit is stronger; Institutional trust and interpersonal trust both positively regulate the relationship between risk preference and adaptive behavior at the level of 1%. Research shows that we should take into account risk education and production environment optimization, pay attention to the supplementary role of private lending, and build a multi-level trust promotion system to jointly improve the climate adaptability of farmers. Full article

In the context of global climate change and the green transformation of the tourism industry, low-carbon tourism has emerged as an important topic within the field of sustainable development research. Consequently, there is a pressing need to systematically review and synthesize its knowledge domain. This study utilizes bibliometric analysis, employing CiteSpace, to review 468 articles published in the Web of Science Core Collection from 2010 to 2026, thereby elucidating publication trends, keyword clustering, and research hotspots within the field of low-carbon tourism. Additionally, it employs content analysis to provide an in-depth discussion of the knowledge system in this research area. Key findings are as follows: (1) The number of published papers on low-carbon tourism exhibits a phased growth pattern, with contributions predominantly centered around scholars such as Gössling and institutions such as the Chinese Academy of Sciences. Moreover, keyword co-occurrence and clustering analyses uncover a development from essential concepts such as low-carbon tourism and climate change to a more extensive range of themes, including carbon emission accounting, tourist behavior, and systemic governance, and research topics have undergone a phased evolution, moving from macro-level cognition to quantitative analysis, and then to systemic governance. (2) The research hotspots encompass five key areas: basic cognition and related concepts, carbon emission accounting methods and applications, factors influencing emissions and assessment frameworks, tourists’ low-carbon behaviors and decision-making mechanisms, and pathways for multi-party collaborative governance. (3) Current research is still facing four challenges, i.e., the absence of a standardized framework for assessing carbon emissions, outdated assessment methods, a disconnect between behaviors and governance, and fragmented governance entities. This indicates that research on low-carbon tourism has progressed beyond the initial macro-level discussions and has entered a critical phase closely linked to substantive governance. Future research needs to focus on deeply exploring the standardization of accounting methods, the development of dynamic assessment models, the design of behavioral intervention mechanisms, and the establishment of multi-level collaborative governance mechanisms. These efforts are essential to provide scientific evidence and practical guidelines for the global tourism industry to achieve neutrality goals. Full article

In China’s increasingly stratified education system, a growing number of high-scoring junior secondary students are choosing the Vocational Secondary–Undergraduate Articulation Program over key academic senior high schools, challenging conventional assumptions about merit, school choice, and vocational education. Existing studies have mainly examined this pathway from institutional and policy perspectives, with limited attention to the micro-level decision-making logic of students and families. Drawing on rational choice theory and a theoretical thematic analysis of online public discourse, this study explores how high-scoring students and their families interpret, evaluate, and justify this educational choice. The findings show that participation in the articulation program is organized around four interrelated mechanisms: action foundations based on academic strengths and family evaluation; action purposes aimed at securing a relatively stable route to a bachelor’s degree while gaining vocational advantages; action consequences involving the weighing of risks and expected returns; and institutional and cultural impacts produced by the interaction between policy incentives and persistent academic hierarchies. The study argues that choosing this pathway is not a deviant decision, but a rational response to educational competition and structural constraints, and it sheds light on the changing legitimacy of vocational pathways in contemporary China. Full article

The growing integration of artificial intelligence (AI) into sustainability initiatives has intensified interest in its potential to influence behaviour and advance progress toward the Sustainable Development Goals (SDGs). However, a persistent gap between sustainability intentions and actual behaviours continues to constrain meaningful outcomes. This study conducts a systematic literature review to examine the extent to which AI reduces or reinforces this intention–behaviour gap across multiple levels of influence. Following PRISMA guidelines, 48 studies were analysed, capturing AI interventions across environmental, social, and economic sustainability domains and spanning internal, strategic, value chain, and system-level contexts. The findings show that AI operates as a conditional behavioural mechanism rather than a uniformly positive solution. At the internal level, AI-enabled interventions, including nudges, feedback systems, and decision support tools, are associated with improved behavioural alignment, particularly in domains linked to SDG 12 (Responsible Consumption and Production) and SDG 13 (Climate Action). However, at organisational and system levels, AI frequently reinforces sustainability decoupling by enabling optimisation, reporting, and symbolic compliance without corresponding behavioural change. The study proposes a multi-level conceptual model of AI-mediated behavioural sustainability, demonstrating that AI’s effectiveness depends on contextual, organisational, and institutional conditions that determine whether it supports substantive or symbolic sustainability outcomes. Full article

