Fibrolamellar hepatocellular carcinoma: An epidemiologic and 5-year cancer survival assessment based off SEER data.

The fibrolamellar variant of hepatocellular carcinoma makes up a small percentage of liver tumors. Despite being a subset, it has been noted in the literature to have variations in terms of its epidemiology and intervention recommendations. Using the Surveillance, Epidemiology, and End Results database, 339 cases from 1988 to 2016 were studied. Favorable prognostic epidemiological factors included male sex, younger ages, and white race. Those who underwent any lymph node resection (combined with liver resection) did better than those without lymph node resection; chemotherapy proved beneficial for those where surgery was contraindicated. To our knowledge, this report is the largest conglomerate dataset analyzing prognostic profiles and treatment strategies for fibrolamellar hepatocellular carcinoma.

Carbon footprints across transport infrastructure development and industrial output in Pakistan.

Over the past few decades, the development of transport infrastructure has attracted huge local and foreign direct investments to raise the overall industrial output in Pakistan. Meanwhile, the transport sector has emerged as one of the most emissions-intensive industrial sectors. Thus, this study is the first to investigate how Pakistan's transport infrastructure across four modes-roads, trains, ports, and airways-affects industrial value addition and carbon footprints in the country. By making use of the theoretical and empirical literature, the study builds carbon emission and economic output models to determine the economic and environmental sustainability of transport infrastructure development in the country. The empirical findings conclude long-term environmental sustainability issues in transportation infrastructure development. All means of transport infrastructure development have a significant positive impact on carbon dioxide emissions in the country. Only ports and highways, however, provide a positive contribution to industrial output. Additionally, population growth, capital, labor, and urbanization are positively linked with the industrial output and carbon dioxide emission in the country, whereas trade openness helps to offset the emission intensity to some extent. Given this evidence, we provide detailed policy implications by highlighting the significance of greener technologies under new transport-related infrastructure investment that addresses SDG-9.

COVID-19 Perceptional Disparity Among Dental Healthcare Personnel at King Faisal University: Applying Health Belief Model.

OBJECTIVES: In Saudi Arabia, more than 100, 000 cases of COVID-19 have been reported, and more than 4,000 in Al Hofuf to date. Dental healthcare personnel are at a higher risk of COVID-19 due to their exposure to saliva, blood, and aerosol/droplet during their daily practice. Their perceptions of COVID-19 drive their behaviors. MATERIALS AND METHODS: A cross-sectional online survey to assess COVID-19 related perceptions and possible disparities between them. STATISTICAL ANALYSIS: Data were analyzed using the Statistical Package for the Social Science, version 23 (IBM SPSS). Descriptive analyses were performed using frequencies and percentages for categorical variables, mean and (± SD) for numerical variables. Bivariate analyses were assessed using t-test and one-way ANOVA, with a 95% confidence interval (CI). RESULTS: With a response of 75% (150), results showed that there were perceptional disparities: students and technical staff perceived more barriers to preventive measures compared to faculties with a mean difference of (-0.145 SD ± 0.580, p = 0.802, CI -1.29 / 1.00 and -2.433, SD ± 0.94, p = 0.010), respectively. This was also shown in threat perception with a mean difference of (2.525, SE ± 0.917, CI 0.71/4.34, p = 0. 0.007). Students perceived more threat than clerks did with a mean difference of (1.281, SE ± 0.569, CI - 0.16 / 2.41, p = 0.026), while clerks perceived less threat than the technical staff with a mean difference of (-2.790, SE ± 0.860, CI -4.49 /-1.09, p = 0.001). CONCLUSIONS: There was a clear disparity in the perceptions among the different categories of participants. More emphasis on the training and preparedness of the dental healthcare personnel is required.

Environmental policy stringency, related technological change and emissions inventory in 20 OECD countries.

Since the parties to Paris agreement ink ambitious emissions reduction targets, there is a growing debate - whether the existing environmental regulations have potential to spur enough technological base that could help to achieve the targets by 2030? Thus, this study attempts to empirically investigate the role of stringent environmental regulations towards environmentally friendly technological innovation, carbon emissions, GDP, exports and imports for 20 OECD countries. The results find long-run equilibrium relationship among the variables and suggest that the current environmental regulations encourage green innovation in the panel countries. Furthermore, stringent environmental policies couple with environmentally friendly innovation are impetus to sustainable development. Exports and imports have little to contribute green innovation but, exports reduce carbon emissions in the short-run only and imports are emissions intensive. The study suggests that the OECD countries need to revisit trade related environmental regulations.

