Search Results (39)

The incentive mechanism functions as a core safeguard to ensure the efficient execution of consortium-based Public–Private Partnership (PPP) projects and the realization of value-added outcomes. The heterogeneity of consortium members, their reciprocal preferences, and the collaborative dynamics of the team collectively contribute to the formation of project alliances characterized by resource synergy, complementary advantages, and risk sharing. However, these same factors also contribute to the multi-layered structure of principal–agent relationships and the inherent complexity of incentive pathways and mechanisms in consortium-based PPP settings. Drawing upon the team collaboration effect and reciprocal preferences among consortium members, this study incorporated the member heterogeneity and developed three incentive models for such projects, such as the Dual-Performance (DP) mode, the Total-Performance (TP) mode, and the Individual-Performance (IP) mode. This study examined the conditions under which these incentive modes were established, the relationship between incentive intensity and optimal effort levels of consortium members, and the influence of reciprocal preferences on incentive effectiveness. Further, the selection criteria and appropriate application scenarios for each of the three incentive models were analyzed according to a comparative analysis, thereby putting forward effective suggestions for improving the effort levels of private investors in consortium-based PPP projects. The study results indicate that team synergy effects play an imperative role in improving the optimal effort levels under all three modes, whereas reciprocity preferences exhibit a negative relationship with effort in the DP and TP modes. When reciprocity remains within a moderate range, the DP mode achieves highest aggregate effort levels, whereas the IP mode induces positive incentive effects only under extreme reciprocity conditions. Thus, the application of dual incentive coefficients can enhance operational adaptability and allocative efficiency and governments should establish a multidimensional collaborative incentive for consortium-based PPP projects to strengthen effectiveness and project quality. This comprehensive evaluation provides crucial insights for policymakers, emphasizing the strategic selection of incentive mechanisms to enhance the sustainability and effectiveness of consortium-based PPP Projects. Full article

To advance global climate governance, this study investigates the carbon emission efficiency (CEE) of 110 Chinese resource-based cities (RBCs) using a super-efficiency SBM-GML model combined with kernel density estimation and spatial analysis (2006–2022). Spatial Durbin model (SDM) and geographically and temporally weighted regression (GTWR) further elucidate the driving mechanisms. The results show that (1) RBCs achieved modest CEE growth (3.8% annual average), driven primarily by regenerative cities (4.8% growth). Regional disparities persisted due to decoupling between technological efficiency and technological progress, causing fluctuating growth rates; (2) CEE exhibited high-value clustering in the northeastern and eastern regions, contrasting with low-value continuity in the central and western areas. Regional convergence emerged through technology diffusion, narrowing spatial disparities; (3) energy intensity and government intervention directly hinder CEE improvement, while rigid industrial structures and expanded production cause negative spatial spillovers, increasing regional carbon lock-in risks. Conversely, trade openness and innovation level promote cross-regional emission reductions; (4) the influencing factors exhibit strong spatiotemporal heterogeneity, with varying magnitudes and directions across regions and development stages. The findings provide a spatial governance framework to facilitate improvements in CEE in RBCs, emphasizing industrial structure optimization, inter-regional technological alliances, and policy coordination to accelerate low-carbon transitions. Full article

Against the backdrop of global challenges to food security and China’s push to modernize its agriculture, it is critical to understand how government strategies affect innovation efficiency. This study examines how three modes of intergovernmental competition—fiscal spending competition (strategically increasing public spending to attract resources), tax competition (providing incentives to promote investment), and promotion competition (officials prioritizing short-term projects for promotion)—affect the efficiency of agricultural science and technology innovations across China’s provinces. Utilizing panel data (2000–2021) and a Slack-Based Measure Data Envelopment Analysis (DEA-SBM) model, we find that fiscal spending competition suppresses efficiency, particularly in western regions where infrastructure investments crowd out R&D. Tax competition enhances efficiency, yet its impact is attenuated in central China due to low industrial upgrading. Promotion competition impedes long-term innovation, as frequent official turnover prioritizes short-term projects. Regional heterogeneity highlights eastern China’s market-driven advantages versus central/western regions’ structural constraints. Policy implications advocate for spatially differentiated governance, including R&D tax rebates in the east and cross-regional innovation alliances. This study contributes to fiscal decentralization theory by revealing the nonlinear effects of competition modes on agricultural innovation. Full article

