Green bond as a new determinant of sustainable green financing, energy efficiency investment, and economic growth: a global perspective.

The purpose of the study is to test the role of green bond financing on energy efficiency investment and economic growth. To achieve the study objective, fuzzy decision-making modeling technique is applied. The results revealed that bank loans are now the main source of financing for energy efficiency projects. Project-based financing might be replaced with Energy Performance Contracts (EPC) warranting energy efficiency investment. Moreover, green banks invest both public and private funds in energy efficiency promoting economic growth. The usage of green bonds for financing environmentally beneficial projects or companies is limitless. Providing for screening energy efficiency investment proposals with small payback hurdle rates might have large opportunity costs. Green bonds can be used to remove the financing barriers for green finance and sustainability tool. On this, study provides policy implications to key stakeholders; if suggested policy suggestions implemented successfully, these would help to enhance scope of green bond financing to uplift energy efficiency financing and green growth successfully.

Reactogenicity to the mRNA-1273 Booster According to Previous mRNA COVID-19 Vaccination.

The objective of this study was to assess the local and systemic adverse reactions after the administration of a COVID-19 mRNA-1273 booster between December 2021 and February 2022 by comparing the type of mRNA vaccine used as primary series (mRNA-1273 or BNT162b2) and homologous versus heterologous booster in health care workers (HCW). A cross-sectional study was performed in HCW at a tertiary hospital in Barcelona, Spain. A total of 17% of booster recipients responded to the questionnaire. The frequency of reactogenicity after the mRNA-1273 booster (88.5%) was similar to the mRNA-1273 primary doses (85.8%), and higher than the BNT162b2 primary doses (71.1%). The reactogenicity was similar after receiving a heterologous booster compared to a homologous booster (88.0% vs. 90.2%, p = 0.3), and no statistically significant differences were identified in any local or systemic reactions. A higher frequency of medical leave was identified in the homologous booster dose group vs. the heterologous booster dose group (AOR 1.45; 95% CI: 1.00-2.07; p = 0.045). Our findings could be helpful in improving vaccine confidence toward heterologous combinations in the general population and in health care workers.

Menopause and multiple sclerosis: Influence on prognosis and role of disease-modifying drugs and hormonal replacement therapy.

BACKGROUND: Sex hormones play a role in both the risk and the prognosis of multiple sclerosis (MS). Considering all stages of women's reproductive life, data regarding the influence of menopause on MS and vice versa are scarce. OBJECTIVE: The aim of this study was to review the evidence addressing the relationship between menopause and MS. METHODS: A literature search through PubMed was conducted, selecting studies that assessed (1) the influence of menopause in the MS course, (2) the influence of MS and disease-modifying drugs (DMD) on the development of menopause and (3) the effect of hormone replacement therapy (HRT) on symptoms of menopausal MS patients. RESULTS: (1) Most studies suggest menopause may transitorily aggravate MS symptoms. Two studies found an inflexion point on the Expanding Disability Status Scale (EDSS) with clinical worsening during the menopausal transition. Another study considering full EDSS trajectories from clinically isolated syndrome to postmenopause did not find such an EDSS inflection; (2) MS and DMD do not seem to alter the age of menopause onset; and (3) HRT in menopausal MS patients has not shown consistent benefits. CONCLUSION: Menopause seems to be associated with transient symptom worsening, but the existence of an inflection in disability progression is still controversial. Properly designed studies are necessary to achieve conclusive results.

The Relationship Between CEO Duality and Business Firms' Performance: The Moderating Role of Firm Size and Corporate Social Responsibility.

This study focuses on exploring the relationship between chief executive officer (CEO) duality and firm performance. We focus on how the size and corporate social responsibility (CSR) of firms moderate this relationship. In terms of size, business organizations are of two types: small and large firms. This study uses datasets of listed Chinese business firms included in the China Stock Market and Accounting Research database. It employs a generalized method of moment's technique to explore the connection between CEO duality and the performance of Chinese business firms through double mediation effects. Our empirical analysis showed that CEO duality has a significant negative relationship with firm performance. We also explored the moderating effects of firm size (small and large) and CSR practices on the relationship between CEO duality and improved performance of Chinese firms. Large firms and CSR practices showed significant and positive moderating effects on the relationship between CEO duality and firm performance. Conversely, with CEO duality, small firms showed a negative moderating influence on firm performance. This inclusive model provides valuable insights into how the dual role of the CEO of a firm affected the performance of Chinese firms through the moderating role of CSR practices and firm size for better business performance. The study offers empirical and theoretical contributions to the corporate governance literature. This research framework might help researchers in designing robust strategies to evaluate the effects on firm performance. Researchers may gain helpful insights using this methodology.

