Development and Utilization of Catering Culture and New Countryside Construction in Guizhou of China

The paper pointed out that catering cultural resources played an important role in vitalizing Guizhou,promoting rural tourism development,innovating characteristic mountainous economy,increasing villagers' income and constructing ecological civilization.It emphasized that development and utilization of catering resources could contribute to promotion of economic development and preservation of good ecology on condition that natural environment was not destroyed.Advantages and potentials for development and utilization of catering culture in Guizhou had been analyzed,which lied in diversified food production methods,abundant food materials,obvious regionality,colorful national catering cultures,green foods and so on.It proposed that Guizhou catering culture had gained attention of relevant departments currently and had been developed to a certain degree.Its development status was introduced in brief.On this basis,it put forward relevant strategies,emphasized depending on government's guidance,stimulating villagers' activity,rooting in the soil of Guizhou historical culture,paying attention to establishment and protection of native catering cultural brand,and doing well in sales promotion.

Spectrum of venous thromboembolism in adult patients with ulcerative colitis in Pakistan:A single center retrospective study

BACKGROUND Patients with inflammatory bowel disease are at a 2-8-fold higher risk of deve-loping venous thromboembolism(VTE)as compared to the general population.Although the exact pathogenesis is unclear,the literature suggests that increased risk of thromboembolic events in such patients occurs as a result of increased coagulation factors,inflammatory cytokines,and reduction in anticoagulants leading to a prothrombotic state.AIM To assess the prevalence,risk factors,management,and outcome of ulcerative colitis(UC)patients who develop VTE.METHODS This was a retrospective chart review done in The Gastroenterology Department of The Aga Khan University Hospital.Data was collected from medical records for all patients admitted with a diagnosis of UC from January 2012 to December 2022.RESULTS Seventy-four patients fulfilled the inclusion criteria.The mean±SD of age at presentation of all UC patients was 45 years±10 years whereas for those who developed VTE,it was 47.6 years±14.7 years.Hypertension and diabetes were the most common co-morbid seen among UC patients with a frequency of 17(22.9%)and 12(16.2%),respectively.A total of 5(6.7%)patients developed VTE.Deep venous thrombosis was the most common thromboembolic phenomenon seen in 3(60%)patients.All the patients with UC and concomitant VTE were discharged home(5;100%).CONCLUSION The prevalence of VTE with UC in Pakistani patients corresponds with the international literature.However,multi-centric studies are required to further explore these results.

Nutrition impacts of non-solid cooking fuel adoption on under-five children in developing countries

This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demographic and Health Surveys(DHS).Results from both fixed effects(FE)and instrumental variable(IV)estimates show that using non-solid cooking fuel significantly improves the nutrition outcomes of under-five children.Compared with their peers from households mainly using solid fuel,children from households mainly using non-solid fuel exhibit a lower probability of experiencing stunting(by 5.9 percentage points)and being underweight(by 1.2 percentage points).Our further investigation provides evidence for several underlying mechanisms,such as improved indoor air quality,induced reduction in children’s respiratory symptoms,benefits on maternal health,and reduction in maternal time spent on fuel collection or cooking.Heterogenous analyses suggest that the nutrition benefits of using non-solid cooking fuel are more prominent among boys,children above three years old,and those from households of lower socioeconomic status,rural areas,and Southeast Asia.

Informing policy makers in developing countries:Practices and limitations of geriatric home medication review in Malaysia-A qualitative inquiry

Objective:To explore existing practices and challenges in the delivery of geriatric home medication review(HMR).The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR.Methods:This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public hospitals.The purpose of the interviews was to explore challenges faced by them in the delivery of geriatric HMR.Results:Based on the emerging themes from the qualitative data,the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits,encompassing a diverse patient population with various healthcare needs.However,it faces challenges such as the lack of outcome monitoring,formal training,and workforce constraints.Despite these hurdles,there is a pressing need for the expansion of this service to better serve the community,and collaboration with community pharmacists holds potential to broaden its scope.Ultimately,the findings suggest that pharmacist-led HMR is both warranted and feasible within the Malaysian healthcare context.In order to optimize medicine-use among older people living in the community,approaches for expanding geriatric HMR services in Malaysia must be developed.Conclusions:This study holds profound implications as it attempts to illuminate policy makers in developing countries,enabling them to formulate effective HMR plans.By considering the challenges highlighted within this research,policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population.