In my research, the effects that the racial diversity of firms’ leadership has in deciding the sustainable composition of firms’ alliance portfolios is investigated, defined as the distribution of exploratory, exploitative, and mixed alliances. Grounded in social categorization, information elaboration, and social contact mechanisms, racially homogeneous leadership has a J-shaped relationship with sustainable alliance portfolio composition. Very racially homogeneous or heterogeneous leadership leads firms towards maintaining more exploratory alliances in their portfolio as opposed to moderately diverse leadership, which prefers the safety of exploitative alliances. Further, I explore how racially homogeneous leadership differs from racially heterogeneous leadership in that the former has a higher propensity to maintain more exploratory alliance portfolios compared to the latter. A two-stage analysis on a panel of 128 pharmaceutical and software firms, accompanied by response surface analysis, yields support for our theorizing. This study encourages scholars to further investigate the different weights that social categorization, information elaboration, and social contact exercise on leadership diversity and how they are elemental in firms’ sustainable alliance decision-making. Full article

As the “carbon neutrality” strategy is implemented, green technology R&D, a core competitive strength for sustainable enterprise development, is an essential pathway for China’s transformation and green growth. Green technology, a breakthrough over traditional production technologies, involves lengthy and costly R&D processes with high risks typically beyond the reach of a single enterprise. It requires the heterogeneous functions of enterprises, universities, and research institutions to complement each other’s advantages and establish an “industry–university–research” collaborative innovation alliance for green technologies. This paper constructs differential game models for non-cooperative and cooperative green technology R&D involving a green manufacturer and a research institution. We solve and compare the profits for both parties under these scenarios, apply a time-consistent payment distribution mechanism to allocate cooperative profits, and ensure that neither party deviates from the optimal cooperative trajectory over a prolonged period, achieving Pareto improvement and enhancing social welfare. Full article

At present, global water resource security is facing serious threats, and the construction of a cooperative, open, and mutually beneficial water resource community is a potential solution to the global water resource crisis and water resource hegemony. Previous studies on the formation and beneficial distribution of water resources in cooperative alliances have more often focused on the idea that participants take all of their water resources when they join a cooperative alliance (i.e., a crisp cooperative alliance), while fewer studies have focused on participants including different proportions of their water resources and joining multiple cooperative alliances (i.e., fuzzy cooperative alliances), and even fewer comparative studies concern the use of different benefit-sharing mechanisms. In this paper, in order to improve the efficiency of water use, allocate water resources more optimally, and generate higher returns for water users in a given basin, we propose the establishment of a traditional crisp and improved fuzzy cooperative alliance for water resources in the basin from the perspective of cooperative game theory; we examine the water resource allocation mechanism within the alliance based on the principle of priority; we construct a benefit allocation mechanism for the cooperative alliance based on the core, least core, weak least core, and Shapley value method; and we carry out empirical research using the example of the Tarim River Basin. Our findings are as follows: (1) A cooperative alliance based on the perspective of cooperative game theory can effectively improve overall benefits and individual benefits, and a fuzzy cooperative alliance is more effective than a crisp cooperative alliance in improving the overall water benefits of the region. (2) The participants in the fuzzy cooperative alliance can obtain more benefits than in the crisp cooperative alliance, and the benefit distribution mechanism of the cooperative alliance helps the participants to determine the object of cooperation while maintaining the sustainable existence of the alliance. (3) The different methods of benefit distribution within the cooperative alliance directly affect the overall water benefits of the region. (4) The different methods of benefit distribution directly affect the stability of the alliance, and the players in the game have heterogeneous preferences for different distribution schemes. The resource-sharing mechanism and benefit distribution mechanism of a water resource cooperative alliance have good applicability as solutions to the problem of water resource optimization and allocation in river basins, and they may provide policy references for the efficient use of water resources and optimization of water resource allocation and management in areas with a shortage of water resources, such as arid and semi-arid zones. Full article