Effect of trade on ecological quality: a case of D-8 countries.

Sustainable development inculcates the process of preserving the environment for future generations while maintaining existing human needs. This study attempts to empirically investigate the relationship between CO2 emissions, GDP, energy consumption, and imports and exports using yearly data between 1980 and 2014 for the panel of eight developing countries (i.e., Bangladesh, Egypt, Iran, Indonesia, Malaysia, Nigeria, Pakistan, and Turkey). All the tests for cointegration establish the long-run association among the variables and confirm the environmental Kuznets curve (EKC) hypothesis for the panel of eight countries. GDP and energy consumption remained significant factors for emission intensity both in the long and short run. However, exports found to be positive factor for emissions in the long run only and imports spur emissions in the short run. The country-specific results validate EKC hypothesis for Bangladesh, Iran, Nigeria, Pakistan, and Turkey. The findings are policy oriented and suggest that the countries' economic growth along with energy consumption and exports are highly emission intensive which require necessary adjustments at sustainable development policy front.

What new technology means for the energy demand in China? A sustainable development perspective.

This paper explores the direct impact of new technology on the energy intensity in China. The autoregressive distributed lag (ARDL) bounds test approach to cointegration is utilised over the extended period of 1985-2013. The variables found cointegrated and confirm the long-run association among all the underlying vectors. Furthermore, the results of long- and short-run analysis reveal that new technology spurs energy intensity in China. A 1% increase in technological innovation boosts energy intensity by 0.4% and 0.03% in the long and short run, respectively. The findings suggest that the establishment of smart grids and solar energy parks followed by the reforms in energy sector is yet to achieve plausible efficiency in China. The existing investment and innovation policy reforms are insufficient to assist the energy sector to cope up with the country's exceptional economic growth trend. Unlike other studies, this paper accommodates structural break in the series. During sensitivity analysis, the model is found stable. Hence, the findings possess important policy implications for China and open up new discussion in the field.

A predictive analysis of CO2 emissions, environmental policy stringency, and economic growth in China.

This study takes environmental policy stringency and economic activity as the controlling variables and forecasts the CO2 emissions in China up to 2022. In doing so, an application of corrected grey model with convolution is used over the annual time series data between 1990 and 2012. The simulation results show that (1) between 2012 and 2022, CO2 emissions in China is expected to increase at an average rate of 17.46% annually, raising the emissions intensity from 7.04 in 2012 to 25.461 metric tons per capita by 2022; (2) stringent environmental policies reduce CO2 emissions-whereas, GDP tends to increase the emissions intensity in China; (3) stringent environmental policies are found to have a negative impact on GDP in China. Based on the empirical findings, the study also provides some policy suggestions to reduce emissions intensity in China.

Feasibility randomised multicentre, double-blind, double-dummy controlled trial of anakinra, an interleukin-1 receptor antagonist versus intramuscular methylprednisolone for acute gout attacks in patients with chronic kidney disease (ASGARD): protocol study.

INTRODUCTION: Acute gout occurs in people with chronic kidney disease, who are commonly older people with comorbidities such as hypertension, heart disease and diabetes. Potentially harmful treatments are administered to these vulnerable patients due to a lack of clear evidence. Newly available treatment that targets a key inflammatory pathway in acute gout attacks provides an opportunity to undertake the first-ever trial specifically looking treating people with kidney disease. This paper describes the protocol for a feasibility randomised controlled trial (RCT) comparing anakinra, a novel interleukin-1 antagonist versus steroids in people with chronic kidney disease (ASGARD). METHODS AND ANALYSIS: ASGARD is a two-parallel group double-blind, double-dummy multicentre RCT comparing anakinra 100 mg, an interleukin-1 antagonist, subcutaneous for 5 days against intramuscular methylprednisolone 120 mg. The primary objective is to assess the feasibility of the trial design and procedures for a definitive RCT. The specific aims are: (1) test recruitment and retention rates and willingness to be randomised; (2) test eligibility criteria; (3) collect and analyse outcome data to inform sample and power calculations for a trial of efficacy; (4) collect economic data to inform a future economic evaluation estimating costs of treatment and (5) assess capacity of the project to scale up to a national multicentre trial. We will also gather qualitative insights from participants. It aims to recruit 32 patients with a 1:1 randomisation. Information from this feasibility study will help design a definitive trial and provide general information in designing acute gout studies. ETHICS AND DISSEMINATION: The London-Central Ethics Committee approved the protocol. The results will be disseminated in peer-reviewed journals and at scientific conferences. TRIAL REGISTRATION NUMBER: EudraCT No. 2015-001787-19, NCT/Clinicalstrials.gov No. NCT02578394, pre-results, WHO Universal Trials Reference No. U1111-1175-1977. NIHR Grant PB-PG-0614-34090.

