Looming Crisis Research Articles

MASLD: What We Have Learned and Where We Need to Go-A Call to Action.

Since its introduction in 1980, fatty liver disease (now termed metabolic dysfunction-associated steatotic liver disease [MASLD]) has grown in prevalence significantly, paralleling the rise of obesity worldwide. While MASLD has been the subject of extensive research leading to significant progress in the understanding of its pathophysiology and progression factors, several gaps in knowledge remain. In this pictorial review, the authors present the latest insights into MASLD, covering its recent nomenclature change, spectrum of disease, epidemiology, morbidity, and mortality. The authors also discuss current qualitative and quantitative imaging methods for assessing and monitoring MASLD. Last, they propose six unsolved challenges in MASLD assessment, which they term the proliferation, reproducibility, reporting, needle-in-the-haystack, availability, and knowledge problems. These challenges offer opportunities for the radiology community to proactively contribute to their resolution. The authors conclude with a call to action for the entire radiology community to claim a seat at the table, collaborate with other societies, and commit to advancing the development, validation, dissemination, and accessibility of the imaging technologies required to combat the looming health care crisis of MASLD.

Energizing the future: Unleashing the potential of innovative waste-to-energy technologies for energy development and sustainability within Zimbabwe's tourism sector.

Zimbabwe's tourism industry, renowned for its natural wonders and cultural heritage, faces a looming energy crisis rooted in the detrimental over-reliance on fossil fuels and the underutilization of substantial waste resources that lie dormant. The article investigates multifaceted relationship between six independent variables: landfill gas recovery and anaerobic digestion, pyrolysis and gasification, incineration, biogas production, biodiesel production, ethanol production and syngas fermentation and one dependent variable: energy development and sustainability. In this study, a quantitative methodology was adopted, involving the gathering of data from 519 stakeholders in the tourism supply chain through a simple random sampling technique, with the sample size determined using the Krejcie and Morgan table. The distribution of questionnaires was facilitated through Google Forms, and the data analysis was conducted using Smart PLS. Statistical findings indicate direct significant relationship between variables, and t-statistic values all hypotheses were all greater than the threshold of 1.96, ranging from a minimum of 2.911 to a maximum of 9.431. These findings underscore the robustness of the relationships between the waste-to-energy technologies and energy development and sustainability within Zimbabwe's tourism sector. This empirical evidence highlights the substantial potential for these innovative technologies to play a pivotal role in mitigating the energy crisis and fostering sustainable energy development.

SARS-CoV-2 and Environmental Changes: The Perfect Storm

The COVID-19 pandemic has had a significant impact on the global economy. It also provided insights into how the looming global climate crisis might be addressed, as there are several similarities between the challenges proposed by COVID-19 and those expected from the coming climate emergency. COVID-19 is an immediate health threat, but climate change represents a more gradual and insidious risk that will lead to long-term consequences for human health. Research shows that climate change, air pollution and the pandemics have a negative impact on health. Recent studies show that COVID-19 mortality increases with climate extremes. The goal of our review is to analyze the clinical findings of COVID-19 and how they are affected by the climate change, while also providing insight into the emergence of new variants and their ability to evade the immune system. We selected and synthesized data from primary studies, reviews, meta-analyses, and systematic reviews. Selection was based on rigorous methodological and relevance criteria. Indeed, a new variant of SARS-CoV-2, named JN.1, has emerged as the dominant, first in the United States and then worldwide; the variant has specific mutations in its spike proteins that increase its transmissibility. According to the World Health Organization (WHO), JN.1 is currently the most reported variant of interest (VOI), having been identified in 132 countries. We highlight the link between climate change and pandemics, emphasizing the need for global action, targeted medical approaches and scientific innovation.

ITER full model in MCNP for radiation safety demonstration

The development of nuclear fusion as a safe and virtually limitless power source is receiving growing attention in the context of looming energy crisis and climate change. ITER project stands as the flagship international initiative and is advancing steadily. The construction of the Tokamak Complex is nearly finished, and the assembly of core components has begun on site. Simultaneously, the design is being finalized, and the safety case is becoming more concrete. Current approaches to radiation safety demonstration using 3D nuclear analysis with the Monte Carlo code MCNP require sophisticated artifacts to sew together simulations in separate models for the Tokamak and the rest of the facility. This results in cumbersome studies and, consequently, challengeable conclusions. To address this issue, we have built the an integral MCNP model of the ITER facility: the ITER full model. Along with improvements to the D1SUNED code, we illustrate its computational practicality and pertinence in two meaningful simulations for ITER safety case. This work represents the culmination of a two-decade-long effort of ITER modelling aiming to demonstrate adequate radiation safety. Beyond supporting the remaining design tasks, this model simplifies the corresponding 3D nuclear analysis and improves the robustness of the ITER safety case.

