The utility of NIRS in follow-up of patients with acute ischaemic stroke treated with IV thrombolysis and mechanical thrombectomy in the emergency department.

Revascularization treatments (IV thrombolysis, mechanical thrombectomy) related to ischemic stroke have developed in recent years. With devices such as NIRS, non-invasive monitoring of treatment efficacy is provided. In this study, we aimed to use near-infrared spectroscopy (NIRS) as an objective monitoring method to see the effect of intravenous (IV) thrombolysis or mechanical thrombectomy treatments applied for cerebral oxygenation in patients with acute ischemic stroke. This study was carried out as a prospective study involving patients admitted to the emergency department in the years 2021-2022. NIRS measured regional oxygen saturation (rSO2) of both hemispheres of the brain before IV thrombolysis treatment, during the treatment at 0. min, 15. min, 30. min, 45. min, 60. min, after the treatment, and before and after the mechanical thrombectomy procedure. The significance level of the change in rSO2 values measured by NIRS was examined. 80 patients were included in the study. IV thrombolysis was applied to 58 patients, mechanical thrombectomy was applied to 5 of them, and both treatments were applied to 17 of them. In patients receiving IV thrombolysis, a significant difference was found in the affected hemisphere between the NIRS values measured at 0.min-15.min, 0.min-30.min, 0.min-45.min, 0.min-60.min, 0.min-post-treatment, 15.min-60.min (p < 0.001). In the patients included in the study, there was a strong and significant negative correlation between the deltaNIHSS value and the deltaNIRS values in the affected hemisphere (r=- 0.307, p = 0.013). There was a significant increase in the NIRS measurement values during and after the IV thrombolysis treatment in the affected hemisphere in the group with clinical improvement (p < 0.001). It is thought that IV thrombolysis or mechanical thrombectomy treatment applied to patients admitted to the emergency department with acute ischemic stroke can be followed objectively by NIRS.

Diagnostic value of serum signal peptide-CUB-EGF-like domain-containing protein 1 levels in patients with acute appendicitis.

OBJECTIVE: Acute appendicitis is one of the most common surgical causes of an acute abdomen among patients admitted to the emergency room due to abdominal pain. The clinical diagnosis of acute appendicitis is usually difficult and is made by evaluating the clinical, laboratory, and radiological findings together. The aim of this study was to investigate the diagnostic potential of signal peptide-CUB-EGF-like domain-containing protein 1 as a biomarker for acute appendicitis. METHODS: A total of 67 adult patients without any comorbidities who presented to the emergency department with abdominal pain and were clinically diagnosed with acute appendicitis were included in the case group. The patients included in the study were classified into the negative appendectomy group and the acute appendicitis group according to their histopathological final diagnosis. In addition, 48 healthy volunteers without comorbidities were included in the control group. Signal peptide-CUB-EGF-like domain-containing protein 1 levels of patients and the control group were measured. RESULTS: According to postoperative histopathological examinations of the patients, 7 (10.4%) patients were diagnosed with negative appendectomy, and 60 (89.6%) patients were diagnosed with acute appendicitis. Signal peptide-CUB-EGF-like domain-containing protein 1 levels were higher in the patients with acute appendicitis than in negative appendectomy patients (p=0.012). Signal peptide-CUB-EGF-like domain-containing protein 1 levels were also higher in the case group compared to the control group (p=0.001). CONCLUSION: The admission signal peptide-CUB-EGF-like domain-containing protein 1 level was significantly higher in adults with acute appendicitis. The SCUBE1 level is a novel but promising biomarker that aids in the diagnosis of acute appendicitis.

Determination of Exogenous Adrenaline Levels in Patients Undergoing Cardiopulmonary Resuscitation.

Core-shell quantum dot ZnS/CdSe screen-printed electrodes were used to electrochemically measure human blood plasma levels of exogenous adrenaline administered to cardiac arrest patients. The electrochemical behavior of adrenaline on the modified electrode surface was investigated using differential pulse voltammetry (DPV), cyclic voltammetry, and electrochemical impedance spectroscopy (EIS). Under optimal conditions, the linear working ranges of the modified electrode were 0.001-3 µM (DPV) and 0.001-300 µM (EIS). The best limit of detection for this concentration range was 2.79 × 10-8 µM (DPV). The modified electrodes showed good reproducibility, stability, and sensitivity and successfully detected adrenaline levels.