Background and Objectives: Vitamin D is a secosteroid hormone essential for calcium homeostasis and skeletal health, but established evidence highlights its significant roles also in muscle health and in the modulation of immune response. This review aims to explore the impact of impaired vitamin D status on outcomes of muscle function and involvement in inflammatory and autoimmune rheumatic diseases damaging the skeletal muscle efficiency both with direct immune-mediated mechanisms and indirect processes such as sarcopenia. Methods: A comprehensive literature search was conducted on PubMed and Medline using Medical Subject Headings (MeSH) terms: “vitamin D, muscle, rheumatic diseases.” Additionally, conference abstracts from The European Alliance of Associations for Rheumatology (EULAR) and the American College of Rheumatology (ACR) (2020–2023) were reviewed, and reference lists of included papers were scanned. The review emphasizes the evidence published in the last five years, while also incorporating significant studies from earlier years, structured by the extent of evidence linking vitamin D to muscle health in the most commonly inflammatory and autoimmune rheumatic diseases encountered in clinical practice. Results: Observational studies indicate a high prevalence of vitamin D serum deficiency (mean serum concentrations < 10 ng/mL) or insufficiency (<30 ng/mL) in patients with idiopathic inflammatory myopathies (IIMs) and polymyalgia rheumatica, as well as other autoimmune connective tissue diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc). Of note, vitamin D insufficiency may be associated with reduced muscle strength (2 studies on RA, 2 in SLE and 1 in SSc), increased pain (1 study on SLE), fatigue (2 studies on SLE), and higher disease activity (3 studies on IIMs and 1 on SLE) although there is much heterogeneity in the quality of evidence and different associations for the different investigated diseases. Therefore, linked to the multilevel biological intervention exerted by vitamin D, several translational and clinical studies suggest that active metabolites of this secosteroid hormone, play a role both in reducing inflammation, but also in enhancing muscle regeneration, intra-cellular metabolism and mitochondrial function, although interventional studies are limited. Conclusions: Altered serum vitamin D status is commonly observed in inflammatory and autoimmune rheumatic diseases and seems to be associated with adverse muscle health outcomes. While maintaining adequate serum vitamin D concentrations may confer muscle-protective effects, further research is needed to confirm these findings and establish optimal supplementation strategies to obtain a safe and efficient serum threshold. Full article

Somalia is one of 20 countries in the world with the highest numbers of zero-dose children. This study aims to identify who and where zero-dose and under-vaccinated children are and what the existing vaccine delivery strategies to reach zero-dose children in Somalia are. This qualitative study was conducted in three geographically diverse regions of Somalia (rural/remote, nomadic/pastoralists, IDPs, and urban poor population), with government officials and NGO staff (n = 17), and with vaccinators and community members (n = 52). The data were analyzed using the GAVI Vaccine Alliance IRMMA framework. Nomadic populations, internally displaced persons, and populations living in remote and Al-shabaab-controlled areas are three vulnerable and neglected populations with a high proportion of zero-dose children. Despite the contextual heterogeneity of these population groups, the lack of targeted, population-specific strategies and meaningful engagement of local communities in the planning and implementation of immunization services is problematic in effectively reaching zero-dose children. This is, to our knowledge, the first study that examines vaccination strategies for zero-dose and under-vaccinated populations in the fragile context of Somalia. Evidence on populations at risk of vaccine-preventable diseases and barriers to vital vaccination services remain critical and urgent, especially in a country like Somalia with complex health system challenges. Full article

Background: Clinically, there is considerable heterogeneity in the presentation of transthyretin amyloidosis (ATTR), which ranges from primarily cardiac and primarily neurologic to mixed disease, among other manifestations. Because of this complex presentation, the diagnosis and management of patients with ATTR are often challenging and should be performed in interdisciplinary centers specialized in amyloidosis. Here, we aimed to increase awareness of ATTR detection and pathophysiology through a multidimensional multiorgan approach. Case report: We reported on a 60-year-old man with wild-type ATTR who underwent a number of both basic and advanced cardiological and neurological investigations at baseline and after a treatment period with the TTR tetramer stabilizer, tafamidis. Several findings are provided here, some of which might be considered instrumental correlates of the patient’s clinical improvement after therapy. Conclusions: Adequate awareness and prompt recognition of ATTR support early diagnosis and faster access to therapies, thereby slowing the progression and improving the prognosis. The need for a multidisciplinary alliance between specialists and the opportunity to perform, at least in selected cases, a set of specific examinations for a detailed assessment of ATTR patients can also provide valuable insights into the physiopathology and response to therapy of a disease as complex and intriguing as ATTR. Full article

