Power transitions and global trade governance:The impact of a rising China on the export credit regime

The existing liberal international economic order was constructed during the era of American hegemony and heavily shaped by US power. How is the rise of China affecting global economic governance? This article analyzes the case of export credit, which has long been considered a highly effective international regulatory regime and an important component of global trade governance. I show that the rise of China is profoundly altering the landscape of export credit and undermining its governance arrangements. State-backed export credit is a key tool of China’s development strategy, yet I argue that an explosion in China’s use of export credit is eroding the efficacy of existing international rules intended to prevent a competitive spiral of state subsidization via export credit. The case of export credit highlights a fundamental tension between liberal institutions of global governance and the development objectives of emerging powers

Climate-induced redistribution of people is not inevitable

As climate change intensifies, scientific and policy discussions increasingly address questions of future habitability and potential population movements. In this perspective, we caution against premature or top-down characterizations of areas as uninhabitable, or portrayals of large-scale climate-induced displacement as inevitable—particularly when the perspectives and preferences of affected populations are excluded. While we recognize the importance of modelling and scenario-building to assess future risks, we argue that such efforts must be grounded in local realities and include diverse forms of knowledge.
Habitability is not determined by climate alone, but emerges from intersecting environmental, political, economic, and cultural dynamics—including governance, inequality, and historical injustice. Framings that do not consider this risk producing two problematic outcomes: first, by prematurely defining areas as uninhabitable, they may undermine the legitimacy of in-situ adaptation and the agency of affected communities; second, when modelling or the use of modelling results does not consider local context, it may inadvertently contribute to narratives portraying climate-induced mass displacement as inevitable, reinforcing deterministic understandings of migration and overlooking the complex drivers of mobility and immobility.
To counter these risks, we propose five guiding recommendations: (1) avoid declaring hard limits to habitability without inclusive, context-specific assessments; (2) treat model-based projections as possible, not predetermined futures; (3) reject simplistic global North/South assumptions in assessing vulnerability and mobility; (4) uphold people’s right to remain, alongside the right to move; and (5) prioritize investment in in-situ adaptation that addresses structural inequalities. These principles aim to inform more reflexive and justice-oriented approaches to climate mobility and habitability research—approaches that recognize lived experiences, engage diverse knowledge systems, and help secure equitable futures for those most exposed to environmental change

Climate-induced redistribution of people is not inevitable

As climate change intensifies, scientific and policy discussions increasingly address questions of future habitability and potential population movements. In this perspective, we caution against premature or top-down characterizations of areas as uninhabitable, or portrayals of large-scale climate-induced displacement as inevitable—particularly when the perspectives and preferences of affected populations are excluded. While we recognize the importance of modelling and scenario-building to assess future risks, we argue that such efforts must be grounded in local realities and include diverse forms of knowledge.
Habitability is not determined by climate alone, but emerges from intersecting environmental, political, economic, and cultural dynamics—including governance, inequality, and historical injustice. Framings that do not consider this risk producing two problematic outcomes: first, by prematurely defining areas as uninhabitable, they may undermine the legitimacy of in-situ adaptation and the agency of affected communities; second, when modelling or the use of modelling results does not consider local context, it may inadvertently contribute to narratives portraying climate-induced mass displacement as inevitable, reinforcing deterministic understandings of migration and overlooking the complex drivers of mobility and immobility.
To counter these risks, we propose five guiding recommendations: (1) avoid declaring hard limits to habitability without inclusive, context-specific assessments; (2) treat model-based projections as possible, not predetermined futures; (3) reject simplistic global North/South assumptions in assessing vulnerability and mobility; (4) uphold people’s right to remain, alongside the right to move; and (5) prioritize investment in in-situ adaptation that addresses structural inequalities. These principles aim to inform more reflexive and justice-oriented approaches to climate mobility and habitability research—approaches that recognize lived experiences, engage diverse knowledge systems, and help secure equitable futures for those most exposed to environmental change