Background/Objectives: Hypoglossal nerve palsy is a rare but disabling complication of general anesthesia, typically associated with tracheal intubation and head and neck surgery. This study evaluated the incidence, clinical characteristics, and potential mechanisms of postoperative tongue deviation after breast reconstruction and other surgeries performed under general anesthesia with orotracheal intubation. Methods: We retrospectively reviewed 240,646 consecutive general anesthetic procedures with orotracheal intubation performed at two tertiary hospitals between September 2011 and October 2025. Eighteen patients who developed new-onset postoperative tongue deviation were identified, and demographic features, surgical department, breast reconstruction status, anesthetic details, patient positioning, laterality of deviation, symptom duration, and recovery outcomes were analyzed. Results: Postoperative tongue deviation was documented in 18 patients, corresponding to an overall incidence of approximately 0.01%, most frequently after breast reconstruction (7/18, 38.9%), followed by vascular (27.8%), head and neck tumor (16.7%), neurosurgical (11.1%), and hepatobiliary–pancreatic surgery (5.6%). All seven breast-reconstruction cases occurred at the breast-cancer center hospital, corresponding to 0.31% of 2256 breast reconstructions. The median age was 58.0 years; 66.7% patients were female. Most patients (77.8%) achieved complete recovery, whereas 16.7% had residual deviation. Conclusions: Postoperative hypoglossal nerve palsy with tongue deviation is an exceptionally rare event after general anesthesia. In our two-center cohort, it was observed most frequently among patients undergoing breast reconstruction at one participating center; this pattern is confounded by institution-specific anesthetic and positioning practices and should not be interpreted as evidence that the procedure itself carries inherent risk. The findings are hypothesis-generating and suggest that prolonged operating time, repeated intraoperative position changes, and specific head-fixation and tube-fixation practices warrant prospective investigation. Meticulous head–neck alignment, careful tube fixation, and a structured postoperative cranial-nerve check (tongue-protrusion and voice-quality assessment in the recovery room and on postoperative day 1) may aid the early detection of this complication. Full article

Urban resilience to earthquakes refers to the capacity of cities to anticipate, absorb, and adapt to seismic shocks through a combination of structural, institutional, and social mechanisms. In the context of Japan, one of the world’s most seismically active countries, this concept has evolved through both post-disaster learning and anticipatory planning. This entry examines two complementary trajectories of urban resilience in Japanese cities: reactive resilience, which develops through adaptation after a destructive event, and proactive resilience, which is embedded in preventive policies and preparedness strategies before a shock occurs. The city of Kobe, following the 1995 Great Hanshin Earthquake, exemplifies a reactive trajectory shaped by institutional reform, community mobilization, and regulatory change. In contrast, Tokyo represents a proactive resilience model based on stringent seismic standards, advanced monitoring and early warning systems, and a widespread culture of disaster preparedness. By comparing these trajectories, the entry outlines a conceptual framework for understanding urban seismic resilience as a dynamic process that integrates social adaptation, governance, and technological innovation. Full article

China’s urban size distribution has increasingly shifted toward concentration in large cities amid global urbanization and the restructuring of urban development patterns. This trend has intensified governance and spatial pressures in major cities while exposing weaker growth momentum in small and medium-sized cities and reducing overall urban system coordination. Existing studies mainly explain this pattern through market forces such as agglomeration economies, housing prices, and migration, while others examine the consequences of local land practices from the perspectives of land finance, local competition, and institutional change. However, there is still no systematic explanation of why centrally imposed aggregate land constraints, operating through heterogeneous local land allocation, generate uneven urban outcomes. Against the background of the 2004 strict land management reform, this paper develops a theory-oriented conceptual framework linking central land constraints, local land allocation, and urban size structure. It clarifies how uniform central constraints may be translated into uneven urban outcomes through differentiated local land-allocation practices. Local land allocation is identified as the key transmission mechanism through which development opportunities are reshaped across cities and, under specific institutional conditions, the upper tiers of the urban hierarchy are reinforced. This paper therefore offers a bounded explanation of how central–local land governance shapes China’s urban size structure, while also underscoring the relevance of land governance to more balanced, resource-efficient, and sustainable urban development. Full article