Emissions reduction potentials in business aviation with electric aircraft

Under the looming climate crisis, public concerns have been raised regarding the environmental impacts of private jet flights. Electric aircraft are currently considered one of the most encouraging technological keys to significantly reducing the environmental impacts of aviation. This research aims to study the replacement of currently used business jets with fully electric aircraft. This study is based on actual flight data of a European business carrier. The carbon dioxide emissions reduction potential for different aircraft ranges was estimated. Obtained results showed that with fully electric aircraft the studied business carrier could significantly reduce its annual emissions by up to 93%. On a per-passenger basis, the emissions could decrease from 6,787 g of carbon dioxide equivalent per passenger kilometre to 449 g. However, as electric aircraft will operate at a slower speed than business jets, flight times would increase by 10–41 min, depending on the distance.

Unchecked Antibiotic Access: A Looming Crisis in Pakistan.

Null.

P041 COMMUNITY-BASED STRATEGIES TO IMPROVE HEALTH-RELATED OUTCOMES IN PEOPLE LIVING WITH HYPERTENSION IN LOW MIDDLE-INCOME COUNTRIES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Background and objective: Hypertension affects one billion people globally and is a major risk factor for cardiovascular diseases. Currently, it is estimated that high blood pressure (BP) is related to the deaths of more than 10 million people every year. Interventions to mitigate the looming hypertension crisis in low- and middle-income countries (LMIC) need strong community involvement whilst concurrently addressing access to care and quality of care issues. The objective of this systematic review was to evaluate community-level interventions to improve hypertension control among patients living in LMICs. Methods: Nine databases were searched (July 22, 2023) for randomized controlled trials (RCTs) and cluster randomized control trials (cRCTs) implementing community-level interventions in adults with hypertension in LMICs. Studies were included based on an explicit focus on BP control. Quality assessment was done using the Revised Cochrane Risk of Bias tool for randomized trials (ROBS 2). Results were presented following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Fixed-effect meta-analysis were conducted for studies that reported continuous outcome measures. Results: We identified and screened 7125 articles. Eighteen studies were included in the analysis, 7 RCTs and 11 cRCTs. The overall summary effect of BP control from the meta-analysis was significant, risk ratio = 1.48 (95%CI = 1.40–1.57, n=12). For the RCTs risk ratio was 1.68 (95%CI = 1.40–2.01, n=5), and for the cRCTs 1.46 (95% CI = 1.32 – 1.61, n=7). For studies that reported on the individual components of the composite interventions, the risk ratio was 1.27 (95%CI = 1.04–1.54, n=3). Conclusions: Community-based strategies are relevant in addressing the burden of hypertension in LMICs. Community-based interventions can help decentralize hypertension care in LMIC and address the access to care gap without diminishing the quality of hypertension control.

Unmasking a looming crisis: Escalating MIC of last resort drugs against MRSA isolates from a tertiary care hospital in Central India

PurposeThe Centers for Disease Control and Prevention has classified methicillin-resistant S aureus (MRSA) as a serious public health threat. The escalating minimum inhibitory concentration (MIC) of standard anti-methicillin-resistant S aureus (MRSA) drugs within the susceptible range, known as "MIC creep," jeopardizes their effectiveness against MRSA infections, posing additional challenges in managing MRSA infections. This cross-sectional study was conducted in a tertiary care hospital in Central India to assess the susceptibility trends of clinical MRSA isolates against commonly used anti-MRSA drugs and to observe MIC creep, if any, over three years (2020–2022). MethodsThe study included 158 non-repetitive clinical MRSA isolates. The MICs of vancomycin, teicoplanin, and linezolid were determined in MRSA strains using agar dilution, while the MIC of daptomycin was performed by broth microdilution. MIC creep was assessed by calculating MIC50, MIC90, Modal MIC, G-mean MIC, and susceptible and resistant percentages for the fiscal years 2020, 2021, and 2022. ResultsOf the 158 MRSA isolates, none were resistant to vancomycin, teicoplanin, and daptomycin, but two showed resistance to linezolid (LRSA). However, fifteen isolates showed intermediate resistance to vancomycin (VISA), and five showed intermediate resistance to teicoplanin (TISA). MIC of these anti-MRSA drugs increased in 2021 and 2022 compared to 2020. G-mean MIC for vancomycin, teicoplanin, and linezolid in MRSA strains increased significantly over the study period, while daptomycin MIC remained relatively stable, with a slight increase in 2021 and 2022. There was a high resistance rate for clindamycin, doxycycline, and chloramphenicol among VISA, TISA, and LRSA isolates compared to MRSA. ConclusionsDuring the three years of the study, “MIC creep” was observed in vancomycin, teicoplanin, and linezolid and, to some extent, for daptomycin in MRSA strains. The recovery of VISA, TISA, and linezolid-resistant MRSAs is worrisome, suggesting possible MRSA treatment failure and being a forerunner of resistant strains.