The role of repeated extended FAST in patients with stable blunt thoracoabdominal trauma.

BACKGROUND: Thoracic and abdominal computed tomography scans are widely used modalities for trauma patients in emergency department (ED). However, alternative diagnostic and follow-up tools are also needed, due to limitations such as high cost and exces-sive radiation exposure. This study aimed to investigate the utility of repeated extended focused abdominal sonography for trauma (rE-FAST) performed by the emergency physician in patients with stable blunt thoracoabdominal trauma. METHODS: This was a prospective, single-center diagnostic accuracy study. Patients with blunt thoracoabdominal trauma admitted to the ED were included in the study. The E-FAST was performed on the patients included in the study at the 0th h, the 3rd h, and the 6th h during their follow-up. Then, the diagnostic accuracy metrics of E-FAST and rE-FAST were calculated. RESULTS: The sensitivity and specificity of E-FAST in determining thoracoabdominal pathologies were found to be 75% and 98.7%, respectively. The sensitivity and specificity for specific pathologies were 66.7% and 100% for pneumothorax, 66.7% and 98.8% for hemothorax, and 66.7% and 100% for hemoperitoneum, respectively. The sensitivity and specificity of rE-FAST in determining thoracal and/or abdominal hemorrhage in stable patients were found to be 100% and 98.7%, respectively. CONCLUSION: E-FAST successfully rules in thoracoabdominal pathologies in patients with blunt trauma, with its high specificity. However, only a rE-FAST might be sensitive enough to exclude traumatic pathologies in these stable patients.

Energy productivity and environmental degradation in the Netherlands: evidence from the novel Fourier-based estimators.

Due to the incessant quest for economic growth, global energy demand has increased to a level that requires urgent rethinking. The Netherlands depends heavily on traditional energy sources, which are finite and equally emit a lot of greenhouse gasses, causing further environmental destruction. To sustain economic growth and protect the ecosystem, it is crucial for the Netherlands to consume energy efficiently. Given that policy directions are required, this paper investigates the effect of energy productivity on environmental degradation in the Netherlands between 1990Q1 and 2019Q4, using the Fourier ARDL (autoregressive distributed lag) and Fourier Toda-Yamamoto causality approaches. The Fourier ADL estimates indicate that all variables are cointegrated. Additionally, the long-run Fourier ARDL estimates indicate that investments in energy productivity could help reduce carbon dioxide emissions in the Netherlands. Furthermore, the Fourier Toda-Yamamoto causality outcomes suggest that energy productivity, economic growth, and renewable energy consumption have a unidirectional causal effect on CO2 emissions. These revealing outcomes provide significant policy insights for the Netherlands' energy productivity objectives in their new energy policy proposed in 2022. The government could, through the new energy policy, increase investment in smart meters and review existing fossil fuel subsidies and energy trade taxes. Additionally, the government could consider reviewing the Netherlands' economic structure by increasing the share of the primary and tertiary sectors to the rising economic growth to reduce energy consumption.

Spontaneous Forniceal Rupture Identified by Point-of-care Ultrasound.

Spontaneous forniceal rupture is one of the rarest diagnoses of abrupt onset abdominal pain. Moreover, urolithiasis is the most prevalent cause and coexistent condition. Delayed-phased Contrast-enhanced computed tomography scans or intravenous pyelograms are needed for an exact diagnosis in most circumstances. Herein, we report a case of a healthy middle-aged female who presented to the emergency department with flank and abdominal pain. The diagnosis of forniceal rupture was made by the emergency point of care ultrasound. To the best of our knowledge, this is one of the first cases of spontaneous forniceal rupture secondary to urolithiasis diagnosed by the physician-performed ultrasound before confirmation of the diagnosis with computed tomography. In conclusion, emergency physicians and surgeons should be aware of rare conditions like spontaneous forniceal rupture and its sonographic findings to make a rapid diagnosis of urine extravasation so that unwanted complications are avoided. Key Words: Renal stone, Ultrasound, Forniceal rupture, Renal colic, Urinoma.

Carbon dioxide intensity of GDP and environmental degradation in an emerging country.

