Treatment of anemia in myelofibrosis: focusing on novel therapeutic options.

INTRODUCTION: Myelofibrosis is a clonal myeloproliferative neoplasm associated with the proliferation of hematopoietic stem cells, increased bone marrow fibrosis, extramedullary hematopoiesis, hepatosplenomegaly, abnormal cytokine production, and constitutional symptoms. These and many other factors contribute to the development of anemia in myelofibrosis patients. AREAS COVERED: This review summarizes novel and promising treatments for anemia in myelofibrosis including transforming growth factor-ß inhibitors luspatercept and KER-050, JAK inhibitors momelotinib, pacritinib, and jaktinib, BET inhibitors pelabresib and ABBV-744, antifibrotic PRM-151, BCL2/BCL-XL inhibitor navitoclax, and telomerase inhibitor imetelstat. EXPERT OPINION: Standard approaches to treat myelofibrosis-related anemia have limited efficacy and are associated with toxicity. New drugs have shown positive results in myelofibrosis-associated anemia when used alone or in combination.

Do the effects of aggregate and disaggregate energy consumption on different environmental quality indicators change in the transition to sustainable development? Evidence from wavelet coherence analysis.

In the 2030 Agenda for Sustainable Development, adopted by the United Nations (UN) member states in 2015, half of the target period has been exceeded. However, China, whose energy consumption relies heavily on fossil resources, remains at the top of the list of global polluters. Therefore, investigating the environmental impacts of energy types is essential to China's path towards Sustainable Development Goals (SDG)-7 and SDG-13. Based on this motivation, the paper offers new insights into the energy-environment literature for China with wavelet coherence analysis (WCA). This approach can investigate the relationship between variables in a periodic manner based on the frequency behavior of the models. The paper separately analyzes the effects of primary energy consumption (PEC), fossil energy consumption (FEC), renewable energy consumption (REC), nuclear energy consumption (NEC), GDP, and population (POP) on three different environmental indicators in China. Using two environmental pollution indicators (carbon emission (CO2) and ecological footprint (EF)) and one environmental quality indicator (load capacity factor (LCF)), the paper allows for comparison and robustness checks on the environmental impacts of energy indicators. Empirical findings reveal the following: (i) Except for REC and POP in the CO2 model, the variables in all three models largely move together during the period under observation; (ii) variables other than POP have consistent coefficient signs; (iii) PEC, FEC, NEC, and GDP increase CO2 and EF while decreasing LCF; (iv) the effect of NEC on LCF is more obvious until 2000; (v) unlike the others, REC affects CO2 and EF negatively and LCF positively; (vi) there is bidirectional causality between PEC and environmental indicators but not for REC; (vii) the causality relations of other variables with environmental indicators differ in terms of model, time, and direction of causality. In light of the findings, the paper highlights that only the REC improves environmental quality in China. Other energy indicators contribute to environmental degradation. China, whose ecological deficit has increased dramatically in recent years, urgently needs to reduce its dependence on fossil energy sources by accelerating investments in REC. Governments should also review nuclear energy policies, which are expected to help achieve carbon neutrality.

The ecological footprint facing asymmetric natural resources challenges: evidence from the USA.

One of the most critical problems of today is the environmental policies with the focus on economy. Despite the many efforts of global organizations, environmental pollution is the subject of human beings. For this, the most polluting countries attract the attention of researchers. Many studies produce economy-centered environmental policies for the USA. However, the asymmetric effect of natural resources on environmental pollution has been neglected in the literature. In this paper, the effects of economic growth, renewable energy, biocapacity, and natural resources on the ecological footprint are addressed within the framework of the Environmental Kuznets Curve hypothesis over the period 1980-2017. Empirical findings confirm that economic growth and biocapacity increase environmental degradation, while renewable energy consumption helps reduce environmental damage. More specifically, when the results are analyzed in terms of natural resources, positive shocks in natural resources contribute to reducing environmental damage, while negative shocks in it negatively affect the environmental quality. The paper presents important policy implications for economy-centered environmental issues.

The efficiency and duration of the analgesic effects of musical therapy on postoperative pain.

OBJECTIVES: The aim of this study was first to find out the effect of music therapy on postoperative analgesia and second to determine the duration of its effect. METHODS: Seventy patients who were undergoing elective cesarean delivery were enrolled. The patients were randomly allocated into two groups as follows: In Group 1, patients listened to music through a headphone for one hour after surgery, while in Group 2, patients did not listen to any music during the same period. In the postanesthesia care unit, patients were connected to a Patient Controlled Analgesia (PCA) device. The PCA device (tramadol 3 mg/ml) was set to deliver a bolus of 20 mg, with a lockout interval of 15 min and 4-hour maximal dose of 150 mg. Postoperative pain was assessed with a visual analog scale (VAS) and consumption of tramadol was recorded at 4, 8, 12, 16, 20 and 24 hours. RESULTS: There was a significant decrease in Group 1 with respect to PCA delivery frequency at the 4th hour postoperatively (p<0.05). Concerning the postoperative tramadol consumption, values measured at the 4th hour were significantly lower in Group 1 (p<0.05). The total amount of tramadol consumption and additional analgesic use in the postoperative 24 hours were again lower in Group 1 when compared with Group 2 (p<0.05). All VAS values were lower in Group 1 when compared with Group 2 (p<0.05). CONCLUSION: We suggest that music therapy given after surgery decreases postoperative pain in the first 24 hours and the analgesic consumption during the first four hours.

Epileptic seizure during anaesthesia induction with etomidate.

In this report a 20-year-old male patient who had suffered tonic-clonic seizure after a single induction dose of etomidate until a bispectral index value of 60 is presented. Our best knowledge, this case is the first report of pure etomidate (with induction dose) induced generalized tonic clonic seizure proven with EEG. Anaesthesiologists should be careful against such a complication even in the induction stage of anaesthesia during etomidate use.