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The designation of health care providers is limited to physicians, physician assistants, nurse practitioners, certified nurse midwives, nurse anesthetists, clinical psychologists, dietitians, and social workers. Pharmacists are not federally recognized health care providers and, therefore, are not eligible for cognitive service reimbursements. This commentary explains the intentions of adding pharmacists as Medicare Part B providers, evaluates current state pharmacist provider status, and calls pharmacists, technicians, and other key stakeholders to advocate on behalf of the profession of pharmacy. If federal provider status is granted to pharmacists, patients will gain better access to care, health spending will decline, and physician lead care teams will have an expert in medications readily available for consultation or other medication-related needs. Reimbursement would provide more resources to administer these needed services to more patients in areas with limited access to health care resources.
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Assistência Farmacêutica , Farmácia , Idoso , Humanos , Estados Unidos , Farmacêuticos , Medicare , Pessoal de SaúdeRESUMO
Given the dire state of global warming, it is critical to investigate the elements that influence carbon emissions intensity and to precisely monitor progress in carbon emissions intensity growth in order to meet the aim of lowering CO2 emissions. This research explores the association among renewable energy and non-renewable energy consumption, the urban population, research and development expenditure, technological innovation, and carbon emissions intensity in China using annual time series data over the period 1990 to 2019. The Dynamic ARDL simulation technique was utilized to investigate the long-run and short-run correlations between renewable and non-renewable energy consumption and CEI. The results suggest that there is strong evidence of a long-run correlation between the variables. The findings indicate that in the long-run, renewable energy and non-renewable energy consumption, and research and development expenditure have a positive influence on CEI by 0.27%, 0.75%, and 0.21%, whereas the urban population has a negative influence by 2.31%, respectively. However, the urban population and technological innovation have positively affected the short-run CEI by 12.17% and 0.23%, respectively. Policies should focus on continuous investment in renewable energy sources, clean energy innovation, improving energy efficiency, forest restoration, and carbon neutrality initiatives to lessen the environmental extreme pressure associated with CO2 emissions.
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Dióxido de Carbono , Desenvolvimento Econômico , Carbono , Dióxido de Carbono/análise , China , Investimentos em SaúdeRESUMO
Introduction: Obesity is a major health problem because it is associated with increased risk of cardiovascular disease, diabetes, hypertension, and some cancers. Strategies to prevent or reduce obesity focus mainly on the possible effects of natural compounds that can induce a phenotype of browning adipocytes capable of releasing energy in the form of heat. Allicin, a bioactive component of garlic with numerous pharmacological functions, is known to stimulate energy metabolism. Methods: In the present study, the effects of allicin on human Simpson-Golabi-Behmel Syndrome (SGBS) cells were investigated by quantifying the dynamics of lipid droplets (LDs) and mitochondria, as well as transcriptomic changes after six days of differentiation. Results: Allicin significantly promoted the reduction in the surface area and size of LDs, leading to the formation of multilocular adipocytes, which was confirmed by the upregulation of genes related to lipolysis. The increase in the number and decrease in the mean aspect ratio of mitochondria in allicin-treated cells indicate a shift in mitochondrial dynamics toward fission. The structural results are confirmed by transcriptomic analysis showing a significant arrangement of gene expression associated with beige adipocytes, in particular increased expression of T-box transcription factor 1 (TBX1), uncoupling protein 1 (UCP1), PPARG coactivator 1 alpha (PPARGC1A), peroxisome proliferator-activated receptor alpha (PPARA), and OXPHOS-related genes. The most promising targets are nuclear genes such as retinoid X receptor alpha (RXRA), retinoid X receptor gamma (RXRG), nuclear receptor subfamily 1 group H member 3 (NR1H3), nuclear receptor subfamily 1 group H member 4 (NR1H4), PPARA, and oestrogen receptor 1 (ESR1). Discussion: Transcriptomic data and the network pharmacology-based approach revealed that genes and potential targets of allicin are involved in ligand-activated transcription factor activity, intracellular receptor signalling, regulation of cold-induced thermogenesis, and positive regulation of lipid metabolism. The present study highlights the potential role of allicin in triggering browning in human SGBS cells by affecting the LD dynamics, mitochondrial morphology, and expression of brown marker genes. Understanding the potential targets through which allicin promotes this effect may reveal the underlying signalling pathways and support these findings.