This paper investigates whether the carbon dioxide (CO2) intensity of GDP matters for environmental degradation in an emerging country, namely, Turkey, over the period of 1990-2018 while controlling economic growth, foreign direct investment, and renewable energy consumption. The present study uses both linear and nonlinear time series estimators, namely, the Gregory and Hansen cointegration test, bounds test, nonlinear autoregressive distributed lag (NARDL) model, fully modified ordinary least squares (FMOLS), dynamic ordinary least squares (DOLS), and canonical cointegrating regressions (CCR), to encapsulate the possible effect of CO2 intensity of GDP, economic growth, foreign direct investment, and renewable energy consumption on environmental degradation in Turkey. The empirical finding of the present study reveals that the CO2 intensity of GDP is an important factor to determine environmental degradation in Turkey and the declining CO2 intensity of GDP reduces environmental degradation. Moreover, economic growth is the primary environmental sustainability factor in Turkey. The result is vital for policymaking and can perhaps be applied to take decisive policy actions to mitigate environmental issues.

The nexus between remittances, natural resources, technological innovation, economic growth, and environmental sustainability in Pakistan.

Globally, the issues about sustainable development are on the increase. Moreover, these issues are rising every day in Pakistan, as remittances are increasing, technology innovation is ambiguous, natural resources are degraded, and economic expansion might pose serious challenges to the environment. Thus, this research looks at how remittances, natural resources, technological innovation, and economic growth affect carbon dioxide (CO2) emissions in Pakistan by controlling energy consumption and urbanization from 1990 to 2019. The Bayer and Hanck test of combined cointegration discloses a cointegration between remittances, natural resources, technological innovations, economic growth, and CO2 emissions. Moreover, the autoregressive distributive lag model (ARDL) proposes a significant positive association between remittances and CO2 emissions in the long run, indicating that the increase in remittances distresses the environmental performance of Pakistan. Our study confirms that natural resources decrease CO2 emissions while technological advancement, economic progress, energy use, and urbanization increase CO2 emissions. In addition, the results of robustness checks by employing fully modified ordinary least squares and dynamic ordinary least squares are parallel to the conclusions of ARDL estimations. Furthermore, the frequency causality test results show that remittances, natural resources, technological innovation, economic growth, energy use, and urbanization cause CO2 emissions at different frequencies. Therefore, to achieve the sustainable development goals, appropriate policy repercussions can be developed toward advanced and environmentally sustainable sources of energy.

Determinants of load capacity factor in South Korea: does structural change matter?

By likening biocapacity and ecological footprint, the load capacity factor follows a specified ecological threshold, permitting for an in-depth analysis of ecological damage. It can be seen that as the load capacity factor is reduced, the ecological damage intensifies. Until now, scholars have used carbon dioxide, ecological footprint, nitrogen oxide, sulfur dioxide, and other indices to objectively examine ecological problems. The utilization of these metrics can cause the supply side of ecological concerns to be overlooked. To make up for this weakness, this paper evaluates the impact of structural change and trade globalization on the load capacity factor. The research also considers other drivers of load capacity factors such as economic growth and energy. We utilized the nonparametric such as nonparametric causality and quantile-on-quantile (QQ) regression approaches to scrutinize these interconnections for South Korea between 1970 and 2018. The findings from the QQ approach disclosed that in the majority of the quantiles, the influence of economic growth, structural change, energies (renewable and nonrenewable), and trade globalization mitigate the load capacity factor. Moreover, the nonparametric causality test divulged that in variance and mean, all the independent variables can predict the load capacity factor. Policy proposals for South Korea's sustainable development are offered based on the findings.

Financial Development and Health Outcomes: Do Financial Globalization Matter in Selected Asian Economies?

The importance of health is well documented in the development economics literature because of its increasing effects on economic growth in the long-run. Financial development and financial globalization are essential resources for health. This study examines the role of financial development and financial globalization in the rapid rise of life expectancy in China, India, and Japan by using the annual data covering the period of 1991-2019. The ARDL bounds testing approach confirm the long-run relationship between financial development, financial globalization, and life expectancy in the presence of GDP, health expenditure, and the internet. The long-run findings indicate that financial development positively affects life expectancy by 0.599% in China. The novel findings also indicate that financial globalization positively affects life expectancy by 1.247% in Japan and 1.121% in India. Our findings offer new empirical insights to policymakers crucial to improving life expectancy in China, India, and Japan.

Does political risk spur environmental issues in China?