Multiple sclerosis registries in Europe - results of a systematic survey.

BACKGROUND: Identification of MS registries and databases that are currently in use in Europe as well as a detailed knowledge of their content and structure is important in order to facilitate comprehensive analysis and comparison of data. METHODS: National MS registries or databases were identified by literature search, from the results of the MS Barometer 2011 and by asking 33 national MS societies. A standardized questionnaire was developed and sent to the registries' leaders, followed by telephone interviews with them. RESULTS: Twenty registries were identified, with 13 completing the questionnaire and seven being interviewed by telephone. These registries differed widely for objectives, structure, collected data, and for patients and centres included. Despite this heterogeneity, common objectives of the registries were epidemiology (n=10), long-term therapy outcome (n=8), healthcare research (n=9) and support/basis for clinical trials (n=8). While physician-based outcome measures (EDSS) are used in all registries, data from patients' perspectives were only collected in six registries. CONCLUSIONS: The detailed information on a large number of national MS registries in Europe is a prerequisite to facilitating harmonized integration of existing data from MS registries and databases, as well as comprehensive analyses and comparison across European populations.

TNFRSF1A polymorphisms rs1800693 and rs4149584 in patients with multiple sclerosis.

OBJECTIVES: To investigate the roles of 2 polymorphisms of the tumor necrosis factor (TNF) receptor superfamily member 1A (TNFRSF1A) gene, rs1800693 (a common variant) and rs4149584 (a coding polymorphism that results in an amino acid substitution-R92Q), as genetic modifiers of multiple sclerosis (MS), and to evaluate their potential functional implications in the disease. METHODS: The effects of rs1800693 and rs4149584 on 2 measures of disease severity, age at disease onset and Multiple Sclerosis Severity Score, were analyzed in 2,032 patients with MS. In a subgroup of patients, serum levels of the soluble form of TNF-R1 (sTNF-R1) were measured by ELISA; mRNA expression levels of the full-length TNF-R1 and Δ6-TNF-R1 isoform were investigated in peripheral blood mononuclear cells (PBMC) by real-time PCR; cell surface expression of the TNF-R1 was determined in T cells by flow cytometry. RESULTS: For rs4149584, R92Q carriers were younger at disease onset and progressed slower compared to noncarriers. However, no association with disease severity was observed for rs1800693. Serum levels of sTNF-R1 and mRNA expression levels of the full-length receptor were significantly increased in patients with MS carrying the R92Q mutation (p = 0.003 and p = 0.011, respectively), but similarly distributed among rs1800693 genotypes; cell surface TNF-R1 expression in T cells did not differ between rs4149584 and rs1800693 genotypes. The truncated soluble Δ6-TNF-R1 isoform was identified in PBMC from patients carrying the risk allele for rs1800693. CONCLUSIONS: These findings suggest that both rs1800693 and rs4149584 TNFRSF1A polymorphisms have functional consequences in the TNF-R1.

Congenital transmission of Trypanosoma cruzi in non-endemic areas: evaluation of a screening program in a tertiary care hospital in Barcelona, Spain.

The impact of Chagas disease is no longer restricted to endemic areas. The aim of this study is to evaluate a 2-year period of a vertical transmission screening program of Trypanosoma cruzi infection in a tertiary care hospital in Barcelona (Spain). Two enzyme-linked immunosorbent assays (recombinant and crude antigen) were performed in parallel to pregnant women at risk of T. cruzi infection. Discordant results were confirmed by a third diagnostic test. In the case of a positive result, the newborn was tested at birth and after 8 months of life. A total of 1,473 women met the inclusion criteria for the screening program with a resulting seroprevalence for T. cruzi of 3.5% (2.2-5.2% 95% confidence interval [95% CI]). One case of congenital infection was identified. Screening programs for vertically transmitted T. cruzi acute infection are beneficial in non-endemic areas for early detection and treatment of acute infection.