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Adipócitos Marrons , Obesidade , Humanos , Adipócitos Marrons/metabolismo , Fenótipo , Obesidade/metabolismo , Fatores de Transcrição/metabolismoRESUMO
China is the foremost global consumer, producer, and exporter of fresh apples. In 2021, China produced roughly 44 million tons of apples and exported just over 1 million tons, a nearly 2% increase over the previous year. However, the ongoing COVID-19 pandemic has had a detrimental impact on global trade and has led to a decrease in China's agricultural exports. The present study aims to contribute to the existing body of literature by analyzing plausible macroeconomic determinants that might impact China's apple exports. We used novel dynamic autoregressive distributed lag (DYARDL) simulations to model causal relationships among fundamental economic parameters. We made use of annual time series data from 1990 to 2020 from the World Bank and China's national statistical bureau. We found that increases in apple orchard area, apple production, and trade openness had a positive impact on apple exports over both the short and long term. Conversely, decreases in the prices of exported apples, agrochemicals, and carbon emissions in the agricultural sector had a positive impact on the long-term and short-term exportation of apples. Finally, we note that pictographic illustrations from the DYARDL simulations provide corroborative evidence for our findings. Based on the study results, this study proposes that the adoption of technological advancements in apple orchards could potentially enhance apple production while simultaneously upholding environmental sustainability.
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COVID-19 , Malus , Humanos , Carbono , Pandemias , China , Dióxido de Carbono/análise , Desenvolvimento EconômicoRESUMO
Climate change-related environmental challenges are prompting an increasing number of countries to set carbon-neutral targets. Since 2007, China has pursued numerous initiatives to attain carbon neutrality by 2060, including increasing the percentage of non-fossil energy, developing zero-emission and low-emission technologies, and taking actions that reduce CO2 emissions or boost carbon sinks. As a result, utilizing quarterly data from 2008/Q1 to 2021/Q4, and applying the nonlinear autoregressive distributed lag (NARDL) approach, this study evaluates the effectiveness of the measures taken by China to improve the ecological situation. The results of the study show that the measures enacted to reduce CO2 emissions did not accomplish their ultimate purpose. Specifically: (i) high-speed railways and new energy vehicles do not improve the environment in the long run; (ii) investments and patents in the energy sector, as well as low-carbon sources, will degrade the environment; (iii) only investments in the treatment of environmental pollution will improve the ecological situation. Various policy implications are suggested based on the empirical results in order to attain environmental sustainability.
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The study examines the asymmetric effect of electricity consumption on carbon dioxide (CO2) emissions by analyzing end-user groups. In this context, the study focuses on the USA, which is the largest economy. The study includes the most available monthly data from January 1973 to November 2021, performs nonlinear quantile approaches as Granger causality-in-quantiles, nonparametric causality-in-quantiles, and quantile-on-quantile regression (QQR). Besides, quantile regression (QR) approach is used for robustness checks. The empirical results show that (i) correlation relationship between the electricity consumption and CO2 emissions changes according to the terms; (ii) there are generally causality effects in quantiles excluding some lower (0.05, 0.25), middle (0.70, 0.75), and high (0.95) quantiles, while the results for end-user groups vary; (iii) similarly, there is nonparametric causality from the end-user electricity consumption indicators to the CO2 emissions for the mean (return) and the variance (volatility) in most of the quantiles excluding some; (iv) the effects of the electricity consumption indicators on the CO2 emissions are higher in lower quantiles; (v) the QR results show the robustness of the QQR results. Overall, the effects of the electricity consumption indicators on the CO2 emissions are asymmetric and change according to the terms, quantiles, mean, variance, and end-user groups. Furthermore, policy implications are discussed.
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Dióxido de Carbono , Desenvolvimento Econômico , Eletricidade , PolíticasRESUMO
There is conflicting evidence for the association between smoking and dry eye disease (DED). We conducted a meta-analysis to determine the true relationship between smoking and DED. A systematic literature search was performed using electronic databases, including PubMed, Embase and Cochrane Library, till August 2021 to identify observational studies with data on smoking as risk factor of DED. Quality assessment of the included studies was conducted using Joanna Briggs Institute (JBI) critical appraisal checklists. The random-effects model was used to calculate the pooled odds ratio (OR). Heterogeneity was evaluated by Cochrane Q and I2 index; in addition, subgroup, sensitivity, and meta-regression analyses were performed. Publication bias was assessed using funnel plot and Egger's regression test. A total of 22 studies (4 cohort and 18 cross-sectional studies) with 160,217 subjects met the inclusion criteria and were included in this meta-analysis. There is no statistically significant relationship between current smokers (ORadjusted = 1.14; 95% CI: 0.95-1.36; P = 0.15; I2 = 84%) and former smokers (ORadjusted = 1.06; 95% CI: 0.93-1.20; P = 0.38; I2 = 26.7%) for the risk of DED. The results remained consistent across various subgroups. No risk of publication bias was detected by funnel plot and Eggers's test (P > 0.05). No source of heterogeneity was observed in the meta-regression analysis. Our meta-analysis suggest current or former smoking may not be involved in the risk of dry eye disease. Further studies to understand the mechanism of interaction between current smokers and formers smokers with DED are recommended.
