Mechanical characteristics and failure behavior of puckered and buckled allotropes of antimonene nanotubes: a molecular dynamics study.

In recent years, antimonene nanotubes have attracted considerable interest for diverse applications owing to their promising physical properties. In this study, classical molecular dynamics simulations with Stillinger-Weber potential were carried out to explore the fundamental mechanical characteristics of two stable allotropes of antimonene nanotubes (SbNTs), namely puckered (α-) and buckled (ß-) nanotubes. Mechanical properties and deformation mechanisms of antimonene nanotubes, including ultimate tensile strength, fracture strain, and Young's modulus, were thoroughly examined by considering chirality, diameter, temperature, and strain rate variables. Numerical simulations revealed that all SbNT specimens examined in this study exhibit brittle failures with a complete loss of load-bearing capability following the ultimate stress level. The brittle nature of the SbNTs with varied diameters remained unchanged under different temperatures and loading-rate conditions. Owing to their distinct crystal structure in the armchair and zigzag directions, α-SbNTs present a distinctive anisotropic behavior compared to ß-SbNTs. While the variation of the elastic modulus with temperature is not notable, the tensile strength and fracture strain of SbNTs deteriorated considerably at high temperatures. Furthermore, it was observed that the effects of diameter and temperature on zigzag α-SbNT are more pronounced due to its lower stability. Altogether, this study presents a comprehensive examination of the mechanical characteristics of the two stable antimonene allotropes and provides useful information for their potential utilizations in a wide range of applications.

Effects of different intraabdominal pressures on internal jugular vein, liver and kidney functions in obese patients undergoing laparoscopic sleeve gastrectomy.

OBJECTIVE: The aim of this study was to investigate whether there was a difference in laparoscopic sleeve gastrectomy (LSG) performed with either 10 mmHg or 13 mmHg intraabdominal pressures. Effects of these pressures on the internal jugular vein (IJV) diameter and flow along with the liver and kidney function tests were evaluated. MATERIALS AND METHODS: The patients were divided into two groups with respect to the intraabdominal pressure performed during LSG (either 10 or 13 mmHg). The patients' age, comorbidities, surgical history, height, weight, body mass index, family history, duration of surgery, length of hospital stay, serum liver and kidney function tests (Urea, creatinine, Aspartate transaminase, Alanine transaminase, Gamma-glutamyltransferase, Alkaline phosphatase, bilirubin) and the right IJV diameter and flow measured by Duplex ultrasound before intubation (t1), 10 min after insufflation (t2), and at the end of insufflation (t3) were recorded. RESULTS: Preoperative and postoperative kidney and liver function values of the patients in both groups were within the reference range. In both groups, there was a significant decrease in the IJV diameter and flow measurement values at t2 compared to t1, and a significant increase was observed at t3 compared to t2 (p < 0.05). The mean IJV diameter and flow were significantly higher in the 10 mmHg pressure group compared to the 13 mmHg group (p < 0.05). CONCLUSION: Neither of the peak pressures performed intraabdominal during LSG caused an adverse effect on liver or kidney functions. Our study emphasizes that low insufflation pressure does not have an advantage in terms of liver and kidney functions. But laparoscopic sleeve gastrectomy with low intra-abdominal pressure may be beneficial especially in patients who require central vein catheterization during the operation. We consider that LSG performed with CO2 pneumoperitoneum at 10 mmHg is a safe, effective and feasible method that can facilitate the insertion of the intraoperative central venous catheter due to lesser charges in the IJV diameter and flow compared to the standard technique.

A 10-year bibliometric analysis of publications in emergency medicine.