Climate-induced redistribution of people is not inevitable

As climate change intensifies, scientific and policy discussions increasingly address questions of future habitability and potential population movements. In this perspective, we caution against premature or top-down characterizations of areas as uninhabitable, or portrayals of large-scale climate-induced displacement as inevitable—particularly when the perspectives and preferences of affected populations are excluded. While we recognize the importance of modelling and scenario-building to assess future risks, we argue that such efforts must be grounded in local realities and include diverse forms of knowledge. Habitability is not determined by climate alone, but emerges from intersecting environmental, political, economic, and cultural dynamics—including governance, inequality, and historical injustice. Framings that do not consider this risk producing two problematic outcomes: first, by prematurely defining areas as uninhabitable, they may undermine the legitimacy of in-situ adaptation and the agency of affected communities; second, when modelling or the use of modelling results does not consider local context, it may inadvertently contribute to narratives portraying climate-induced mass displacement as inevitable, reinforcing deterministic understandings of migration and overlooking the complex drivers of mobility and immobility. To counter these risks, we propose five guiding recommendations: (1) avoid declaring hard limits to habitability without inclusive, context-specific assessments; (2) treat model-based projections as possible, not predetermined futures; (3) reject simplistic global North/South assumptions in assessing vulnerability and mobility; (4) uphold people’s right to remain, alongside the right to move; and (5) prioritize investment in in-situ adaptation that addresses structural inequalities. These principles aim to inform more reflexive and justice-oriented approaches to climate mobility and habitability research—approaches that recognize lived experiences, engage diverse knowledge systems, and help secure equitable futures for those most exposed to environmental change

Concept, Design, and Preclinical Testing of a Remote-Control Robotic System for Transesophageal Echocardiography

Background: Interventional echocardiography (IE) plays a critical role in guiding structural heart interventions. IE specialists face challenges including high radiation exposure and unfavorable ergonomics. To address these issues, a novel remote-control robotic (RCR) system for transesophageal echocardiography (TEE) control has been developed. This study aims to describe the novel RCR system and to assess its performance in bench tests and in vitro models in terms of functionality, image quality, and reproducibility. Methods: Bench testing and in vitro testing were performed using the RCR system. All tests were performed using the GE 6VT-D TEE probe and the GE Vivid E95. Results: Key findings include proof of concept through bench testing, remote control of all five degrees of freedom of the TEE probe, and reliable, fast, and accurate reproducibility using automated navigation. The ROB’E Base is securely attached to the operating table, optimizing the footprint in the operating room. The ROB’E Guide accurately performs the forward and backward motion of the flexible portion of the TEE probe, stabilizing the achieved positions and preventing twisting during rotation. The ROB'E RCR system can store and reproduce TEE probe positions and has demonstrated reliable and accurate automated reproducibility in both bench and in vitro tests. Conclusions: The ROB'E RCR system for TEE overcomes the limitations of conventional IE by using a RCR approach that eliminates the need for the echocardiographer to be physically present in the operating room. Thus, it significantly reduces radiation exposure and demonstrates its capabilities to improve image quality, reproducibility, and overall safety in IE

Articulating and Claiming the Right to Stay in the Context of Climate Change

Climate-related displacement is a topic of increasing concern in both academic research and the political, social, and humanitarian spheres. As many seek to develop legal regimes that will allow those living in the most climate-affected areas to move with dignity, individuals and communities living in these countries, regions, and localities are often resistant to the idea of migration as their best adaptation option, and instead call for policy choices that will allow them to stay in place. In this article we seek to legally situate these calls for a right to stay and examine the specific forms that they are taking on the ground. We suggest that there is a typology of right to stay claims, ranging from classic claims—primarily against local government or private actors, against takings or for protection from forced eviction or relocation—to more expansive claims for revised economic, social, or environmental policies to address the underlying drivers of displacement, which may also involve national government and even the international community. We argue that the full range of these different types of claims have relevance in the climate change context, and that such claims may have important legal, moral, and discursive power in efforts to meaningfully address climate change-related displacement in a manner consistent with the rights of those most affected