Constructing cascade electric fields and sulfur vacancies in Ni3S4/NiS2/v-Zn3In2S6 photocatalyst for efficient degradation of contaminants and H2 production

The increasing environmental pollution and looming energy crisis necessitate the development of advanced photocatalysts that demonstrate efficient separation and transfer of the photo-generated holes and electrons, as well as multiple functions to address the above issues. Herein, a bifunctional Ni3S4/NiS2/v-Zn3In2S6 photocatalyst has been constructed to degrade environmental hormones and antibiotics with simultaneous H2 production. Sulfur vacancies have been engineered in the Zn3In2S6 from a kinetic point of view to accelerate the separation of photogenerated charge carriers and act as active sites. Ni3S4 and NiS2 are introduced to construct cascade electric fields with Zn3In2S6 via ohmic junctions for spatially separated charge carriers and reduced hydrogen evolution potential. As a result, the composite exhibits enhanced photocatalytic H2 production and efficient degradation of bisphenol A, norfloxacin, and tetracycline, respectively. Specifically, the degradation pathways of BPA have been investigated based on Fukui calculations and liquid chromatography-mass spectrometry techniques. This work may shed new light on the design and construction of dual-function photocatalysts for wastewater treatment and H2 production.

How Shared Dietary Behaviors Within Asian American Families Are Influenced by Emotional Interaction Qualities: A Nationwide Cross-sectional Analysis.

Asian American (AA) young adults face a looming diet-related non-communicable disease crisis. Interactions with family members are pivotal in the lives of AA young adults and form the basis of family-based interventions; however, little is known on the role of these interactions in shared family food behaviors. Through an analysis of 2021 nationwide survey data of 18-35-year-old AAs, this study examines how the quality of family member interactions associates with changes in shared food purchasing, preparation, and consumption. Interaction quality was assessed through 41 emotions experienced while interacting with family, and was categorized as positive (e.g., "I look forward to it"), negative (e.g., "I feel annoyed"), and appreciation-related (e.g., "I feel respected") interactions. Participants were also asked how frequently they ate meals, ate out, grocery shopped, and cooked with their family. Among the 535 AAs surveyed (47.6% East Asian, 21.4% South Asian, 22.6% Southeast Asian), 842 unique family interactions were analyzed; 43.5% of interactions were with mothers, followed by siblings (27.1%), and fathers (18.5%). Participants most frequently ate meals with their family (at least daily for 33.5% of participants), followed by cooking (at least daily for 11.3%). In adjusted analyses, an increase in shared food behaviors was particularly associated with positive interactions, although most strongly with cooking together and least strongly with eating meals together; significant differences between ethnic subgroups were not observed. Findings revealed the importance of family interaction quality when leveraging family relationships to develop more tailored, impactful AA young adult dietary interventions.

Exploring the feasibility of dimethyl ether (DME) and LPG fuel blend for small diesel engine: A simulation perspective

There is a looming global crisis owing to the increase in greenhouse gases and the escalating fossil fuel process. The issue is further compounded by the ongoing conflicts in different places in the world. Hence, there is an urgent need for a bouquet of alternative fuels suitable to power the incumbent internal combustion engine. Among various options available Dimethyl Ether (DME) is a friendly environment fuel, easy to liquefy, and suitable for use in diesel engines, while Liquefied Petroleum Gas (LPG) is another potential alternative fuel suitable for internal combustion engines. The present study is an endeavor to investigate the characteristics of a diesel engine powered with DME-diesel blends as pilot fuel while LPG was used as the main fuel. During engine testing, different blends of diesel-DME were used containing 0%, 25%, 50%, and 75% DME. The AVL Boost software was employed for modeling the engine performance and tailpipe emission. The test fuel combination was successful in running the engine sans any abnormality in sound or performance. The results showed carbon monoxide (CO) and hydrocarbon (HC) emissions were reduced using the test fuel combination while there was a marginal increase in the oxides of nitrogen (NOx) levels. In general, the combination of DME and LPG could be considered as a potential and promising solution to reducing pollutant emissions.