OBJECTIVE: Emergency medicine (EM) research is growing at a rapid pace. It is important to understand the scope and trends over time in order to identify gaps and future areas for growth. This study aimed to describe trends in scientific publications within EM over the past decade. METHODS: We searched the Web of Science database's Emergency Medicine category for all scientific publications published between 2010 and 2019. Data were presented via descriptive statistics. Inferential bibliometric analyses included clustering of the selected parameters of keywords, Keyword Plus, titles, and abstracts; Bradford's law to evaluate core journals, and the Sankey diagrams to evaluate the flows between research themes over time. RESULTS: We identified 32,858 articles written by 85,693 authors. The mean citations per document were 11. The top five countries with the highest number of publications were the United States (n = 42,221), Turkey (n = 6595), Canada (n = 6545), Australia (n = 5867), and China (n = 5322). The journals with the highest number of publications: the American Journal of Emergency Medicine, Journal of Emergency Medicine, Resuscitation, and Pediatric Emergency Care. The most frequent topics were cardiovascular emergencies, resuscitation, mortality, patient outcomes, emergency imaging, triage, education, and management. CONCLUSION: This bibliometric study is a quick snapshot of research in the EM field in the last decade and may provide insights into the scientific agendas of the EM professionals.

The Cardiopulmonary Effects of Medical Masks and Filtering Facepiece Respirators on Healthy Health Care Workers in the Emergency Department: A Prospective Cohort Study.

BACKGROUND: International COVID-19 guidelines recommend that health care workers (HCWs) wear filtering facepiece (FFP) respirators to reduce exposure risk. However, there are concerns about FFP respirators causing hypercapnia via rebreathing carbon dioxide (CO2). Most previous studies measured the physiological effects of FFP respirators on treadmills or while resting, and such measurements may not reflect the physiological changes of HCWs working in the emergency department (ED). OBJECTIVE: Our aim was to evaluate the physiological and clinical impacts of FFP type II (FFP2) respirators on HCWs during 2 h of their day shift in the ED. METHODS: We included emergency HCWs in this prospective cohort study. We measured end-tidal CO2 (ETCO2), mean arterial pressure (MAP), respiratory rate (RR), and heart rate values and dyspnea scores of subjects at two time points. The first measurements were carried out with medical masks while resting. Subjects then began their day shift in the ED with medical mask plus FFP2 respirator. We called subjects after 2 h for the second measurement. RESULTS: The median age of 153 healthy volunteers was 24.0 years (interquartile range 24.0-25.0 years). Subjects' MAP, RR, and ETCO2 values and dyspnea scores were significantly higher after 2 h. Median ETCO2 values increased from 36.4 to 38.8 mm Hg. None of the subjects had hypercapnia symptoms, hypoxia, or other adverse effects. CONCLUSION: We did not observe any clinical reflection of these changes in physiological values. Thus, we evaluated these changes to be clinically insignificant. We found that it is safe for healthy HCWs to wear medical masks plus FFP2 respirators during a 2-h working shift in the ED.

A Novel Factor in Determining the Risk of Ischemic Cerebrovascular Events in Patients with Atrial Fibrillation: Pulmonary Hypertension.

OBJECTIVES: Pulmonary hypertension (PH) is closely related to clinical decompensation and poor clinical outcomes in atrial fibrillation (AF) patients. However, the association between PH and ischemic cerebrovascular events (ICE) in AF patients has not been investigated. The authors purposed to examine this relationship. MATERIALS AND METHODS: The researchers conducted an observational study on 371 AF patients between January and November 2021. In line with the European Society of Cardiology guideline recommendations, echocardiographic parameters suggestive of PH were performed. The study population was stratified into two groups based on the presence (n = 98, 31%) or non-presence (n = 219, 69%) of PH. Also, we did logistic regression analyses for the independent predictors of the ICEs in AF patients. RESULTS: Ischemic cerebrovascular events were significantly more frequent in the PH group than the non-PH group (n = 30, 13% vs. n = 18, 18%, p = 0.03). At univariable analysis, hypertension, diabetes mellitus, PH (OR = 0.23 [95% CI, 0.13-0.41], p = 0.005) and diastolic dysfunction were significantly related to ICE in AF patients. Moreover, at multivariable analysis, age, diabetes mellitus, PH (OR = 0.19 [95% CI, 0.10-0.36], p = 0.01), and diastolic dysfunction were predictive of ICE. CONCLUSIONS: Pulmonary hypertension is likely associated with ischemic cerebrovascular events in patients with AF, requiring further investigation to determine its association.