Articulating and Claiming the Right to Stay in the Context of Climate Change

Climate-related displacement is a topic of increasing concern in both academic research and the political, social, and humanitarian spheres. As many seek to develop legal regimes that will allow those living in the most climate-affected areas to move with dignity, individuals and communities living in these countries, regions, and localities are often resistant to the idea of migration as their best adaptation option, and instead call for policy choices that will allow them to stay in place. In this article we seek to legally situate these calls for a right to stay and examine the specific forms that they are taking on the ground. We suggest that there is a typology of right to stay claims, ranging from classic claims—primarily against local government or private actors, against takings or for protection from forced eviction or relocation—to more expansive claims for revised economic, social, or environmental policies to address the underlying drivers of displacement, which may also involve national government and even the international community. We argue that the full range of these different types of claims have relevance in the climate change context, and that such claims may have important legal, moral, and discursive power in efforts to meaningfully address climate change-related displacement in a manner consistent with the rights of those most affected

P6491Predictive effect of mitral annular size on persistent mitral valve dysfunction after transcatheter edge-to-edge mitral valve repair for functional mitral regurgitation

Abstract Background In patients with functional mitral regurgitation (FMR), deformation of the mitral valve (MV) apparatus leads to deteriorating coaptation of both leaflets. The MV geometry is essential to predict procedural success of using the MitraClip™ for FMR patients. Persistent such mitral regurgitation (MR) and post-procedural mitral stenosis (MS) are parameters for an increasing mortality rate after MitraClip implantation. The anterior-to-posterior mitral annulus diameter (MAD) is simple to evaluate with a high reproducibility rate. However, the predictive effect has not been determined to date. Purpose We evaluated the predictive effect of baseline anterior-to-posterior MAD on persistent MV dysfunctions after MitraClip™ implantation. Methods We investigated the prevalence of procedural failure (MR at discharge &gt; grade 2+) and post-procedural MS (mean transmitral gradient (mTMG) at discharge ≥6 mmHg) in a patient cohort with FMR (n=190), who underwent MitraClip™ implantation. We measured the MV apparatus geometry on mid-systole using transoesophageal echocardiography before the index procedure. The MAD was stratified by interquartile ranges (IQR) in the comparison. (≤34 mm, 35 to 37 mm, 38 to 40 mm, and ≥41 mm, respectively) Results The mean age was 75±9 years, and 63 patients (33%) were female. The mean left ventricular ejection fraction was 34±14%. Moderate-to-severe (3+) or severe MR (4+) were documented in all patients before the procedure. Transthoracic echocardiography at discharge revealed residual MR (&gt;2+) in 10 patients (5%) and post-procedural MS in 13 patients (7%), in which one patient presented with both residual MR and MS. After stratification by the IQRs of MAD, there were significant differences in body weight (p&lt;0.001), height (p&lt;0.001), and body surface area (p&lt;0.001), but no significant differences in the other baseline characteristics. Notably, significant differences in the prevalence of procedural failure (p=0.004) and post-procedural MS (p=0.022) were observed among the groups. (Figure) Specifically, in the cohort with the 4th IQR (MAD ≥41 mm, n=44), procedural failure was observed in 7 patients (16%), although the prevalence was only 2% in the other IQR groups. Moreover, the cohorts with the 1st and 2nd IQR presented with higher prevalence of post-procedural MS (6 of 46 patients (13%) in the 1st IQR group, and 6 of 51 (12%) in the 2nd IQR group) than those with the 3rd and 4th IQRs. (1 of 49 patients (2%) in the 3rd IQR, and none of 44 patients in the 4th IQR) Figure 1 Conclusion In this analysis we showed that the mitral annulus size affected MV dysfunction after MitraClip™. Anterior-to-posterior MAD was useful to predict the procedural result. For FMR candidates with dilated mitral annulus larger than 40 mm, new-generation MitraClip-XTR™ system or other therapeutic concept such as annuloplasty may be reasonable to obtain satisfactory MV function. </jats:sec