Production and trade trend of oils and oilseeds in BRICS countries

In order to promote agricultural production and trade cooperation among BRICS countries,and ensure the security and stability of the oils and oilseeds industrial and supply chains in China and the world,the production,consumption,trade trend,and cooperation potential of oils and oilseeds in BRICS countries were expounded,and relevant policy recommendations were put forward.Most of the BRICS countries are major agricultural producers,and they are also important agricultural product consumption markets in the world.In 2023/2024,the production and consumption of oilseeds in BRICS countries account for nearly half of the world's total;the production of vegetable oils exceeds a quarter of the world's total,and the consumption of vegetable oils accounts for 40%of the world's total.In 2023/2024,the import and export volume of oilseeds exceeds half of the world's total;vegetable oil imports account for 40%of the world's total,and exports account for about one tenth of the world's total.China's imports of oilseeds and oils from BRICS countries account for 68%and 29%of its global imports in 2023,respectively.BRICS countries are rich in agricultural land resources,have great potential for oils and oilseeds production,obvious complementary advantages in trade structure,and huge space for future cooperation.It is suggested that Brazil should be included in the"Belt and Road"co-construction category to promote the continuous deepening of agricultural cooperation between China and Brazil.It is suggested to explore regional agricultural trade agreements among BRICS countries,promote currency settlement and exchange among BRICS countries,and enhance the facilitation and stability of BRICS trade.It is suggested that China should increase its investment in BRICS countries and export advanced technology and management experience to benefit local agricultural development and achieve a mutually beneficial and win-win situation.

Snapshot Survey of the Presence of Perfluoroalkyl Substances in Products, Articles, and the Environment in Ecuador

The Stockholm Convention on Persistent Organic Pollutants(POPs)is a legally binding instrument for 186 Parties(status:April 2023).Accordingly,among other responsibilities,countries are obliged to report the production,import,or export of the POPs listed in Annexes A,B,or C;provide information to registers;maintain inventories;and monitor the presence of POPs in the environment.In the broader context of international chemicals and waste management,producer responsibilities,harmonized reporting,and compliance with national and international regulations,Ecuador has addressed the newly listed group of perfluorinated alkyl substances(PFAS)in its national implementation plan and sent selected products from its national market for PFAS analysis.The products analyzed came from the initially listed fields of specific exemptions and acceptable purposes,including:fire-fighting foams;photographic aids;greasers/degreasers;various kinds of paper/packaging;textiles;and leather,coatings,cleaners,metal plating,and pesticides.Our results showed that the three PFAS presently listed in the Stockholm Convention could be quantified in only a few samples;additional PFAS,not yet listed in the Convention also had low detection frequencies.Although the number of samples was limited,the samples covered a large spectrum of sample matrices,making it possible to conclude that—once these products become waste and are regulated under the Basel Convention—they would not constitute a disposal problem.Nevertheless,verification of the presence of PFAS in products on the market is expected to pose an analytical challenge for both,developed and developing countries.

Overcoming geographical and socioeconomic limitations in colorectal cancer screening

Despite colorectal cancer’s(CRC)high global incidence,residents of low-and middle-income countries,as well as low-income minorities in advanced economies have low screening rates.Observational studies demonstrate that in these groups higher incidence of CRC is observed,yet screening rates remain low for consistent reasons.Low income,low educational background,and lack of awareness in combination with inadequate social security of certain population groups impede access and compliance rates to CRC screening.On the other hand,despite the global availability of multiple screening approaches(colonoscopy,sigmoidoscopy,faecal occult blood test,faecal immunochemical test,computed tomography-colonography,etc.)with proven diagnostic validity,many low-income countries still lack established screening programs.The absence of screening guidelines in these countries along with the heterogeneity of guidelines in the rest of the world,demonstrate the need for global measures to tackle this issue comprehensively.An essential step forward is to develop a global approach that will link specific elements of screening with the incidence and available resources in each country,to ensure the achievement of at least a minimum screening program in low-income countries.Utilizing cheaper,cost-effective techniques,which can be carried out by less specialized healthcare providers,might not be equivalent to endoscopy for CRC screening but seems more realistic for areas with fewer resources.Awareness has been highlighted as the most pivotal element for the effective implementation of any screening program concerning CRC.Moreover,multiple studies have demonstrated that outreach strategies and community-based educational programs are associated with encouraging outcomes,yet a centrally coordinated expansion of these programs could provide more consistent results.Additionally,patient navigator programs,wherever implemented,have increased CRC screening and improved follow-up.Therefore,global coordination and patient education seem to be the main areas on which policy making needs to focus.