Predictive power of diastolic parameters on medical cardioversion success in acute atrial fibrillation.

BACKGROUND: Diastolic function assessment has been reported to provide valuable data in patients with atrial fibrillation (AF). The purpose of this study was to evaluate the effects of diastolic parameters on predicting the effectiveness of medical cardioversion in restoring sinus rhythm among patients with acute AF. METHODS: 40 non-valvular, new onset AF patients were included. All participants received an intravenous infusion of amiodarone. In patients whom sinus rhythm could not be restored with amiodarone, an electrical cardioversion was performed. Two groups, patients who achieved sinus rhythm with amiodarone (Group-1) and who failed to achieve sinus rhythm with amiodarone (Group-2) were compared with respect to initial echocardiographic measurements. RESULTS: Group-1 patients were younger comparing with Group-2 (mean age; 54.4 ± 13.9 years vs 63.3 ± 10.3 years, p = 0.028). Comparing with Group-1, Group-2 patients had; a higher left atrium volume index (17.1 ± 4.8 cm3 / m2 vs 22.6 ± 6.6 cm3 / m2 , p = 0.03); a shorter pulmonary vein S (49.6 ± 3.8 cm/sec vs 41.1 ± 3.0 cm/sec, p < 0.001); and a shorter pulmonary vein D peak velocity (55.9 ± 2.4 cm/sec vs 52.3 ± 1.8 cm/sec, p < 0.001). Moreover, both IVRT and DT were significantly shorter in Group-2, comparing with Group-1 (45.1 ± 2.1 msec vs 51.1 ± 2.5 msec, p < 0.001 and 51.3 ± 2.4 msec vs 56.5± 3.2 msec, p < 0.001, respectively). CONCLUSION: The present study revealed that admission pulmonary vein S and D wave peak velocities, IVRT, DT, and Pro-BNP levels could be predictors of failure of medical cardioversion among AF patients.

Predictors of long-term outcomes after polytetrafluoroethylene-covered stent-graft repair of peripheral arterial aneurysms, pseudo-aneurysms, and arterio-venous fistulas.

OBJECTIVES: To evaluate the primary patency rate at three years for the infra-aortic peripheral arterial pathologies treated with polytetrafluoroethylene-covered stent-grafts. METHODS: Patients treated with self-expandable polytetrafluoroethylene-covered stent-grafts for infra-aortic peripheral arterial aneurysms, pseudo-aneurysms, and arterio-venous fistulas were evaluated retrospectively. A total of 48 patients (35 male, 13 female; mean age: 53.8 ± 13.5) were included with 29.0 ± 16.5 months (median 27, range 4-70) mean follow-up period. The primary objective was to determine the primary patency rate at three years. The secondary objectives were to compare type and localization of pathology, and length and diameter of the stent-grafts with primary patency rate. Kaplan-Meier test was used as the main statistical method. RESULTS: Overall mean primary patency rate at three years was 77.10%. Polytetrafluoroethylene-covered stent-graft implantation in aneurysms had worse primary patency rate than pseudo-aneurysms and arterio-venous fistulas (66.6%, P = 0.03; 76.9%, P = 0.03; 88.2%, P = 0.01, respectively). Stent-graft location, length, and diameter are not associated with primary patency rate (P > 0.05) but stent diameter is associated with better primary assisted and secondary patency rates (P < 0.05). CONCLUSIONS: Pathology of the lesion is associated with the long-term primary patency rate of polytetrafluoroethylene-covered stent-grafts but not the stent-graft location, length, or diameter. Stent diameter is associated with primary assisted and secondary patency rates.

Management of Renal Artery Occlusion during Endovascular Aortic Repair.

A 67-year-old man was admitted to the emergency unit with abdominal pain. An infrarenal aortic aneurysm with a diameter of 70 millimeters was detected by computed tomography. In the catheter laboratory, graft stents were implanted into the infrarenal aorta. Total occlusion of the right renal artery was seen in angiography. The graft stent was punctured with a 30° angled Brockenbrough catheter, and another stent was implanted.

