Analyzing the effectiveness of energy aid for driving the transition towards energy decarbonization; Evidence from Asian developing countries.

Environmental degradation poses a significant challenge in many developing countries, as they heavily rely on fossil fuels to drive economic activities. The transition towards renewable energy is crucial to mitigate ecological depletion, yet numerous Asian developing countries may struggle to achieve the desired levels of renewable energy adoption due to financial constraints. Foreign aid in the energy sector can expedite this transition process. This study aims to examine the impact of foreign aid on the energy decarbonization transition in 22 Asian developing countries from 2003 to 2022 to analyze its contributions and challenges to promote renewable energy adoption. This paper incorporates the two types of foreign aid in the energy sector (nonrenewable and renewable energy aid) provided by the OECD to developing economies. Utilizing the System-Generalized Method of Moments (Sys-GMM), the findings reveal that energy aid significantly contributes to the transition towards energy decarbonization by providing financial support for embracing renewable energy technologies. Specifically, the analysis indicates that a 1% increase in energy aid leads to approximately 3% enhancement in the decarbonization transition process. Moreover, this study adds to the existing body of knowledge by examining the mediating impact of human capital and financial development as well as the moderating effect of institutional quality and demand for clean fuel. These factors play a pivotal role in energy decarbonization transition by fostering financial development and enhancing human capital through capacity-building initiatives and facilitating the adoption of renewable energy technologies.

Base excess and hematocrit predict response to indomethacin in very low birth weight infants with patent ductus arteriosus.

BACKGROUND: The treatment of patent ductus arteriosus (PDA) in very low birth weight (VLBW) infants remains a challenge. The ability to predict which infants will respond to indomethacin could spare some from the risks of unnecessary medications. Our objective was to determine if indicators of acid-base homeostasis could predict response to indomethacin treatment for ductal closure, and thus help guide treatment decisions. METHODS: We performed a retrospective analysis of medical records of VLBW (< 1500 g) neonates with hemodynamically significant PDA born at our institution between January 2009 and December 2012; all infants included in the study were treated with indomethacin for ductal closure within the first 2 weeks of life. We extracted data for a number of clinical variables including gestational age, birth weight, blood chemistries, surfactant use, hematocrit, and blood gas parameters. Our primary outcome measure was successful closure of PDA following the first round of indomethacin. Using variables that were significant on initial testing, we created multivariable regression models to determine the independent association of selected variables with indomethacin response. RESULTS: Of the 91 infants included in the study, 62 (68%) responded to the first course of indomethacin with successful ductal closure. Multivariable regression modeling revealed that both base excess and hematocrit were independently associated with indomethacin response; odds of PDA closure increased with increasing base excess (OR [odds ratio]: 1.81; 95% confidence interval [CI]: 1.36-2.60) and increasing hematocrit (OR: 1.21; 95% CI: 1.01-1.45). The optimal cutoff value for base excess was - 4.56, with a sensitivity of 96.8% (95% CI: 89-100) and specificity of 79.3% (95% CI: 60-92); optimal cutoff value for hematocrit was 40, with 69.4% sensitivity (95% CI: 56-80) and 65.5% specificity (95% CI: 46-82). CONCLUSIONS: Base excess and hematocrit may be independent predictors of indomethacin response in VLBW infants with PDA. Low-cost and readily accessible, acid-base indicators such as base excess could help guide treatment decisions.

Aortic Involvement in Pediatric Marfan syndrome: A Review.

Outlining specific protocols for the management of pediatric patients with Marfan syndrome has been challenging. This is mostly due to a dearth of clinical studies performed in pediatric patients. In Marfan syndrome, the major sources of morbidity and mortality relate to the cardiovascular system. In this review, we focus on aortic involvement seen in pediatric patients with Marfan syndrome, ranging from aortic dilatation to aortic rupture and heart failure. We discuss the histological, morphological, and pathogenetic basis of the cardiac manifestations seen in pediatric Marfan syndrome and use a specific case to depict our experienced range of cardiovascular manifestations. The survival for patients with Marfan syndrome may approach the expected survival for non-affected patients, with optimal management. With this potentiality in mind, we explore possible and actual management considerations for pediatric Marfan syndrome, examining both medical and surgical therapy modalities that can make the possibility of improved survival a reality.