A harmonisation approach to traditional Chinese medicine registration in Asian countries

The traditional Chinese medicine(TCM)industry is critical to not only for public health but also for economic growth.According to the European Union(EU)directives,under the EU framework for(traditional)herbal medicinal products,herbal medicines with long history of use can be registered in EU.However,there is a condition in this directive in which only those that have at least 10e15 years in the EU market are accepted for registration and/or marketing authorization.In author opinion,the condition of 10-15 years of use in EU countries set within the EU regulatory framework is with consideration of the genetic differences which can result in variation in adverse drug responses among different world populations.With this concept in mind,it is reasonable to project the principal of the EU directive to the Asian countries where TCM is originated.Countries like China,Singapore,Japan and South Korea that have well established drug registration framework are in best position in executing the best practice and facilitate harmonization of registration for TCM within the region.Furthermore,the registration process itself allows more safety and efficacy data to be collected systemically before and after product registration/marketing authorization.These are valuable information for future drug development.The therapeutic value of TCM is limitless,it has been left out in the EU regulatory framework,and the opportunity for it to be expanded and carried forward in modern medicines is shadowed by the limited number of TCM that are qualified to be registered under the EU regulatory framework.An early establishment of a harmonized risk-based registration process for TCM in Asian countries is important.This will strengthen the database to substantiate the history of safe use and further preserving and expanding the therapeutic values of TCM within and beyond the Asian region.

Is economic fitness helpful in achieving environmental sustainability in BRICS economies?A risk exposure perspective

A country’s ability to create complex goods and diversify its lines of products is essential for addressing all types of vulnerabilities.Quantifying a country’s vulnerability to extreme climatic events,such as droughts,superstorms,and other natural disasters,and its capacity for successful adaption,is an essential global need that has been ignored.This study examines the role of economic fitness(EF)in addressing climate change risk ex‐posure in BRICS countries in the context of the environmental Kuznets curve using panel data from 1995 to 2015.Panel threshold methodology is employed to ascertain the nonlinear relationship between EF and climate change risk exposure(i.e.,Notre Dame Global Adaptation Initiative Country Index(ND-GAIN)).In addition,empirical associations were estimated using panel-corrected standard errors,Driscoll-Kraay standard errors,and feasible generalized least squares estimation techniques.These findings demonstrated an inverted N shaped link between EF and ND-GAIN.Moreover,even after controlling for significant ND-GAIN influencing variables such as gross domestic product per capita,financial development,and urbanization,our robustness checks revealed significant and consistent findings.

Morphological and Molecular Characterizations of Country Bean (Lablab purpureus L.) Genotypes for Drought Tolerance

Country bean, Lablab purpureus (L.) is considered one of the most important leguminous crops, but their cultivation under drought stress condition encounters challenges. In this study, an experiment has been conducted among 30 genotypes under drought condition to explore morphological diversity of qualitative and quantitative, biochemical, molecular analysis. The study identified significant variations in eight traits among the genotypes examined, with phenotypic variance exceeding genotypic variance, indicating both genetic and environmental influences. High heritability and genetic advance were observed in primary, secondary, and tertiary branch lengths, suggesting these traits are likely controlled by additive gene effects, making them effective targets for selection. Principal component analysis identified three components that made a substantial contribution, accounting for approximately 73.06% of the overall quantitative variations. Among the quantitative traits, the highest coefficient of variation (CV%) has been found in number of flowers (55.05%). While number of primary branches, primary branch length, number of secondary branches, secondary branch length, number of tertiary branches, tertiary branch length has individually more than 20% of CV%. The genotypes have been grouped into three clusters based on quantitative traits. Analysis of protein reveals that the genotypes of DS28 and DS29 have higher protein content than other genotypes. Dehydrogenase responsive genotypes have been found on DS28 and DS29 from the molecular analysis. The results suggest that the genotypes DS28 and DS29 could contribute as genetic resource of high protein content and DREB responsive, and the eight quantitative traits of 30 genotypes could be used for further breeding programme.