Tailoring regulatory components for metabolic engineering in cyanobacteria.

The looming climate crisis has prompted an ever-growing interest in cyanobacteria due to their potential as sustainable production platforms for the synthesis of energy carriers and value-added chemicals from CO2 and sunlight. Nonetheless, cyanobacteria are yet to compete with heterotrophic systems in terms of space-time yields and consequently production costs. One major drawback leading to the low production performance observed in cyanobacteria is the limited ability to utilize the full capacity of the photosynthetic apparatus and its associated systems, i.e. CO2 fixation and the directly connected metabolism. In this review, novel insights into various levels of metabolic regulation of cyanobacteria are discussed, including the potential of targeting these regulatory mechanisms to create a chassis with a phenotype favorable for photoautotrophic production. Compared to conventional metabolic engineering approaches, minor perturbations of regulatory mechanisms can have wide-ranging effects.

The pandemic crisis narrated by the populist radical right parties. The cases of the Lega per Salvini and the Rassemblement National

One of the characteristics of populist communication is the staging of crises. In particular, populist radical right parties (PRRPs) often communicate a sense of looming crisis by naming real or imagined threats. In light of the recent pandemic crisis, an event that disrupted the ordinary and opened a space for discursive competition, we aim to answer the following questions: what crisis narrative did PRRPs offer? Is it possible to identify a populist articulation in their crisis narratives? Were there differences from their own previous political discourses and the narratives of other similar PRRPs? We propose a qualitative analysis of Facebook posts made in 2020 by the leaders of the Lega per Salvini in Italy and the Rassemblement National in France, Matteo Salvini and Marine Le Pen. We show that the two leaders used a combination of two main strategies: distraction from the crisis by politicizing other issues and maximization of the crisis by identifying enemies and victims. Their crisis narratives had many similarities due to their shared membership of the PRR family and their competitive position as challenger parties but they also had differences that depend on their identity specific characteristics.

ESKAPE: Navigating the Global Battlefield for Antimicrobial Resistance and Defense in Hospitals

The current healthcare environment is at risk due to the facilitated transmission and empowerment of the ESKAPE pathogens, comprising of Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species. These pathogens have posed significant challenges to global public health and the threat has only amplified over time. These multidrug-resistant bacteria have become adept at escaping the effects of conventional antibiotics utilized, leading to severe healthcare-associated infections and compromising immunocompromised patient outcomes to a greater extent. The impact of ESKAPE pathogens is evident in the rapidly rising rates of treatment failures, increased mortality, and elevated healthcare costs. To combat this looming crisis, diverse strategies have been adopted, ranging from the development of novel antimicrobial agents and combination therapies to the implementation of stringent infection control measures. Additionally, there has been a growing emphasis on promoting antimicrobial stewardship programs to optimize the use of existing antibiotics and reduce the selective pressure driving the evolution of resistance. While progress has been made to some extent, the rapid adaptability of these pathogens and the enhancement of antimicrobial resistance mechanisms proves to be a major hurdle yet to be crossed by healthcare professionals. In this viewpoint, the impending threat heralded by the proliferation of ESKAPE pathogens, and the need for a concerted global effort via international collaborations for the assurance of effective and sustainable solutions, are explored. To curb the possibility of outbreaks in the future and to safeguard public health, better preparation via global awareness and defense mechanisms should be given paramount importance.