Hyaluronan as a Promising Biomarker for Myocardial Damage.

Hyaluronan is a glycosaminoglycan, one of the chief components of the extracellular matrix. The aim of the present study is to investigate plasma hyaluronan levels among patients with acute myocardial infarction (AMI). This prospective study enrolled 56 consecutive patients with AMI who underwent percutaneous coronary intervention within 2 hours after admission. Plasma levels of hyaluronan were measured at the time of admission (baseline), and on the 7th and 30th day after AMI. Echocardiographic examinations were performed at baseline and on the 30th day after AMI. The hyaluronan levels were 33.2 ± 3.1 ng/ml (mean ± SD) at baseline, increased on the 7th day (46.2 ± 5.9 ng/ml), and continued to remain high on the 30th day after AMI (50.1 ± 5.1 ng/ml). There were significant correlations of the hyaluronan levels between baseline and on the 7th day (r = 0.535, p < 0.001) and between baseline and on the 30th day (r = 0.263, p = 0.05). Significant correlations were also found between hyaluronan levels on the 30th day, and the peak levels of CK-MB (r = 0.429, p = 0.001) or highly sensitive troponin levels (r = 0.360, p = 0.006). The hyaluronan levels were significantly higher on the 30th day after AMI in patients with anterior infarction, but not in patients with non-anterior infarction (p = 0.01 vs. p = 0.653). In conclusion, this is the first report that demonstrates the increase of plasma hyaluronan levels among patients with AMI.

The Significance and Reliability of Imaging Findings in Pseudotumor Cerebri.

The objective of our study was to provide a comparative assessment of previously reported magnetic resonance imaging (MRI) parameters in primary and secondary pseudotumor cerebri (PTC) patients, to examine their diagnostic contribution, and to evaluate their association with symptoms, neuro-ophthalmological findings, laboratory results, and cerebrospinal fluid characteristics. Twenty-eight consecutive patients with PTC were included in the study. Age- and sex-matched 20 individuals with normal neurologic examination served as the control group. Modified Dandy Criteria were used for the diagnosis of PTC. Orbital and cranial MRI and MR venography of all patients and controls were assessed by three radiologists. According to our study, posterior flattening of the globe (64% sensitive, 100% specific), optic nerve sheath distention (46% sensitive, 100% specific), vertical tortuosity of the optic nerve (30% sensitive, 95% specific), and partial empty sella (43% sensitive, 100% specific) emerged as particularly valuable markers for a diagnosis of PTC.

Misdiagnosed epigastric mass: Ectopic liver.

We discuss an ectopic liver misdiagnosed as an abdominal mass and the importance of magnetic resonance imaging (MRI) in liver positional anomalies. A solid midline mass midline adjacent to the liver was found in a 45-year-old female at an external center during an ultrasound investigation conducted for occasional abdominal pain of many years. The patient was referred to us for MRI. MRI revealed a solid epigastric lesion adjacent to the liver but unrelated to the liver parenchyma. The mass was of similar intensity as the liver in all sequences and in postcontrast dynamic phases following hepatospecific contrast material administration. We also observed contrast material excretion into the solid lesion from the biliary ducts in the hepatobiliary phase. The lesion was diagnosed as ectopic liver tissue with these findings. LEVEL OF EVIDENCE: 5 J. Magn. Reson. Imaging 2017;45:761-763.

Atrium Advanta V12 Large Diameter Stent-Graft Applications for Infrarenal Abdominal Aortic Pseudoaneurysms (due to Behcet Disease): Safety and Efficacy.