Chest pain in adolescent Japanese male mimicking acute coronary syndrome.

Acute chest pain with very elevated troponin level and abnormal EKG in adult population is considered sine qua non to acute coronary syndrome (ACS) unless proved otherwise. Similar presentation in adolescent population is seen less often but raises suspicion for ACS. Most common etiology for chest pain with cardiac enzyme elevation in adolescent population is usually viral myopericarditis. The adolescent population presenting with chest pain and elevated cardiac enzymes should be carefully evaluated for ACS and other etiologies including myocarditis, myopericarditis, pulmonary embolism, acute rheumatic fever, and trauma. We report one Japanese adolescent male with mycoplasma pneumoniae myocarditis who presented to the ER with chest pain, elevated cardiac enzymes, and abnormal EKG.

Chest pain in two athletic male adolescents mimicking myocardial infarction.

Acute chest pain with elevated troponin and CK-MB levels and focal ST elevation on electrocardiogram is considered to be myocardial infarction unless proven otherwise. The cardiac enzymes can be elevated in other etiologies of chest pain including myopericarditis, pulmonary embolism, acute rheumatic fever, and trauma. Therefore, patients presenting with chest pain and elevated cardiac enzymes should be carefully evaluated for other etiologies after ruling out acute coronary process. We report 2 male adolescents with myopericarditis who presented to the emergency department with chest pain and elevated cardiac enzymes.

Isolated left bundle branch block in a toddler.

Left bundle branch block (LBBB) usually occurs as a postoperative complication from surgical correction of congenital heart disease and can be associated with hypertensive heart disease, coronary artery disease, myocarditis, and aortic valvular disease. Although isolated LBBB is a conduction abnormality found in some healthy adults, it has not been reported in pediatric population. We report a 2-year-old, healthy African American female who was incidentally discovered to have isolated LBBB that has persisted in a follow-up of 3 years.

Double-outlet right ventricle with an intact ventricular septum: a unique stage 1 palliation.

This report describes a case of double-outlet right ventricle with intact ventricular septum diagnosed in a newborn male. The initial diagnosis was made by echocardiography. The baby underwent a hybrid procedure including pulmonary artery banding and stenting of the patent ductus arteriosus. He subsequently underwent stenting of the atrial communication. The patient was discharged at 55 days of life with the intent to perform palliative repair at a later date.

Hypertrophic cardiomyopathy: role of current recommendations by the american heart association for infective endocarditis.

In the past decade, there has been evolution in the diagnosis, management, and long-term care of patients with infective endocarditis and its complications. This includes the relatively new but contentious prophylactic antibiotic regimen. However, these cases still continue to pose a challenge in the adult and pediatric populations. We present a case of a teenager with hypertrophic cardiomyopathy that had an atypical presentation of infective endocarditis.

Natural history of conduction abnormalities in a patient with Kearns-Sayre syndrome.

Kearns-Sayre syndrome is a rare mitochondrial disorder characterized by large-scale deletion or rearrangement of mitochondrial DNA, which is usually not inherited but occur spontaneously probably at the germ cell level or very early in embryonic development by Mehndiratta et al. (Neurol India 50:162-167, 2002). Neuromuscular and cardiac conduction abnormalities are most commonly involved in these patients, which may have subtle presenting signs.

T-wave inversion in diabetic ketoacidosis with normokalemia in an adolescent.

Myriad electrocardiographic changes, such as ST-segment elevation/depression, altered T-wave morphology, and QT prolongation, have been described with hyperkalemia in the setting of diabetic ketoacidosis (DKA) [2, 3]. We present an adolescent with DKA in whom T-wave inversions was seen despite his having normal serum potassium level.

Atrial fibrillation in two adolescents.

Idiopathic atrial fibrillation (AF) in adolescents is extremely rare and has usually been associated with structural heart disease. We present two cases of symptomatic AF in adolescents without any identifiable etiology. No definitive guidelines are available for management of such patients.