The 3 Decades Global Financial Policy Failure in Housing Market, Runaway Home Prices, Today’s Growing Homeless Crisis: Eddison Walters Real Estate Housing Technology Structural Change Transformational Theory

Failure to address technological-driven structural changes in the real estate market that began three decades ago has caused runaway home prices that developed countries are experiencing today. The real estate crash that preceded the Global Financial Crisis, and the entire Global Financial Crisis resulted from the panic that was created about the rapid increase in home prices that was falsely labeled a real estate bubble by the media which was quickly adapted by policymakers. Policymakers and the media blamed greedy mortgage brokers for the rapid increase in home prices, accusing mortgage brokers of providing mortgages to too many people for homes that the borrowers could not afford. It turns out that the media and policymakers were completely wrong when mortgage brokers were falsely blamed for creating a real estate bubble because a real estate bubble never existed. The true cause of the rapid increase in home prices was the early stages of a real estate boom from technological-driven structural changes in the real estate market. Failure to address structural changes in the real estate housing market which started three decades ago, has resulted in runaway home prices in the United States and developed countries around the world. As a result of the failure widespread economic hardship from homelessness is a significant risk as working families find themselves priced out of the housing market. Three decades of economic policy failures and the mismanagement of the housing sector have resulted in a looming housing crisis that continues to increase as developed countries face runaway home prices. Policymakers throughout developed countries eagerly accepted the media-driven misinformation of a real estate bubble without any evidence presented supporting the narrative. The failure of policymakers to gain an understanding of factors that have been driving the rapid increase in home prices which began three decades ago, resulted in the real estate crash, Global Financial Crisis, and Great Recession. Much of the economic hardship and the looming housing crisis facing working families today could have been avoided. For many working American families, the prospect of home ownership no longer exists due to skyrocketing home prices. The looming homeless crisis facing the developed world today is the direct result of economic policy failures that have ignored the structural changes in the housing market for three decades. The move from print media real estate listings to online real estate listings and the adaptation of online mortgage loan applications along with automated mortgage underwriting between 1995 and 1999, exponentially increased the quantity of inventory needed in the housing market of developed countries. The shift in the demand curve for housing structurally changed the housing market in developed countries resulting in the complete transformation that saw the demand for housing skyrocket by 2000. New homebuyers who previously only had access to local housing markets before the transformation of the housing market began in 1995, had full access to homes listed anywhere online in other real estate markets by the end of 1999. The increased demand caused the rapid growth in home prices. Failure to implement policies to drastically increase home inventory in developed countries to address the structural transformation of the housing market which drastically increased the demand for homes was a significant economic policy failure. Instead of implementing policies to significantly increase home inventory, new construction was idle for over a decade as policymakers adopted the media-driven misinformation of a real estate bubble and supported policies to address the nonexistent real estate bubble.

Phage therapy: breathing new tactics into lower respiratory tract infection treatments.

Lower respiratory tract infections (LRTIs) present a significant global health burden, exacerbated by the rise in antimicrobial resistance (AMR). The persistence and evolution of multidrug-resistant bacteria intensifies the urgency for alternative treatments. This review explores bacteriophage (phage) therapy as an innovative solution to combat bacterial LRTIs. Phages, abundant in nature, demonstrate specificity towards bacteria, minimal eukaryotic toxicity, and the ability to penetrate and disrupt bacterial biofilms, offering a targeted approach to infection control. The article synthesises evidence from systematic literature reviews spanning 2000-2023, in vitro and in vivo studies, case reports and ongoing clinical trials. It highlights the synergistic potential of phage therapy with antibiotics, the immunophage synergy in animal models, and the pharmacodynamics and pharmacokinetics critical for clinical application. Despite promising results, the article acknowledges that phage therapy is at a nascent stage in clinical settings, the challenges of phage-resistant bacteria, and the lack of comprehensive cost-effectiveness studies. It stresses the need for further research to optimise phage therapy protocols and navigate the complexities of phage-host interactions, particularly in vulnerable populations such as the elderly and immunocompromised. We call for regulatory adjustments to facilitate the exploration of the long-term effects of phage therapy, aiming to incorporate this old-yet-new therapy into mainstream clinical practice to tackle the looming AMR crisis.

"There is nothing to protect us from dying": Black women's perceived sense of safety accessing pregnancy and intrapartum care.

Pregnancy and childbirth have become a dangerous journey for Black women as harrowing stories of death and near-death experiences resonate within Black communities. While the causes of pregnancy-related morbidity and mortality are well documented, little is known about how Black Canadian women feel protected from undesirable maternal health outcomes when accessing and receiving pregnancy and intrapartum care. This critical qualitative inquiry sheds light on Black women's perceived sense of safety in accessing pregnancy and intrapartum care. Twenty-four in-depth interviews were conducted with Black women who were pregnant or had given birth. Five interconnected themes were generated through thematic analysis: (1) There is a lot of prejudice towards us, (2) We are treated as sick bodies, (3) There is a lot of stereotypes towards us, (4) Our care is lacking in quality, and (5) We feel unsafe in the healthcare system. These themes highlight the perils faced by Black women accessing pregnancy and intrapartum care. The right to safe motherhood and equitable care for Black women should be a national priority in Canada to avert a looming crisis.