BACKGROUND: The aim of the study was to determine the safety and effectiveness of Atrium Advanta V12 large diameter stent-graft applications for infrarenal abdominal aortic pseudoaneurysms (due to Behcet disease [BD]). METHODS: Data of Advanta V12™ (Atrium Europe B.V, Mijdrecht, the Netherlands) applied 12 female patients (mean age 30.5 ± 6.3, range 26-44) with infrarenal abdominal aortic pseudoaneurysms were analyzed retrospectively. All Advanta V12 large diameter stent grafts were implemented from right or left sided 12F femoral sheaths. Stent grafts with 12-16 mm in size and 29-61 mm in length were utilized. Technical success rate, procedure-related mortality and morbidity, and primary patency rate at 4 years were evaluated. RESULTS: Technical success rate was 100%. Neither procedure-related mortality nor morbidity was determined. The mean aortic diameter was 14.0 ± 0.8 mm for pseudoaneurysmatic abdominal aortas. The mean follow-up period was 46.5 ± 40.3 months (range 18-75). During follow-ups, only one recurrent aneurysm has evolved at the stenting site due to patients' withdrawal of immunosuppressive treatment. The advent of a new aneurysm proximal or distal to the stent-graft region or at the femoral access localization was not observed. There were no stent occlusions. Primary patency rate at 4 years was 100%. Complete aneurysm exclusion was achieved 100% at 48 months. CONCLUSIONS: The use of Advanta V12 large diameter stent grafts for infrarenal abdominal aortic pseudoaneurysms (due to BD), especially in female patients with small aortic diameter, is safe and efficient. Primary patency rate of the stent grafts at 4 years is excellent.

Research into the relationship between digital health literacy and healthy lifestyle behaviors: an intergenerational comparison.

Introduction: Digital health literacy wields a pivotal role in individuals' health status in terms of seeking and choosing appropriate and accurate information, and useful services from a vast array of choices. This study is aimed at assessing the validity and reliability of the Turkish version of Digital Health Literacy Instrument (DHLI) and examining the relationship between DHL and the healthy lifestyle behaviors of participants from X, Y, and Z generations. Methods: In this study, to conduct a cross-sectional web-based survey, an online self-report questionnaire was built, and a convenience sample with a snowball approach was used. The study was conducted among 1,274 respondents aged between 18 and 64 years. Data collection tools consisted of the Personal Information Form, Lifestyle Behavior Scale II (HLBS II), and DHLI. Cultural validation and psychometric testing of DHLI, exploratory factor analysis, confirmatory factor analysis, Cronbach's alpha test, and bivariate and multivariate regression analysis were used for statistical analysis. Results: In the study, the Turkish version of the DHLI tool consisting of six dimensions proved to be valid and reliable, and deemed appropriate for use across all age groups. The average digital health literacy of the respondents was sufficient, but the mean of healthy lifestyle behavior scores was moderate. There was a positive significant relationship between the total mean scores of DHLI and HLBS. Among the subdimensions of DHLI, while the highest mean scores were in DHLI Reliability, DHLI Privacy, and DHLI Search, DHLI Navigation and DHLI Relevance showed the lowest mean scores. DHLI Reliability, DHLI Relevance, and DHLI Adding Content were statistically significant predictors of health-related behaviors of the respondents. Conclusion: The most important feature and novelty of this study is that, although the DHLI scale has been widely translated for use in many countries, it has been translated and adapted to Turkish for the first time herein. The study offers crucial evidence about Generation X, Y, and Z's DHL level and its positive relationships with health-related behaviors. Therefore, the community and its partners should lead the way in empowering individuals to understand and use online information in an effective, secure, and health-promoting manner, along with governments.

The effect of COVID-19 on the thromboembolic outcomes in atrial fibrillation patients in the long run.