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Síndromes do Olho Seco , Fumar , Estudos de Coortes , Estudos Transversais , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/epidemiologia , Síndromes do Olho Seco/etiologia , Humanos , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologiaRESUMO
Purpose: To conduct a systematic review and meta-analysis for estimating the prevalence of pediatric cataracts across Asia. Methods: A detailed literature search of PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar databases, from 1990 to July 2021, was performed to include all studies reporting the prevalence of cataracts among children. Two researchers performed the literature search and screening of articles independently, and a third researcher critically reviewed the overall search and screening process to ensure the consistency. The JBI Critical Appraisal Checklist for studies reporting prevalence data was used to assess the methodological quality of the included studies. Results: Of the 496 identified articles, 35 studies with a sample size of 1,168,814 from 12 Asian countries were included in this analysis. The estimated pooled prevalence of pediatric cataracts in Asian children is 3.78 (95% confidence interval: 2.54-5.26)/10,000 individuals with high heterogeneity (I[2] = 89.5%). The pooled prevalence by each country per 10,000 was 0.60 in Indonesia, 0.92 in Bangladesh, 1.47 in Iran, 2.01 in Bhutan, 3.45 in Laos, 3.68 in China, 4.27 in Thailand, 4.47 in India, 5.33 in Malaysia, 5.42 in Nepal, 9.34 in Vietnam, and 10.86 in Cambodia. Conclusions: This study utilizes existing literature to identify the prevalence of cataracts in Asian children. Moreover, it highlights the need for more epidemiological studies with large sample sizes from other countries in Asia to accurately estimate the burden of disease.
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SARS-CoV-2 preferentially targets the human's lungs, but it can affect multiple organ systems. We report a case of cardiorenal syndrome in a 37-year-old man who had symptoms of fever, myalgia and cough. He tested positive for COVID-19 and presented 5 days later with acute heart failure. Work up was done including echocardiography showing reduced ejection fraction. Later in the hospital course he developed acute renal failure and was treated with intermittent renal replacement therapy. No other definite cause of cardiorenal complications was identified during the course of the disease. A possible link with COVID-19 was considered with underlying mechanisms still needed to be explored. This case highlights the potential of SARS-CoV-2 affecting heart and kidneys. The disease not only involves the organs directly but can exacerbate the underlying comorbid illness.
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COVID-19 , Síndrome Cardiorrenal , Adulto , COVID-19/complicações , COVID-19/diagnóstico , Síndrome Cardiorrenal/virologia , Humanos , MasculinoRESUMO
Globally, the rising concentration of anthropogenic greenhouse gases emission in the atmosphere is extremely detrimental to the environment. The high concentration among all greenhouse gases is carbon dioxide emission. Therefore, this study explores the linkages between energy consumption, trade openness, globalization, urbanization, and carbon dioxide emission for Malaysia over the spans from 1978 to 2018. ARDL bound testing model was employed to investigate involvement in the elevation of carbon dioxide emissions in the economy. The study illustrates that a 1% growth in energy consumption, trade openness, and urbanization will deteriorate the environment by 0.18%, 0.03%, and 2.51% respectively. Further, variance decomposition analysis predicts that all the determinants in the study have significantly caused carbon dioxide emission in Malaysia. The paper presents scientific support for further studies and argues for the use of innovation shocks as a policy instrument for a prosperous future by formulating more successful environmental policies.
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Desenvolvimento Econômico , Gases de Efeito Estufa , Dióxido de Carbono/análise , Malásia , UrbanizaçãoRESUMO
This study aims to contribute to the literature and examine the causal relationship between Pakistan's agricultural products export, industrialization, urbanization, transportation, energy consumption, and carbon emissions. For the last four decades, time-series data were used to employ short-run and long-run nexus between the selected variables by analyzing the autoregressive distributed lag model (ARDL). The Granger causality test was analyzed to estimate the causality directions. The unit root test results indicate that all the selected variables are stationary at the level and first difference. The bound test confirmed that all variables are cointegrated at a 1% significance level. Long-run estimates suggest that an increase in energy consumption will increase the export of agricultural products. An increase in urbanization, transportation, and carbon emission resulted in a decrease in agricultural products export in Pakistan. In the short run, an increase in industrialization, transportation, and energy consumption leads to an increase in agricultural products export. Increasing urbanization and carbon emission decrease the agricultural products export of Pakistan. Based on our findings, we recommend sustainable agricultural production, renewable energy consumption, low carbon emission technologies, and a green portfolio for sustainable agricultural products export.