The emission abatement policy paradox in Australia: evidence from energy-emission nexus.

This paper attempts to investigate the emissions embodied in Australia's economic growth and disaggregate primary energy sources used for electricity production. Using time series data over the period of 1990-2012, the ARDL bounds test approach to cointegration technique is applied to test the long-run association among the underlying variables. The regression results validate the long-run equilibrium relationship among all vectors and confirm that CO2 emissions, economic growth, and disaggregate primary energy consumption impact each other in the long-run path. Afterwards, the long- and short-run analyses are conducted using error correction model. The results show that economic growth, coal, oil, gas, and hydro energy sources have positive and statistically significant impact on CO2 emissions both in long and short run, with an exception of renewables which has negative impact only in the long run. The results conclude that Australia faces wide gap between emission abatement policies and targets. The country still relies on emission intensive fossil fuels (i.e., coal and oil) to meet the indigenous electricity demand.

The sheer scale of China's urban renewal and CO2 emissions: multiple structural breaks, long-run relationship, and short-run dynamics.

In the light of urban environmental transition (UET) theory, this study explores the relationship between carbon dioxide (CO2) emissions, economic growth, urbanization, and trade openness using updated Chinese data over the extended period (1971-2013). After confirming that all the underlying series are stationary and adjusted with single structural break point, the results of autoregressive distributed lag (ARDL) bounds test approach to cointegration confirm the cointegration between the variables. The long- and short-run dynamics reveal that urbanization reduces the CO2 emissions both in short and long runs, but statistically insignificant. These findings contrast with previous literature and sound the validation of urban environmental transition theory (UET). However, economic growth and trade openness contribute environmental degradation both in long- and short-run paths. The causality analysis reports bidirectional causal link between trade openness and urbanization in the short run. However, in the long-run, economic growth Granger causes carbon dioxide emissions, urbanization, and trade openness. Similarly, trade openness Granger causes carbon dioxide emissions, economic growth, and urbanization in the long run. The overall results imply that rural to urban immigration is still mostly driven by export-related manufacturing sectors. In addition, the higher GDP also contributes to urbanization as a feedback effect. In the end, stability of the model is also checked, model found stable, and findings are suitable for environmental policy control use.

The short musculoskeletal functional assessment (SMFA) score amongst surgical patients with reconstructive lower limb injuries in war wounded civilians.

BACKGROUND/OBJECTIVES: The MSF programme in Jordan provides specialized reconstructive surgical care to war-wounded civilians in the region. The short musculoskeletal functional assessment score (SMFA) provides a method for quantitatively assessing functional status following orthopaedic trauma. In June 2010 the Amman team established SMFA as the standard for measuring patients' functional status. The objective of this retrospective study is to evaluate whether the SMFA scores can be useful for patients with chronic war injuries. METHODS: All patients with lower limb injuries requiring reconstruction were enrolled in the study. Each patient's SMFA was assessed at admission, at discharge from Amman and during follow-up in home country. In the analysis we compared patients with infected versus non-infected injuries as well as with both high and low admissions dysfunctional index (ADI). RESULTS: Among infected patients, higher ADI correlated with more surgeries and longer hospital stay. Infected patients with ADI >50 required an average of 2.7 surgeries while those with ADI <50, averaged 1.7 operations (p = 0.0809). Non-infected patients with ADI >50 required an average of 1.6 operations compared to 1.5 for those with ADI <50 (p = 0.4168). CONCLUSIONS: The ADI score in our sample appeared to be useful in two areas: (1) hospital course in patients with infection, where a high ADI score correlated with longer hospital stays and more surgeries, and (2) prognosis, which was better for non-infected patients who had high ADI scores. A scoring system that predicts functional outcome following surgical reconstruction of lower limb injuries would be enormously useful.