Do Environmental Regulations Facilitate a Low-Carbon Transformation in China's Resource-Based Cities?

Resource-based cities (RBCs) are not only important for ensuring national resource and energy security, but they also face serious ecological and environmental problems. To achieve China's carbon peaking and neutrality goals in the coming years, RBCs' achievement of a low-carbon transformation has become increasingly significant. The core of this study is an investigation as to whether governance, including environmental regulations, can facilitate the low-carbon transformation of RBCs. Based on RBC data from 2003 to 2019, we establish a dynamic panel model to research the influence and mechanism of environmental regulations on low-carbon transformation. We found that China's environmental regulations facilitate a low-carbon transformation in RBCs. Mechanism analysis identified that the environmental regulations facilitate the low-carbon transformation in RBCs by strengthening foreign direct investment, enhancing green technology innovation and promoting industrial structure upgrading. Heterogeneity analysis found that the environmental regulations play a greater role in facilitating the low-carbon transformation of RBCs in regions with more developed economies and less dependence on resources. Our research provides theoretical and policy implications for environmental regulations for the low-carbon transformation of RBCs in China, applicable to other resource-based areas.

The Impact of COVID-19 on Electricity Demand and Generation in Japan

This research considered changes in monthly electricity generation and demand in Japan during the COVID-19 pandemic. Observed network electricity demand and generation type for the January–June 2020 period were compared to forecast values (using a triple exponential smoothing method) based on trends established from 2016 to 2019. Regional level electricity demand data showed little variation from expected trends for domestic energy users, but lower than expected business and industrial network demand, particularly in the 50–2000 kW cohort. Electricity demand was most likely to deviate from existing trends in May 2020, which is in-line with the voluntary lockdown activities. These results are consistent with observed patterns from other international studies into the impact of COVID-19 on electricity demand. Generation was found to be reduced in May and June of 2020, without significant impacts to the generation makeup, largely due to Japan’s positioning within a broader energy transition context. These findings validate previous studies and add to the broader discussions on drivers and the rationale for electricity demand behaviors between user scales. Previous studies examined the electricity demand reductions of full and partial lockdowns. This analysis adds to this discourse by documenting the impacts of a voluntary lockdown.

Diagnostic performance of the combined nasal and throat swab in patients admitted to hospital with suspected COVID-19.

BACKGROUND: Accurate diagnosis in patients with suspected coronavirus disease 2019 (COVID-19) is essential to guide treatment and limit spread of the virus. The combined nasal and throat swab is used widely, but its diagnostic performance is uncertain. METHODS: In a prospective, multi-centre, cohort study conducted in secondary and tertiary care hospitals in Scotland, we evaluated the combined nasal and throat swab with reverse transcriptase-polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in consecutive patients admitted to hospital with suspected COVID-19. Diagnostic performance of the index and serial tests was evaluated for a primary outcome of confirmed or probable COVID-19, and a secondary outcome of confirmed COVID-19 on serial testing. The diagnosis was adjudicated by a panel, who recorded clinical, laboratory and radiological features blinded to the test results. RESULTS: We enrolled 1368 consecutive patients (median age 68 [interquartile range, IQR 53-80] years, 47% women) who underwent a total of 3822 tests (median 2 [IQR 1-3] tests per patient). The primary outcome occurred in 36% (496/1368), of whom 65% (323/496) and 35% (173/496) had confirmed and probable COVID-19, respectively. The index test was positive in 255/496 (51%) patients with the primary outcome, giving a sensitivity and specificity of 51.4% (95% confidence interval [CI] 48.8 to 54.1%) and 99.5% (95% CI 99.0 to 99.8%). Sensitivity increased in those undergoing 2, 3 or 4 tests to 60.1% (95% CI 56.7 to 63.4%), 68.3% (95% CI 64.0 to 72.3%) and 77.6% (95% CI 72.7 to 81.9%), respectively. The sensitivity of the index test was 78.9% (95% CI 74.4 to 83.2%) for the secondary outcome of confirmed COVID-19 on serial testing. CONCLUSIONS: In patients admitted to hospital, a single combined nasal and throat swab with RT-PCR for SARS-CoV-2 has excellent specificity, but limited diagnostic sensitivity for COVID-19. Diagnostic performance is significantly improved by repeated testing.