Climate change is intensifying natural hazards across Central Europe, increasing pressure on national systems of climate change adaptation (CCA), disaster risk reduction (DRR), and civil protection. Although international and European policy frameworks promote coherence among these domains, their practical integration remains uneven. This study presents a comparative governance analysis of five Central European countries (Slovakia, Czechia, Hungary, Poland, and Austria), examining how CCA, DRR, and civil protection are integrated across strategic, institutional, operational, and financial dimensions. A structured qualitative assessment of national strategies, legal acts, and institutional arrangements was conducted using a standardized indicator-based framework. The results reveal systematic cross-dimensional asymmetries. Strategic alignment between CCA and DRR is relatively advanced across all countries, largely driven by international and EU policy frameworks. However, institutional coordination mechanisms, operational integration of climate risk information into preparedness planning, and dedicated financing for prevention and adaptation remain weak or fragmented in most cases. Civil protection systems continue to be predominantly response-oriented, with limited linkage to long-term climate risk governance. Based on these patterns, the study identifies distinct national integration typologies and highlights key governance gaps constraining sustainable climate risk management. The findings underline that effective integration depends not only on strategic commitments but on reinforcing linkages across institutions, operational practice, and financing. The study concludes by identifying concrete governance adjustments needed to strengthen cross-sectoral coordination, climate-informed preparedness, and stable financing mechanisms for resilience-building in Central Europe. Full article

Since the 1980s, South Korea has continuously supplied public rental housing alongside the development of new towns. However, systematic studies examining the relationship between qualitative changes in floor plan design and the institutional factors influencing them remain limited. This study is based on the premise that floor plans in public rental housing are not merely the result of design improvements, but are structurally shaped by legal and institutional frameworks. It systematically analyzes changes in floor plan types and planning elements according to development periods and housing sizes. To achieve this, this study examines public rental housing supplied in Korean new towns from the 1990s to the 2010s, classifying floor plan types by period and housing size and analyzing their planning characteristics. The analysis focuses on the composition and arrangement of interior spaces, the size of each space, bay structure, and aspect ratio. A comparative analysis further examines the relationship between floor plan changes and relevant laws and institutional frameworks. The results show that floor plan configurations evolved in distinct phases in response to institutional changes and housing size differentiation. In the 1990s, standardized one-bay layouts with integrated living and sleeping spaces were predominant under strict regulatory conditions, including spatial dimension constraints. In the 2000s, following the legalization of balcony extensions, floor plans diversified into two-bay and three-bay configurations. In the 2010s, floor plan types became increasingly diversified and complex under the influence of district unit plans and detailed design guidelines issued by public agencies. In terms of housing size, smaller units (around 20 m²) maintained simplified one-room configurations, while medium-sized units (around 30–40 m²) exhibited a clear transition from integrated to functionally separated layouts, and larger units (around 50 m²) showed a significant increase in spatial diversity and variation in layout composition. These findings indicate that floor plan evolution is not a linear process of design improvement, but a structurally conditioned transformation shaped by regulatory frameworks, institutional changes, and path dependency. The persistence and gradual modification of earlier standardized layouts suggest that floor plan configurations are continuously reproduced and adapted within institutional constraints. By empirically identifying the structural relationship between institutional frameworks and floor plan design, this study reveals the mechanisms through which institutional conditions shape housing design. Furthermore, it contributes to an interdisciplinary understanding that integrates architecture, urban planning, and housing policy, and provides important implications for design guidelines and policy development aimed at improving the quality of public rental housing. Full article

Knowledge management platforms are increasingly important for strengthening governance, scientific collaboration, and evidence-based decision making in complex regional networks. This study analyses the prospective intention to adopt two strategic digital mechanisms of the Amazon Cooperation Treaty Organization (OCTA): the Amazon Regional Observatory (ORA) and the Network of Amazonian Research Centres (REDCIA). Adapting the Unified Theory of Acceptance and Use of Technology (UTAUT) to a pre-implementation context, the study focuses on performance expectancy, social influence, and facilitating conditions, while operationalizing these constructs through a Knowledge, Attitudes, and Practices (KAP) survey. Using a quantitative, non-experimental, cross-sectional design, penalized ordinal logistic regression models were estimated from 162 responses collected from institutional actors and experts across eight Amazonian jurisdictions. The results show that social influence is the only statistically significant predictor of intention to use in both mechanisms, whereas performance expectancy and facilitating conditions are not significant in the estimated models. These findings suggest that, in the Amazonian cooperation context, adoption is driven less by individual evaluations of utility or technical feasibility than by institutional legitimacy, peer expectations, and collaborative norms. The study contributes to the information systems literature by providing an ex ante analytical approach for assessing technology acceptance in the absence of an operational artefact. It also offers practical guidance for OCTA by highlighting the importance of change management, political endorsement, and network-based incentives to support future implementation. Full article