BACKGROUND: While there has been a wealth of reports concerning the acute effects of the coronavirus disease 2019 (COVID-19), further information is needed to see how things unfold in the long run. This research aimed to ascertain whether the COVID-19 pandemic has increased the probability of thromboembolic events in atrial fibrillation (AF) patients. METHODS: In this retrospective study, we scanned 952 AF patients and classified 643 eligible ones per their history of catching COVID-19. Two hundred thirty-nine of 643 patients had a history of COVID-19 (Group 1), and 404 did not (Group 2). We then compared two years of thromboembolic events between the groups. RESULTS: Composite thromboembolic outcomes were seen in 76 (11.8%) patients. Of those, 32 (13.4%) were in Group 1, and 44 (10.8%) were in Group 2 (p = .03). 10 of 32 patients (31%) in Group 1 and 11 of 44 (25%) in Group 2 died because of thromboembolic events (p = .02). Histories of diabetes mellitus, chronic obstructive pulmonary disease, and COVID-19 independently predicted thromboembolic events in AF patients. CONCLUSIONS: Having caught COVID-19 is likely to be associated with increased long-term thromboembolic outcomes in AF patients. Albeit the study design does not permit us to infer causality, our results question the necessity of more intensive anticoagulant therapy and closer follow-up in AF patients with past COVID-19.

Environmental quality and health expenditures efficiency in Türkiye: the role of natural resources.

The environmental pollution caused by climate change and global warming pose significant risks to health. This raises the question how environmental disturbances can affect health expenditures. Based on this, this study examines the asymmetric effect of environmental quality on health expenditures in Türkiye using the non-linear ARDL (NARDL) model for the 1975-2019 period. In addition to environmental quality, natural resources, economic growth, and trade openness variables are also included in the health expenditure model. The findings support the existence of an asymmetric cointegration relationship between the series. The findings also indicate that positive environmental pollution shocks affect health expenditures positively in the long run, while negative environmental pollution shocks do not have a statistically significant effect on health expenditures. Positive and negative natural resource shocks affect health expenditures negatively in the long run. Despite the effect of positive economic growth shocks on health expenditures is positive but statistically insignificant, the effect of negative economic growth shocks is positive and significant. Besides, positive trade openness shocks have a negative effect on health expenditures and negative trade openness shocks have a positive effect. The findings prove that the steps to be taken to protect the environment in the current period will increase the effectiveness of health expenditures in the future. This situation has a guiding feature for policy-makers in terms of policy decisions.

Greenhouse gas emissions, economic globalization, and health expenditures nexus: does population aging matter in emerging market economies?

Papers on population aging and the effects of environmental quality on health expenditure have critical policy consequences. However, findings in the relevant literature are mixed, and papers generally focus on developed countries. To provide new information to the literature, this paper examines the impact of globalization, economic growth, greenhouse gas emissions, and population aging on health expenditures in emerging market economies with annual data for the period 2000 to 2018. The paper follows a second-generation advanced panel data method that considers cross-sectional dependency. The estimation results reveal that population aging, economic growth, and greenhouse gas emissions have an increasing effect on health expenditures, while globalization has a decreasing effect. Furthermore, one-way causality running from population aging to health expenditures is confirmed, while a feedback causality relationship is observed between health expenditures and other indicators (globalization, economic growth, and greenhouse gas emissions). After all, the outputs of this paper can provide critical policy implications about the relationships between aging, globalization, air quality, and health expenditures in developing countries.

Does globalization mitigate environmental degradation in selected emerging economies? assessment of the role of financial development, economic growth, renewable energy consumption and urbanization.

While the acceleration of globalization in newly developing (emerging) economies contributes positively to economic developments on the one hand, it is a research topic that can have an impact on environmental pollution on the other hand. Therefore, this study analyzes the impact of globalization on environmental pollution for 14 emerging economies in the 1991-2018 period by including economic growth, financial development, renewable energy consumption, and urbanization in the ecological footprint model. In addition to the AMG forecaster, Driscoll-Kraay, PCSE, and FGLS estimation techniques are used for long-term forecasting. Causal linkages among variables are analyzed by the Dumitrescu-Hurlin panel bootstrap causality test. The findings show that the series are cointegrated, that is, a long-term relationship between the variables. In the long term, globalization and renewable energy consumption reduce environmental pollution, while economic growth and financial development play a role in encouraging environmental pollution. Causality analysis enumerates a causality from economic growth and financial development to environmental pollution, as well as a two-way causality between globalization and environmental pollution and renewable energy consumption and environmental pollution. Empirical findings can offer important implications for policies that will reduce environmental pollution in these countries.