Highly efficient solar-thermal-electric conversion based on asymmetric binary-architecture design in solid-solid composite phase change materials

The application of phase change materials (PCMs) in solar-thermal conversion is largely limited by the inherently inferior thermal conductivity (TC) and poor solar-thermal energy transition capacity of PCMs. Herein, 1,1,1-tri(hydroxymethyl)ethane@melamine foam/cellulose nanofiber/graphene nanoplate (TME@MCGx) shape-stable composite PCMs (ss-CPCMs) are prepared by encapsulating TME into MCGx aerogels. Profited by the effective heat-conducting MCG25 networks, the resulting TME@MCG25 ss-CPCM achieves high TC of 0.73 Wm-1k−1 for internal heat conduction. Meanwhile, the combination of surface photothermal etching and hydrophobic polydimethylsiloxane (PDMS) coating endows the obtained T-TME@MCG25 highly efficient solar-thermal conversation efficiency of 93.1 %, arising from the exposed 3D MCG25 skeletons for absorbing sunlight and the thin PDMS layer for preventing the absorbed solar-thermal energy from radiating and dissipating. Consequently, the solar-thermal-electric (STE) conversion system equipped with T-TME@MCG25 generates the prominent output voltage of 213.0 mV and current of 37.6 mA. Furthermore, the acquired T-TME@MCG25 exhibits remarkable hydrophobicity and self-cleaning performances, due to the micro-nano structures of MCGx skeleton surfaces and the low surface energy of PDMS coating. The design strategy of asymmetric binary-architecture containing 3D photothermal absorption layer and water repellency layer provides a valuable insight into STE energy conversion associated with hydrophobic ss-CPCMs, which can alleviate the looming energy crisis.

An economic sustainability analysis of hybrid solar-biomass system for sugar industries in India

Renewable energy systems have been gaining more importance in developing countries not only due to the increase in concern towards environmental sustainability but also resolving the looming energy crisis that bewilders economic development. Till date, inadequate attention has been paid to the integration of Renewable Energy (RE) sources in the industrial sectors of TamilNadu, India. Since industries have been key drivers of electricity consumption in the past decade, this paper aims at the simulation and analysis of hybrid Biomass-Solar Photovoltaic system for electrification of the process industries, especially sugar industries. The main objective of the paper is to minimize the cost of energy and Green House Gas (GHG) emissions leading to sustainable development. The economic feasibility analysis is performed using Hybrid Optimization Model for Electric Renewables (HOMER) software and the sustainability analysis with the help of Clean Development Mechanism that can be adopted for the sugar industry. The simulation results support the effectiveness of the proposed grid connected solar-biomass hybrid system for the sugar industry with the net present cost of 16 million dollars (M$) combined with emission reductions of 6,266 tons/year.

China, international competition and the stalemate in sovereign debt restructuring: beyond geopolitics

Abstract Until recently, developing countries were supposedly enjoying an unprecedented ‘age of choice’ when borrowing. Many observers were arguing then that geopolitical competition between lenders allowed them to extract better terms. Today, many face a looming debt crisis: financing options have shrivelled and restructuring talks are painfully slow, compounding debtors' misery. This is frequently attributed to creditors' geopolitical rivalry, reflecting China's rise as a sovereign lender. But why should competition between providers, once supposedly a boon for borrowers, now be a bane? This article explains this, by switching an inadequate geopolitics lens for a political economy analysis. The earlier expansion in lending was primarily driven not by geopolitical contestation but by prevailing politico-economic conditions within China and on international financial markets amid US-led quantitative easing, and was, furthermore, facilitated by China's fragmented internal governance. As economic conditions changed, financing dried up and creditors scrambled to secure returns. China's current chief competitors are not western states, but rival lenders: commercial bondholders and multilateral development banks. Given China's fragmented governance, lenders' commercial motives to recoup their loans primarily drive Chinese behaviour, not geopolitical objectives. This limits China's hegemonic potential and suggests developing countries may benefit less from the ‘second Cold War’ than some imagine.