Colorectal cancer’s burden attributable to a diet high in processed meat in the Belt and Road Initiative countries

BACKGROUND Colorectal cancer(CRC)plays a significant role in morbidity,mortality,and economic cost in the Belt and Road Initiative(“B and R”)countries.In addition,these countries have a substantial consumption of processed meat.However,the burden and trend of CRC in relation to the consumption of a diet high in processed meat(DHPM-CRC)in these“B and R”countries remain unknown.AIM To analyze the burden and trend of DHPM-CRC in the“B and R”countries from 1990 to 2019.METHODS We used the 2019 Global Burden of Disease Study to collate information regarding the burden of DHPM-CRC.Numbers and age-standardized rates(ASRs)of deaths along with the disability-adjusted life years(DALYs)were determined among the“B and R”countries in 1990 and 2019.Using joinpoint regression analysis,the average annual percent change(AAPC)was used to analyze the temporal trends of age-standardized DALYs rate(ASDALR)from 1990 to 2019 and in the final decade(2010–2019).RESULTS We found geographical differences in the burden of DHPM-CRC among“B and R”countries,with the three highest-ranking countries being the Russian Federation,China,and Ukraine in 1990,and China,the Russian Federation,and Poland in 2019.The burden of DHPM-CRC generally increased in most member countries from 1990 to 2019(all P<0.05).The absolute number of deaths and DALYs in DHPM-CRC were 3151.15[95%uncertainty interval(UI)665.74-5696.64]and 83249.31(95%UI 15628.64-151956.31)in China in 2019.However,the number of deaths(2627.57-2528.51)and DALYs(65867.39-55378.65)for DHPM-CRC in the Russian Federation has declined.The fastest increase in ASDALR for DHPM-CRC was observed in Vietnam,Southeast Asia,with an AAPC value of 3.90%[95%confidence interval(CI):3.63%-4.16%],whereas the fastest decline was observed in Kyrgyzstan,Central Asia,with an AAPC value of-2.05%(95%CI:-2.37%to-1.73%).A substantial upward trend in ASR of mortality,years lived with disability,years of life lost,and DALYs from DHPM-CRC changes in 1990-2019 and the final decade(2010-2019)for most Maritime Silk Route members in East Asia,South Asia,Southeast Asia,North Africa,and the Middle East,as well as Central Europe,while those of the most Land Silk Route members in Central Asia and Eastern Europe have decreased markedly(all P<0.05).The ASDALR for DHPM-CRC increased more in males than in females(all P<0.05).For those aged 50-74 years,the ASDALR for DHPM-CRC in 40 members exhibited an increasing trend,except for 20 members,including 7 members in Central Asia,Maldives,and 12 high or high-middle social development index(SDI)members in other regions(all P<0.05).CONCLUSION The burden of DHPM-CRC varies substantially across“B and R”countries and threatens public health.Relevant evidence-based policies and interventions tailored to the different trends of countries in SDIs or Silk Routes should be adopted to reduce the future burden of CRC in“B and R”countries via extensive collaboration.

Digital psychiatry in low-and-middle-income countries:New developments and the way forward

Low-and middle-income countries(LMICs)bear the greater share of the global mental health burden but are ill-equipped to deal with it because of severe resource constraints leading to a large treatment gap.The remote provision of mental health services by digital means can effectively augment conventional services in LMICs to reduce the treatment gap.Digital psychiatry in LMICs has always lagged behind high-income countries,but there have been encouraging developments in the last decade.There is increasing research on the efficacy of digital psychiatric interventions.However,the evidence is not adequate to conclude that digital psychiatric interventions are invariably effective in LMICs.A striking development has been the rise in mobile and smartphone ownership in LMICs,which has driven the increasing use of mobile technologies to deliver mental health services.An innovative use of mobile technologies has been to optimize task-shifting,which involves delivering mental healthcare services in community settings using non-specialist health professionals.Emerging evidence from LMICs shows that it is possible to use digital tools to train non-specialist workers effectively and ensure that the psychosocial interventions they deliver are efficacious.Despite these promising developments,many barriers such as service costs,underdeveloped infrastructure,lack of trained professionals,and significant disparities in access to digital services impede the progress of digital psychiatry in LMICs.To overcome these barriers,digital psychiatric services in LMICs should address contextual factors influencing the delivery of digital services,ensure collaboration between different stakeholders,and focus on reducing the digital divide.