Pharmacists have traditionally supported the prescribing process, arguably in reactive or corrective roles. The advent of pharmacist prescribing in 2004 represented a major shift in practice, leading to greater responsibility for making clinical decisions with and for patients. Prescribing rights require pharmacists to take a more prescriptive role that will allow them to contribute to long-standing prescribing challenges such as poor medication adherence, overprescribing, and the need for shared decision-making and person-centered care. Central to these endeavors are the development and possession of effective consultation skills. University schools of pharmacists in the UK now routinely include consultation skills training, which is also provided by national education bodies. These challenges remain difficult to overcome, even though it is understood, for example, that increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments. More recently, a concerted effort has been made to tackle overprescribing and the harm that may occur through the inappropriate use of medication. In routine pharmacy work, these priorities may linger at the bottom of the list due to the busy and complex nature of the work. Solutions to these problems of adherence, optimizing benefits of medication, and overprescribing have typically been pragmatic and structured. However, an arguably reductionist approach to implementation fails to address the complex patient interactions around prescribing and taking medication, and the heterogeneity of the patient’s experience, leaving the answers elusive. We suggest that it is essential to explore how person-centered care is perceived and to emphasize the relational aspects of clinical consultations. The development of routine pharmacist prescribing demands building on the core values of person-centered care and shared decision making by introducing the concepts of “relational prescribing” and “open dialogue” to cultivate an essential pharmacotherapeutic alliance to deliver concrete positive patient outcomes. We provide a vignette of how a clinical case can be approached using principles of relational prescribing and open dialogue. We believe these are solutions that are not additional tasks but must be embedded into pharmacy practice. This will improve professional satisfaction and resilience, and encourage curiosity and creativity, particularly with the advent of all pharmacists in Great Britain becoming prescribers at graduation from 2026. Full article

(1) Background: Digitalization is the key to sustainable village development, posing a new challenge for village planning, construction, and governance in all countries. The construction of digital villages is currently in the stage of experimentation and exploration; China is the largest developing country and a pioneer in the digitization of villages. (2) Methods: Based on a combination of the Boston Consulting Group Matrix and GeoDetector, we conducted an empirical study on 70 counties in Guangxi, aiming to analyze the construction level, evolution model, and driving mechanism of digital villages and to provide a basis for decisions on government investment and social participation. (3) Results: First, Conspicuous disequilibrium in rural digitalization has manifested in Guangxi, and counties at different levels (leader, follower, and straggler) show significant clustering and correlation effects in their geographical distribution. Second, digital village construction in Guangxi has evolves in diversified modes (divided into four types: star, gazelle, cow, and dog), with hot and cold areas forming a center–periphery structure. Third, rural digitalization has a very complex driving mechanism, with high heterogeneity in the direct influencing factors, significant synergistic enhancement of factors, and nonlinear enhancement dominating the interaction’s relationship. (4) Conclusions: According to the results of analysis, we suggest highlighting the government-driven mechanism and regional linkage in the construction of digital villages, formulating differentiated management policies and development plans based on the combination of top-level design and grassroots innovation, establishing joint meetings or development associations and service alliances, and stimulating the enthusiasm of the whole of society, especially farmers and enterprises, in order to achieve rapid and sustainable rural digitalization. Full article