Enfermedad de Chagas importada en una gran ciudad europea: la experiencia en un centro especializado de Barcelona (2004-2006) / No disponible

Fundamento: El importante aumento de la inmigración en Barcelona los últimos años y concretamente la presencia de inmigrantes procedentes de zonas endémicas de enfermedad de Chagas condiciona que ésta sea una enfermedad emergente en nuestro medio. Este estudio describe las características epidemiológicas de los pacientes infectados por Trypanosoma cruzi atendidos en la Unitat de Medicina Tropical i Salud Internacional Drassanes (UMTSID), y analiza las derivaciones y los motivos de consulta por los cuales fueron atendidos. Métodos: Estudio descriptivo transversal de todos los pacientes procedentes de América Latina, diagnosticados de enfermedad de Chagas, y atendidos en la UMTSID desde julio de 2004 a enero de 2006. Se recogieron las siguientes variables: edad, sexo, país de nacimiento, meses de residencia en España, antecedentes de transfusión sanguínea, permanencia en área rural, viajes a otros países endémicos, motivos de consulta y derivación. Resultados: De los 216 pacientes atendidos en la UMTSID procedentes de países endémicos se diagnosticó enfermedad de Chagas en 46 de ellos. De estos el 83% eran mujeres y el 91% procedía de Bolivia. Los motivos de consulta más frecuentes fueron: diagnóstico previo un 37%, eosinofilia un 17% y cribado general un 15%. El porcentaje de pacientes que acudió por cuenta propia fue el mismo que los derivados por el médico de familia un 41%.Conclusiones: Estos resultados reflejan el trabajo conjunto de la UMTSID con los equipos de atención primaria(EAP) respecto a algunos protocolos, como por ejemplo el de eosinofilia, a pesar de que no se relacione con la enfermedad, pero también demuestran falta de criterios claros por parte de los profesionales médicos para iniciar su estudio. Además se plantean interrogantes respecto a los (..) (AU)

Background: The significant presence of immigrant people from endemic areas of Chagas disease has becomea reality in the medical centres in our country. The present study describes the epidemiological characteristics of patients diagnosed with Trypanosoma cruzi infection attended in the Barcelona Tropical and International Health Unit Drassanes, and analyzes the referrals and consultation reasons. Methods: Descriptive study of all patients from Latin America, Chagas’ disease diagnosed and treated in the UMTSID from July 2004 to January 2006. Variables analyzed were: age, genre, country and department of birth, time after arrival to Spain, past blood transfusions, staying in rural area, travelling to other endemic countries, referral and consultation reason. Results: Of 216 persons coming from the endemic countries, forty-six were diagnosed and studied, most of them were women (83%) and coming from Bolivia (91%). The consultation reasons were previous diagnosis of Chagas disease (37%), eosinophilia (17%), general screening (15%), cardiac (9%) or digestive (9%) symptoms andbeing an infected mother’s child (4%). The same number of patients, 41%, went by themselves and referred by their general practitioner. They also came referred by the paediatrician (7%), gynaecologist (2%), cardiologist (2%)or by family advice (7%).Conclusions: The analysis of the results shows the coordination of the Unit with the primary care services through some protocols such as eosinophilia, despite it is not related to the Chagas disease, but also the lack of established criteria to start the study of the disease. The presence of Chagas disease outside endemic countries demands a greater formation, an approach from different levels (including the social ones) and an extensive epidemiological study (AU)

[Needlestick injuries in health care workers: analysis of non preventable risk factors through standard precautions]. / Accidentes biológicos percutáneos en el personal sanitario: análisis de factores de riesgo no prevenibles mediante precauciones estándares.

OBJECTIVE: To identify potential risk factors of occupational needlestick injuries that were not prevented despite adherence to standard precautions. PATIENTS AND METHOD: Multicentre case control study. Cases were defined as any workers who reported a needlestick injury despite documented use of standard precautions. Controls were workers of the same hospital who had performed procedures similar to matched cases and who reported a needlestick injury without correct use of standard precautions (control 1) or who did not report a needlestick injury during the previous 6 months (control 2). RESULTS: A total of 512 injuries were included (256 cases and 256 controls 1), and 256 controls 2. Analyses based on controls 1 showed an increased risk for physicians (ORa 2.22; 95% CI: 1.07-4.60) and those working in the operating theatre (ORa 2.87; 95% CI: 1.26-6.55). Regarding controls 2, increased risks were found for those younger than 25 years (ORa 2.58; 95% CI: 1.20-5.58), physicians (ORa 5.24; 95% CI: 1.50-18.28), those working in operating theatres (ORa 6.00; 95% CI: 2.07-17.36), emergency services, intensive and life-support units (ORa 3.48; 95% CI: 1.37-8.85) and those exposed to poor lighting (ORa 1.67; 95% CI: 1.02-2.82). Education in occupational risk prevention was found to be a protecting factor when controls 1 were analyzed (ORa 0.61; 95% CI: 0.39-0.97). CONCLUSIONS: Despite adherence to standard precautions, working as a physician, in operating theatres, emergency and life-support units, being younger than 25 years, and being exposed to poor visibility and training in occupational risk prevention appear to be independent risk factors for occupational needlestick injuries.