China’s Industrial Modernization:Development Rationale,Current Status,and Policy Directions

Economies that have effectively escaped the“middle-income trap”demonstrate common traits in their industrial restructuring as they progressed to high-income status.These include a relatively stable share of an economy’s manufacturing sector,a reasonable economic structure,enhanced industrial capabilities,and growth driven by innovation.However,late-moving countries face a number of hurdles as they strive to cross this threshold.China’s development advantages include,among other things,a complete industrial system,a more balanced industrial structure,growing indigenous innovation capabilities,continual expansion and upgrading of domestic demand,and a greater degree of openness.These capabilities have provided continuous momentum for industrial growth,allowing China to capitalize on the next wave of technological and industrial revolutions while also promoting long-term,steady industrial development.During its modernization efforts,China has seen substantial changes in the external environment surrounding its industrial development.We must not only recognize the increasing complexity,intensity,and uncertainty of these changes,but also take proactive steps to solve diverse issues and capitalize on opportunities arising from global digital and green transitions.Equal focus should be placed on strengthening reforms and promoting high-level openness,improving policy coordination and consistency,and pursuing an innovation-driven strategy.This will speed the development of a modern industrial system and encourage the formation of new,high-quality productive forces.

ASEAN Countries' Perceptions and Responses to US Construction of “Indo–Pacific” Minilateral Framework

ASEAN countries are important targets for the United States to promote the “Indo–Pacific” minilateral framework. Their official, think tank, and media opinions regard this as an important opportunity to enhance their national status and promote their national interests, which will be beneficial to peace and stability in the “Indo–Pacific” region. However, they are worried that it will damage the “ASEAN centrality.” ASEAN has responded positively and is committed to reshaping its “central position” and regional leadership and improving regional governance capabilities, but there are differences in the responses of various countries. In the future, ASEAN countries will seek to achieve direct and practical interests through the US “Indo–Pacific” minilateral framework, but they are more wor ried that the “central position of ASEAN” will be replaced and its “neutral and balanced” position will be threatened.

Impact of geopolitical risk,GDP,inflation,interest rate,and trade openness on foreign direct investment:Evidence from five Southeast Asian countries

Historically,geopolitical risk(GPR)has posed significant challenges to international economic,social,and political frameworks.This study investigated how internal GPR in the selected five Southeast Asian countries(Indonesia,South Korea,Malaysia,the Philippines,and Thailand)influences foreign direct investment(FDI)during 1996-2019.The stationarity of the data was assessed using the Augmented Dickey-Fuller(ADF)unit root test,which shows that the data became stationary after the first difference.The Kao,Pedroni,and Westerlund cointegration tests were employed to examine long-term cointegration among the selected variables(FDI,GPR index(GPRI),gross domestic product(GDP),inflation,interest rate,and trade openness(TOP)).The results indicated that these variables have a long-term cointegration.Consequently,regression analysis using the Pooled Ordinary Least Squares(OLS)regression,fixed effect,random effect,Arellano-Bond dynamic panel-data estimation,and system generalized moment method(GMM)revealed that GPRI and TOP negatively impacted FDI in the selected five Southeast Asian countries.At the same time,GDP,inflation,and interest rate positively influenced FDI in these countries.Because FDI is crucial to shaping a country’s macroeconomic structure,this study recommends that governments and central banks of the selected five Southeast Asian countries should implement policies and strategies to encourage foreign investments.

First experience in laparoscopic surgery in low and middle income countries: A systematic review

BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is becoming increasingly common in countries with limited resources.However,introducing laparoscopic surgery in low-and-middle-income countries(LMIC)can be expensive and requires resour-ces,equipment,and trainers.AIM To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and resources.METHODS MEDLINE,EMBASE and Cochrane databases were searched for studies reporting first experience in laparoscopic surgery in LMIC.Included studies were published between 1996 and 2022 with full text available in English.Exclusion criteria were studies considering only open surgery,ear,nose,and throat,endoscopy,arthro-scopy,hysteroscopy,cystoscopy,transplant,or bariatric surgery.RESULTS Ten studies out of 3409 screened papers,from eight LMIC were eligible for inclusion in the final analysis,totaling 2497 patients.Most reported challenges were related to costs of equipment and training programmes,equipment pro-blems such as faulty equipment,and access to surgical kits.Training-related challenges were reliance on foreign trainers and lack of locally trained surgeons and theatre staff.The benefits of introducing laparoscopic surgery were economic and clinical,including a reduction in hospital stay,complications,and morbidi-ty/mortality.The introduction of laparoscopic surgery also provided training opportunities for junior doctors.CONCLUSION Despite financial and technical challenges,many studies emphasise the overall benefit of introducing laparoscopic surgery in LMICs such as reduced hospital stay and the related lower cost for patients.While many of the clinical centres in LMICs have proposed practical solutions to the challenges reported,more support is critically required,in particular regarding training.