This study analyzes transformative collaborative learning as a management innovation in a community-based service ecosystem in Phrom Kiri, Thailand. Leveraging Transformative Learning Theory and Service-Dominant Logic, the study employs qualitative participatory methods (i.e., multi-stakeholder workshops, focus groups, and field observations) to document the dynamic processes through which learning, interactions, and institutional changes evolve. These findings demonstrate how collectively informed strategies for sustainability challenges engendered collective learning processes that led to an alteration of actors’ assumptions, mobilization of shared understanding, and facilitated new governance practices driven by multi-dimensional value drives in response to accumulating disconnects. These reflect the rise of participatory governance mechanisms, the intermediation between actors to create synergies, and the anchoring of institutional frameworks into local contexts to allow for value generation both in economic terms and social ones. Our case study shows that transformative learning can be more than just a cognitive change, also enabling community-level management innovations. It finds that sustainable development of local service ecosystems relies on the formation, institutionalization, and promotion of collaborative practices that facilitate the alignment of stakeholders’ interests and competencies. By conceptualizing transformative collaborative learning as a key mechanism to understand how management innovation and value co-creation unfold in community-based development, this research advances sustainability and management literature. Full article

Human–AI systems often involve repeated interaction among users, organizations, and AI components rather than isolated model outputs. In such settings, cooperation can be pursued either by changing agent incentives or by adding an explicit accountability layer. We formalize the Institutional Monitoring and Ledger (IML) framework, which augments a Markov game with monitoring, evidence logging, delayed settlement, and review while leaving the base dynamics unchanged. We derive conservative incentive checks that clarify how detection quality, review accuracy, settlement delay, and sanction size jointly shape deterrence and wrongful-penalty risk. We then provide pilot evidence in two canonical sequential social dilemmas, Harvest and Cleanup, using five agents, PPO training, five training seeds per condition, and comparisons against PPO, inequity aversion, social influence, and IML ablations. In these settings, IML avoided some of the optimization instability observed in the representative internalization baselines tested here, made monitoring error directly visible through ledger records, and showed how false positives can accumulate into a persistent welfare cost. Agent-level analyses in these symmetric environments found nearly uniform measured enforcement burden, while temporal analyses showed that late-stage enforcement is increasingly dominated by residual false positives. These results do not establish legitimacy in human-facing settings or deployment readiness. They instead position IML as a framework with pilot evidence for studying accountability mechanisms in cooperative human–AI systems and highlight measurement error, review design, and due process as central design constraints. Full article

Post-earthquake emergency response planning requires rapid and adaptive resource allocation under disrupted accessibility, uneven district-level demand, and hazardous field conditions. In large metropolitan areas, these challenges are intensified by spatial differences in social vulnerability, infrastructure disruption, operational feasibility, and responder exposure. Static allocation approaches are often insufficient in such environments because they cannot adequately reflect temporal change or the evolving relationship between urgency, accessibility, and operational risk. This study proposes a dynamic multi-objective model for district-level post-earthquake resource allocation that integrates social vulnerability, occupational safety, and Markov-based updating within a single analytical framework. First, district priority scores are derived through an Analytic Hierarchy Process based on building damage ratio, intervention time, social vulnerability, critical infrastructure damage, secondary hazard risk, team capacity, and occupational safety. Second, a Markov-based updating mechanism is used to represent time-dependent redistribution across response periods. Third, a constrained weighted-sum multi-objective optimization model is formulated to balance district priority, social vulnerability, and responder safety under capacity and accessibility limits. The model is applied to Istanbul using official district-level data from national and local institutional sources. Scenario-based analysis is conducted under balanced, priority-oriented, vulnerability-oriented, and safety-oriented settings, together with static and dynamic model comparisons. The results show that the dynamic structure produces a more adaptive allocation profile than the static structure, with the share of the Very High allocation class declining from 37.66% to 34.95% and the Low allocation class increasing from 12.89% to 16.00% over the response horizon. The findings also indicate that greater emphasis on social vulnerability shifts allocation toward more fragile districts, whereas stronger safety emphasis reduces cumulative operational exposure at the cost of moderate reductions in immediate coverage. Overall, the study contributes to the disaster response literature by linking multi-criteria district prioritization, dynamic redistribution, and safety-aware allocation within a unified district-level decision structure. Beyond the Istanbul application, the proposed framework offers a practical basis for more responsive, equitable, and operationally sustainable post-earthquake planning in complex urban environments. Full article