China is one of the largest emitters of carbon dioxide (CO2) emissions in the world. Therefore, it is essential to explore the determinants of CO2 emissions in China. But previous studies so far have not examined how the political risk of this country can affect its CO2 emissions due to the lack of a long-term dataset. Hence, this study aims to capture the effect of political risk on China's CO2 emissions while controlling renewable energy consumption, technological innovation, and the economy's economic growth. We employ Bayer and Hanck cointegration, FMOLS, DOLS, CCR, and frequency domain causality tests to establish the relationship among the variables mentioned above. The outcome of the study reveals that political stability is an important predictor of environmental degradation in China. Moreover, political stability is helpful to lower CO2 emissions, while technological innovation and renewable energy consumption can reduce CO2 emissions, economic growth further deteriorates environmental quality by increasing its carbon emissions. Therefore, the present study recommends that policymakers in China should control political tension in the country to control CO2 emissions and, at the same time, promote technological innovation and renewable energy consumption.

Transition to renewable energy and environmental technologies: The role of economic policy uncertainty in top five polluted economies.

The United Nations' "Sustainable Development Goals" (SDGs) express attention to climate action. Even though a considerable number of papers have targeted this issue, the literature on the top five, "China, India, Japan, Russia, and the United States" economies is uncommon. Therefore, this paper is targeted to examine the influence of renewable energy (RE), environmental technologies (ETs), and economic policy uncertainty (EPU) on carbon emissions. By using the most recent data available from 1992 to 2020, results are estimated with robust econometric techniques, i. e. "cross-sectionally augmented autoregressive distributed lag (CS-ARDL) and augmented mean group (AMG)". Findings reflect the harmful role of EPU. However, RE and ETs have a supportive role in the transition towards a sustainable environment. The findings are also strong in terms of policy implications for the top five polluters.

Re-Examining the Financial Structure and Health Nexus in Asian Economies.

The study's main purpose is to estimate the impact of the financial structure of Asian economies on the healthcare sector from 2000 to 2019. For empirical estimation, we relied on two-stage least square (2SLS) and generalized method of moment (GMM) estimation techniques. Two different proxies, infant mortality and life expectancy, were used in the analysis to represent the health status of the people. The findings of both 2SLS and GMM models confirm that improved financial structure causes life expectancy to rise and infant mortality to fall. Moreover, the increased usage of the internet also exerts a positive impact on the health status of Asians. Further, the rise in gross domestic product (GDP) and health expenditures also improve the health status of Asians by increasing their life expectancy and reducing their infant mortality rate. Improvement in financial structure causes the health status of the people to rise. Therefore, to achieve superior health status, the development of financial structure should be part and parcel of health policies and strategies in Asian economies.

A Roadmap toward Achieving Sustainable Environment: Evaluating the Impact of Technological Innovation and Globalization on Load Capacity Factor.

Technological innovations have been a matter of contention, and their environmental consequences remain unresolved. Moreover, studies have extensively evaluated environmental challenges using metrics such as nitrogen oxide emissions, sulfur dioxide, carbon emissions, and ecological footprint. The environment has the supply and demand aspect, which is not a component of any of these indicators. By measuring biocapacity and ecological footprint, the load capacity factor follows a certain ecological threshold, allowing for a thorough study on environmental deterioration. With the reduction in load capacity factor, the environmental deterioration increases. In the context of the environment, the interaction between technological innovation and load capacity covers the demand and supply side of the environment. In light of this, employing the dataset ranging from 1980 to 2017 for the case of South Africa, the bound cointegration test in conjunction with the critical value of Kripfganz and Schneider showed cointegration in the model. The study also employed the ARDL, whose outcome revealed that nonrenewable energy usage and economic growth contribute to environmental deterioration, whereas technological innovation and globalization improve the quality of the environment. This study validated the hypothesis of the environmental Kuznets curve for South Africa, as the short-term coefficient value was lower than the long-term elasticity. Furthermore, using the frequency-domain causality test revealed that globalization and economic growth predict load capacity in the long term, and nonrenewable energy predicts load capacity factors in the long and medium term. In addition, technological innovation predicts load capacity factors in the short and long term. Based on the findings, we propose that policymakers should focus their efforts on increasing funding for the research and development of green technologies.

Environmental sustainability and public-private partnerships investment in energy in Bangladesh.