ISO/TC 321电子商务标准化工作对非洲发展中国家的启示

This paper draws on the experience of the eighth plenary meeting of the ISO/TC 321, Transaction assurance in e-commerce, held in Hangzhou of China in November 2023, and explores potential ways in which developing countries in Africa can drive their development and contribute to global industrial progress by leveraging ISO/TC 321 standards. It provides practical recommendations for utilizing e-commerce standardization and related standards to stimulate economic growth and enhance business practices.

Driving factors of CO_(2)emissions in South American countries:An application of Seemingly Unrelated Regression model

Carbon emissions have become a critical concern in the global effort to combat climate change,with each country or region contributing differently based on its economic structures,energy sources,and industrial activities.The factors influencing carbon emissions vary across countries and sectors.This study examined the factors influencing CO_(2)emissions in the 7 South American countries including Argentina,Brazil,Chile,Colombia,Ecuador,Peru,and Venezuela.We used the Seemingly Unrelated Regression(SUR)model to analyse the relationship of CO_(2)emissions with gross domestic product(GDP),renewable energy use,urbanization,industrialization,international tourism,agricultural productivity,and forest area based on data from 2000 to 2022.According to the SUR model,we found that GDP and industrialization had a moderate positive effect on CO_(2)emissions,whereas renewable energy use had a moderate negative effect on CO_(2)emissions.International tourism generally had a positive impact on CO_(2)emissions,while forest area tended to decrease CO_(2)emissions.Different variables had different effects on CO_(2)emissions in the 7 South American countries.In Argentina and Venezuela,GDP,international tourism,and agricultural productivity significantly affected CO_(2)emissions.In Colombia,GDP and international tourism had a negative impact on CO_(2)emissions.In Brazil,CO_(2)emissions were primarily driven by GDP,while in Chile,Ecuador,and Peru,international tourism had a negative effect on CO_(2)emissions.Overall,this study highlights the importance of country-specific strategies for reducing CO_(2)emissions and emphasizes the varying roles of these driving factors in shaping environmental quality in the 7 South American countries.

Research on groundwater ecological environment mapping based on ecological service function:A case study of five Central Asian countries and neighboring regions of China

The groundwater system is a unique ecosystem that serves both resource and ecological functions.Hydrogeologists have conducted extensive theoretical research and practical work on groundwater ecological mapping.This paper,based on the study of groundwater resources and surface ecology in the five Central Asian countries and adjacent areas of China,introduces the concept of ecosystem service functions.It establishes a groundwater ecological zoning index system and conducts research of ecological mapping using the five Central Asian countries and adjacent areas of China as examples.Through this process,the ecosystem service functions of groundwater can be more comprehensively reflected,which can better guide regional geological environment protection and industrial planning.This approach helps coordinate the relationship between socio-economic development and water resource protection,maintain the health of the groundwater ecological environment,enhance the value of groundwater ecological services,and promote the sustainable development of regional economies and societies.

Challenges to establishing and maintaining kidney transplantation programs in developing countries:What are the coping strategies?

Kidney transplantation(KT)is the optimal form of renal replacement therapy for patients with end-stage renal diseases.However,this health service is not available to all patients,especially in developing countries.The deceased donor KT programs are mostly absent,and the living donor KT centers are scarce.Single-center studies presenting experiences from developing countries usually report a variety of challenges.This review addresses these challenges and the opposing strategies by reviewing the single-center experiences of developing countries.The financial challenges hamper the infrastructural and material availability,coverage of transplant costs,and qualification of medical personnel.The sociocultural challenges influence organ donation,equity of beneficence,and regular follow-up work.Low interests and motives for transplantation may result from high medicolegal responsibilities in KT practice,intense potential psychosocial burdens,complex qualification protocols,and low productivity or compensation for KT practice.Low medical literacy about KT advantages is prevalent among clinicians,patients,and the public.The inefficient organizational and regulatory oversight is translated into inefficient healthcare systems,absent national KT programs and registries,uncoordinated job descriptions and qualification protocols,uncoordinated on-site investigations with regulatory constraints,and the prevalence of commercial KT practices.These challenges resulted in noticeable differences between KT services in developed and developing countries.The coping strategies can be summarized in two main mechanisms:The first mechanism is maximizing the available resources by increasing the rates of living kidney donation,promoting the expertise of medical personnel,reducing material consumption,and supporting the establishment and maintenance of KT programs.The latter warrants the expansion of the public sector and the elimination of non-ethical KT practices.The second mechanism is recruiting external resources,including financial,experience,and training agreements.