The Effect of Meteorological Factors on the COVID-19 Pandemic in Northeast Turkiye.

Introduction Although various studies have been conducted on the relationship between meteorological factors and coronavirus disease 2019 (COVID-19), this issue has not been sufficiently clarified. In particular, there are a limited number of studies on the course of COVID-19 in the warmer-humidity seasons. Methods Patients presenting to the emergency departments of health institutions and to clinics set aside for cases of suspected COVID-19 in the province of Rize between 1 June and 31 August 2021 and who met the case definition based on the Turkish COVID-19 epidemiological guideline were included in this retrospective study. The effect of meteorological factors on case numbers throughout the study was investigated. Results During the study period, 80,490 tests were performed on patients presenting to emergency departments and clinics dedicated to patients with suspected COVID-19. The total case number was 16,270, with a median daily number of 64 (range 43-328). The total number of deaths was 103, with a median daily figure of 1.00 (range 0.00-1.25). According to the Poisson distribution analysis, it is found that the number of cases tended to increase at temperatures between 20.8 and 27.2°C. Conclusion It is predicted that the number of COVID-19 cases will not decrease with the increase in temperature in temperate regions with high rainfall. Therefore, unlike influenza, there may not be seasonal variation in the prevalence of COVID-19. The requisite measures should be adopted in health systems and hospitals to manage increases in case numbers associated with changes in meteorological factors.

Emergency Medicine Association of Turkey Disaster Committee Summary of Field Observations of February 6th Kahramanmaras Earthquakes.

An earthquake measuring 7.7 magnitude on the Richter scale occurred at 04:17am on February 6, 2023 in the Pazarcik district of Kahramanmaras province Turkey. In the hours following the 7.7 magnitude event in Kahramanmaras, a second 7.6 magnitude earthquake struck the region and a third 6.4 magnitude earthquake struck Gaziantep, causing extensive damage and death. A total of ten provinces directly experienced the earthquake, including Kahramanmaras, Hatay, Gaziantep, Osmaniye, Malatya, Adana, Diyarbakir, Sanliurfa, Adiyaman, and Kilis. The official figures indicate 31,643 people were killed, 80,278 were injured, and 6,444 buildings were destroyed within seven days of the earthquakes (as of 12:00pm/noon on Monday, February 13th). The area affected by the earthquake has been officially declared to be 500km in diameter. This report primarily relies on observations made by pioneer Emergency Physicians (EPs) who went to the disaster areas shortly after the first earthquake (in the early stages of the disaster). According to their observations: (1) Due to winter conditions, there were transportation problems and a shortage of personnel reaching disaster areas on the first day after the disaster; (2) On the second day of the disaster, health equipment was in short supply; (3) As of the third day, health workers were unprepared in terms of knowledge and experience for the disaster; and (4) The subsequent deployment of health personnel to the disaster area was uncoordinated and unplanned on the following days, which resulted in the health personnel working there not being able to meet even their basic needs (such as food, heating, and shelter). During the first week, coordination was most frequently reported as the most significant problem.

Analysis of the dynamics of environmental degradation for 18 upper middle-income countries: the role of financial development.

This study aims at investigating the dynamics of environmental degradation by focusing on the financial development-CO2 emissions link. In this purpose, economic growth, renewable energy consumption, trade openness and urbanization are integrated into the CO2 emissions model as other explanatory variables. In this study, 18 upper-middle-income countries with the highest growth rate in the world are examined for the period 1990-2018 by AMG method, which considers the cross-sectional dependence and slope heterogeneity. In addition, the causal linkages between variables are explored by Dumitrescu-Hurlin panel bootstrap causality technique. As a result of the study, it is found that financial development and renewable energy consumption reduce CO2 emissions. In addition, it is determined that economic growth, urbanization, and trade openness deteriorate the environmental quality. As a result of causality analysis, while one-way is found from renewable energy consumption to CO2 emissions, a bidirectional causality is observed between financial development and CO2 emissions. Empirical findings provide several policy suggestions that decrease CO2 emissions in these countries.