Understanding later-life role model choice and motivations, particularly for older men in sport, exercise, and health contexts, is complex and heterogenous, making it difficult for health and exercise promotion initiatives. This qualitative study examined: (1) whether older men have aging role models, and if so, their characteristics; and (2) older men’s reasons for role model choice, or lack thereof, and how role models can influence meaningful change in perceptions and practices associated with aging, sport, exercise, and health. Through in-depth interviews and photo-elicitation with 19 Canadian men aged 75 years and over, thematic analysis determined two key themes: Role model choice, and Processes of role models facilitating change. Four key strategies for role models facilitating change in older men were determined: elite (biomedical) transcendence; valued exemplary endeavours; alliance connections; and disconnect and caveats. Ultimately, while promoting the biomedical achievements of role models may resonate with many older men, when applied too closely in sport or exercise contexts (e.g., using Masters athletes as role models), there is potential for unrealistic standards and overmedicalization that could miss uncovering the latent importance that older men place on the diverse experiences and perspectives of aging that go beyond traditional masculine ideals. Full article

Fibromyalgia (FM) is a chronic disease characterized by a heterogeneous set of physical and psychological conditions. The chronic experience of disability felt by patients and the impact on quality of life (QoL) of the disease may worsen the cognitive reappraisal ability and contribute to maintaining an altered pain modulation mechanism. This paper presents the study protocol of an INTEGRated psychotherapeutic interventiOn on the management of chronic pain in patients with fibromyalgia (INTEGRO). The aim of the study is to investigate the efficacy of an integrated psychotherapeutic intervention focused on pain management on QoL and pain perception, in a pilot sample of 45 FM patients with idiopathic chronic pain. The contribution of perceived therapeutic relationship (alliance) and physiological attunement, in both the patient and therapist, will be considered as possible mediators of intervention efficacy. Attachment dimensions, traumatic experiences, difficulties in emotion regulation, mindfulness attitude and psychophysiological profile will also be considered as covariates. The objectives are to evaluate longitudinally if patients will experience an increase in QoL perception (primary endpoint), pain-managing self-efficacy and emotion-regulation abilities as well as a reduction in pain intensity (secondary endpoints), considering the mediating role of perceived therapeutic alliance and physiological attunement in both the patient and therapist. Full article

Several studies have reported stingless Meliponini bees gathering hairs from the labella of Maxillaria spp., including M. ochroleuca, a member of the M. splendens alliance. Such hairs usually contain food materials and are thought to have nutritional value. The papillose labella of representatives of the Maxillaria splendens alliance, however, bear scattered, simple 1-5-celled uniseriate trichomes (hairs) that lack food materials. By contrast, here, as well as polyphenolic compounds, typical labellar papillae usually contain small quantities of starch, protein, and minute droplets of lipid, the last probably involved in the production of fragrance. Towards the labellum apex occur elevated groups of papillae that lack food materials, but contain volatile compounds, probably fragrance precursors. In the past, the terms ‘trichomes’ or ‘hairs’ and ‘papillae’ have been used interchangeably, causing some confusion. Since the trichomes, however, unlike the papillae, are easily detachable and can fragment, it is most likely they, not the papillae, that have previously been observed being collected by bees, but their poor food content indicates that they do not function as food-hairs. Even so, our field observations of M. ochroleuca reveal that stingless bees scrape polyphenol-rich labellar tissue and possibly use this material to produce a resinous, complex, heterogeneous substance commonly referred to as ‘bee glue’, used for nest construction and repair. Full article

With the rapid development of wireless networks, wireless edge computing networks have been widely considered. The heterogeneous characteristics of the 6G edge computing network bring new challenges to network resource scheduling. In this work, we consider a heterogeneous edge computing network with heterogeneous edge computing nodes and task requirements. We design a software-defined heterogeneous edge computing network architecture to separate the control layer and the data layer. According to different requirements, the tasks in heterogeneous edge computing networks are decomposed into multiple subtasks at the control layer, and the edge computing node alliance responding to the tasks is established to perform the decomposed subtasks. In order to optimize both network energy consumption and network load balancing, we model the resource scheduling problem as a Markov Decision Process (MDP), and design a Proximal Policy Optimization (PPO) resource scheduling algorithm based on deep reinforcement learning. Simulation analysis shows that the proposed PPO resource scheduling can achieve low energy consumption and ideal load balancing. Full article