Accidentes biológicos percutáneos en el personal sanitario: análisis de factores de riesgo no prevenibles mediante precauciones estándares / Needlestick injuries in health care workers: analysis of non preventable risk factors through standard precautions

Fundamento y objetivo: identificar los posibles factores de riesgo (FR) de las exposiciones laborales percutáneas no prevenibles mediante las precauciones estándares. Pacientes y método: estudio multicéntrico de casos y controles. Se definió como caso el trabajador que había experimentado una exposición percutánea a pesar de haber seguido las precauciones estándares. Los controles fueron trabajadores del mismo hospital que hubieran realizado procedimientos similares al caso y que hubieran tenido un accidente biológico sin adoptar de forma correcta las precauciones estándares (control 1) o que no hubieran tenido una exposición accidental en los últimos 6 meses (control 2). Resultados: se incluyeron 512 exposiciones (256 casos y 256 controles 1) y 256 controles 2. Respecto a los controles 1, se observó una asociación entre ser médico (odds ratio ajustada [ORa]: 2,22; intervalo de confianza [IC] del 95%: 1,07–4,60) y trabajar en quirófano (ORa: 2,87; IC del 95%: 1,26–6,55). En relación con los controles 2, se observó asociación entre tener una edad inferior a 25 años (ORa: 2,58; IC del 95%: 1,20–5,58), ser médico (ORa: 5,24; IC del 95%: 1,50–18,28), trabajar en quirófanos (ORa: 6; IC del 95%: 2,07–17,36), trabajar en servicios de urgencias, unidades de cuidados intensivos (UCI) y reanimación (ORa: 3,48; IC del 95%: 1,37–8,85) y estar expuesto a iluminación inadecuada (ORa: 1,67; IC del 95%: 1,02–2,82). La formación en prevención de riesgos laborales se mostró como un factor protector en los controles 1 (ORa: 0,61; IC del 95%: 0,39–0,97). Conclusiones: a pesar de seguir de forma correcta las precauciones estándares, ser médico y trabajar en quirófanos, urgencias, UCI o reanimación, la edad inferior a 25 años, la visibilidad inadecuada y la poca formación en prevención son FR independientes de experimentar exposiciones accidentales percutáneas (AU)

Objective: To identify potential risk factors of occupational needlestick injuries that were not prevented despite adherence to standard precautions. Patients and method: Multicentre case control study. Cases were defined as any workers who reported a needlestick injury despite documented use of standard precautions. Controls were workers of the same hospital who had performed procedures similar to matched cases and who reported a needlestick injury without correct use of standard precautions (control 1) or who did not report a needlestick injury during the previous 6 months (control 2).ResultsA total of 512 injuries were included (256 cases and 256 controls 1), and 256 controls 2. Analyses based on controls 1 showed an increased risk for physicians (ORa 2.22; 95% CI: 1.07-4.60) and those working in the operating theatre (ORa 2.87; 95% CI: 1.26-6.55). Regarding controls 2, increased risks were found for those younger than 25 years (ORa 2.58; 95% CI: 1.20-5.58), physicians (ORa 5.24; 95% CI: 1.50-18.28), those working in operating theatres (ORa 6.00; 95% CI: 2.07-17.36), emergency services, intensive and life-support units (ORa 3.48; 95% CI: 1.37-8.85) and those exposed to poor lighting (ORa 1.67; 95% CI: 1.02-2.82). Education in occupational risk prevention was found to be a protecting factor when controls 1 were analyzed (ORa 0.61; 95% CI: 0.39-0.97). Conclusions: Despite adherence to standard precautions, working as a physician, in operating theatres, emergency and life-support units, being younger than 25 years, and being exposed to poor visibility and training in occupational risk prevention appear to be independent risk factors for occupational needlestick injuries (AU)

Prevenció de la transmissió de les infeccions a les unitats d’hospitalització pediàtrica / No disponible

No disponible