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Desenvolvimento Econômico , Desenvolvimento Industrial , Carbono , Dióxido de Carbono/análise , PaquistãoRESUMO
ABSTRACT: The current article looks at the effects of climate change on agriculture, especially crop production, and influence factors of agricultural development in terms of their rational use in Pakistan. Due to the dependence of economic development, and agriculture in the South Asian region on access to renewable national resources and the associated vulnerability to climate change, the limited financial and professional resources of the Islamic Republic of Pakistan require a clear definition of national priorities in this area. In the preparation of this article, general scientific cognition methods, in particular, empirical-theoretical methods were used. Grouping and classification methods have been used to process and systematize the data. The ability to change productivity, depending on the variation of the average annual air temperature and the average annual precipitation rate, was considered using a two-factor regression model. The main finding of the study is that temperature and precipitation have a negative impact on agricultural production. This study can provide a scientific justification for the specialization of agricultural production in the regions of Pakistan as well as the execution of the necessary agricultural activities.
RESUMO: O objetivo deste artigo é examinar os efeitos das mudanças climáticas na agricultura, especialmente a produção agrícola e os fatores de influência do desenvolvimento agrícola em termos de uso racional no Paquistão. Devido à dependência do desenvolvimento econômico e da agricultura na região do sul da Ásia do acesso a recursos nacionais renováveis e à vulnerabilidade associada às mudanças climáticas, os recursos financeiros e profissionais limitados da República Islâmica do Paquistão exigem uma definição clara das prioridades nacionais nessa área. Na preparação deste artigo, foram utilizados métodos gerais de cognição científica, em particular métodos teórico-empíricos. Os métodos de agrupamento e classificação foram utilizados para processar e sistematizar os dados. A capacidade de alterar a produtividade, dependendo da variação da temperatura média anual do ar e da taxa média anual de precipitação, foi considerada usando um modelo de regressão de dois fatores. A principal descoberta do estudo é que a temperatura e a precipitação têm um impacto negativo na produção agrícola. Este estudo pode fornecer uma justificativa científica para a especialização da produção agrícola nas regiões do Paquistão, bem como a execução das atividades agrícolas necessárias.
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ABSTRACT: This study aimed to investigate factors influencing the adoption of improved cultivars (ICs) in peach production in Khyber Pakhtunkhwa province of Pakistan. A total of 270 respondents were randomly selected from the three different cultivated areas of Khyber Pakhtunkhwa, namely, Peshawar, Nowshera and Swat. Binary choice model was used in this study to categorise the ICs of peach farmers into adoption and non-adoption. The study identifies that socio-economic, institutional farm resources, and climatic factors are influencing the adoption of ICs of peach production. Results of the estimated model reveal that farmer's age, education, household size, membership, cell phone, farm size, extension services and the role of the non-government organization have a positive effect on adoption of ICs. In addition, farmer's experience, off-farm income, livestock and machinery ownership, credit access and inputs prices have a positive and significant impact on ICs adoption. Moreover, results of the logit model demonstrate that climatic related factors have a highly significant and positive impact on the adoption of ICs. These results suggested that institutional services should be strengthened to provide managerial and technical skills on ICs technology adoption and on time provision of financial services to enhance the productivity of peach farmers.
RESUMO: Este estudo tem como objetivo investigar os fatores que influenciam a adoção de cultivares melhoradas (ICs) na produção de pessegueiros na província de Khyber Pakhtunkhwa, no Paquistão. Um total de 270 entrevistados foram selecionados aleatoriamente a partir das três diferentes áreas cultivadas de Khyber Pakhtunkhwa, Peshawar, Nowshera e Swat. O modelo de escolha binária foi usado neste estudo para categorizar os ICs dos produtores de pêssego em adoção e não-adoção. O estudo identifica que fatores socioeconômicos, institucionais, recursos agrícolas e climáticos influenciam a adoção de ICs de produção de pêssego. Os resultados do modelo estimado revelam que a idade do agricultor, educação, tamanho do agregado familiar, adesão, telefone celular, tamanho da fazenda, serviços de extensão e o papel da organização não-governamental têm efeito positivo sobre a adoção de ICs. Além disso, a experiência do agricultor, a renda fora da propriedade, a posse de gado e maquinaria, acesso ao crédito e preços dos insumos têm um impacto positivo e significativo na adoção dos ICs. Os resultados do modelo logit demonstram que os fatores climáticos relacionados têm um impacto altamente significativo e positivo na adoção de ICs. Estes resultados sugerem que os serviços institucionais devem ser fortalecidos para prover habilidades gerenciais e técnicas na adoção de tecnologia de ICs e no fornecimento de serviços financeiros para aumentar a produtividade dos produtores de pêssego.