ST-segment elevation in patients presenting with COVID-19: case series.

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the now pandemic disease, coronavirus disease (COVID-19). A number of reports have emerged suggesting these patients may present with signs and symptoms consistent with ST-segment elevation myocardial infarction without coronary artery occlusion. CASE SUMMARY: We report an international case series of patients with confirmed COVID-19 infection who presented with suspected ST-segment elevation myocardial infarction. Three patients with confirmed COVID-19 presented with electrocardiogram criteria for ST-segment elevation myocardial infarction. No patient had obstructive coronary disease at coronary angiography. Post-mortem histology in one case demonstrated myocardial ischaemia in the absence of coronary atherothrombosis or myocarditis. DISCUSSION: Patients with COVID-19 may present with features consistent with ST-segment elevation myocardial infarction and patent coronary arteries. The prevalence and clinical outcomes of this condition require systematic investigation in consecutive unselected patients.

Impacts of COVID-19 on a Transitioning Energy System, Society, and International Cooperation

Short term outcomes of the COVID-19 pandemic have included improved air quality and reduced carbon dioxide (CO2) and other greenhouse gas emissions, while long term repercussions may include a disruption to joint international research efforts, the creation of silos, and the potential for internalizing efforts toward national rather than global goals. In this study, we identified the impacts of reduced mobility on pollutants and emissions, the emergence of nationalist approaches and effects on international cooperation, and how these issues will affect the achievement of global carbon targets and the Sustainable Development Goals (SDGs). COVID-19 presents a global short-term crisis and there is a demonstrated global desire and effort to develop a vaccine and effective treatments. Similarly, climate change is also a near future issue, and as a result we need to reduce CO2 emissions rapidly. This review highlights potential policy interventions, which capitalize on learnings from COVID-19, while identifying SDGs 10, 13, and 17 as critical to engendering a successful, cooperative transition toward sustainability. The recognition of the earth as a closed system, demonstrated by the shared impacts of the COVID-19 crisis, may encourage positive future effects on cooperative approaches toward mitigating climate change, another looming crisis for humanity.

Global evaluation of echocardiography in patients with COVID-19.

AIMS: To describe the cardiac abnormalities in patients with COVID-19 and identify the characteristics of patients who would benefit most from echocardiography. METHODS AND RESULTS: In a prospective international survey, we captured echocardiography findings in patients with presumed or confirmed COVID-19 between 3 and 20 April 2020. Patient characteristics, indications, findings, and impact of echocardiography on management were recorded. Multivariable logistic regression identified predictors of echocardiographic abnormalities. A total of 1216 patients [62 (52-71) years, 70% male] from 69 countries across six continents were included. Overall, 667 (55%) patients had an abnormal echocardiogram. Left and right ventricular abnormalities were reported in 479 (39%) and 397 (33%) patients, respectively, with evidence of new myocardial infarction in 36 (3%), myocarditis in 35 (3%), and takotsubo cardiomyopathy in 19 (2%). Severe cardiac disease (severe ventricular dysfunction or tamponade) was observed in 182 (15%) patients. In those without pre-existing cardiac disease (n = 901), the echocardiogram was abnormal in 46%, and 13% had severe disease. Independent predictors of left and right ventricular abnormalities were distinct, including elevated natriuretic peptides [adjusted odds ratio (OR) 2.96, 95% confidence interval (CI) 1.75-5.05) and cardiac troponin (OR 1.69, 95% CI 1.13-2.53) for the former, and severity of COVID-19 symptoms (OR 3.19, 95% CI 1.73-6.10) for the latter. Echocardiography changed management in 33% of patients. CONCLUSION: In this global survey, cardiac abnormalities were observed in half of all COVID-19 patients undergoing echocardiography. Abnormalities were often unheralded or severe, and imaging changed management in one-third of patients.