The current paper examines the effect of public-private partnerships investment in energy (PPIE) on CO2 emissions while taking economic growth (GDP), foreign direct investment (FDI), and trade openness (TOP) into consideration for Bangladesh from 1997 to 2019. This paper utilizes Bayer and Hanck cointegration approach, fully modified ordinary least squares, dynamic ordinary least squares, canonical regression, and frequency domain causality technique. The outcome of this paper reveals that (i) the cointegrating association among PPIE, GDP, FDI, TOP, and CO2 emissions is verified; (ii) PPIE, GDP, and TOP affect environmental sustainability negatively; (iii) in the long term, PPIE, FDI, and TOP Granger-cause CO2 emissions in Bangladesh. This research suggests technical development for a greener production procedure and public-private partnership funding in green energy. Therefore, as a policy endorsement, this study proposes to invest in the latest technological advancements to manufacture environmentally sustainable goods via public-private partnerships.

Does information and communication technology impede environmental degradation? fresh insights from non-parametric approaches.

Although ICT has played a critical role in the socio-economic growth of human cultures, it has also brought with it significant environmental risks. Nevertheless, scholars remain divided on this topic; some believe that ICT has had a positive influence on the quality of the environment, while others believe that ICT has created major environmental issues. Hence, this research is another effort to assess the effects of ICT on CO2 emissions in the top 10 ICT nations (Denmark, Japan, Luxemburg, South Korea, Netherlands, Iceland, Norway, Sweden, Switzerland, and the United Kingdom) using a dataset from the period between 1986Q1 and 2019Q4. All prior studies have established symmetric association between ICT and CO2. As a result, we applied the novel non-parametric approaches (quantile-on-quantile regression and Granger causality in quantile) to assess this association. The findings from the QQR uncovered that in the majority of the quantiles, for Denmark, Japan, Luxemburg, Netherland, Norway, Sweden, United Kingdom and Switzerland, the effect of ICT on CO2 emissions is negative, while in the majority of the quantiles, the effect of ICT on CO2 emissions is positive for the Netherlands, South Korea, and Iceland. Furthermore, we applied the novel Granger causality in the quantiles approach and the outcomes provided evidence of bidirectional causality between CO2 emissions and ICT in all the selected nations. The study proposes that sustainable ICT should be used to improve carbon reduction and energy savings potential by optimizing other industries, including managing and monitoring energy usage.

Synthesizing urbanization and carbon emissions in Africa: how viable is environmental sustainability amid the quest for economic growth in a globalized world?

Global emission statistics show that Africa is among the least carbon-emitting continents. However, the rising drive for economic growth amid urbanization and globalization in recent years has continued to attract the attention of policymakers to the attendant potential environmental risks. Hence, using robust empirical techniques, this study examines the impacts of increasing urbanization alongside its interactions with energy portfolios on environmental prospects of 15 selected African countries including the most urbanized and leading oil producers in the continent of Africa. The results of the analysis produced insightful implications for achieving both environmental and economic sustainability for the understudied countries. Firstly, the trio of urbanization, economic globalization, and income levels aggravate environmental degradation among these countries as they were found to be essential drivers of carbon emission levels over the understudied period (1990-2015). Secondly, while urbanization significantly poses threat to environmental sustainability, the evidence obtained regarding its interaction with energy portfolios of the understudied countries differs. The significant detrimental environmental impacts of the interaction between urbanization and energy portfolios were only confirmed in the context of fossil energy consumption among the countries, while renewables exist as a significant decarbonization channel within the framework of the increasing level of urbanization among the countries. Thirdly, the study upholds the EKC conjecture. Hence, policymakers and authorities in Africa should capitalize on maximizing the benefits of the huge renewable resource potentials on the continent through adequate investments in green energy technologies for urban infrastructures toward the realization of sustainable development goals (SDGs 11 and 13).

Natural resources volatility and South Asian economies: Evaluating the role of COVID-19.

Since the emergence of the Covid-19 pandemic, global economic performance has been severely affected, which also causes natural resource price instability. Recently, scholars and policy-makers put more attention towards the global economic performance and natural resource volatility nexus. This study investigates four South Asian economies (Afghanistan, Bangladesh, India, and Pakistan) from 1991 to 2021. Using the (Pesaran, 2007) CIPS unit root test, the study found first differenced stationary data cointegrated as confirmed by the (Westerlund, 2007) cointegration test. However, this study employed the CCEMG approach to identify the association of natural resource volatility and economic performance in the selected region. Empirical results revealed that total natural resource rents, forest rents, and oil prices negatively and significantly affect economic performance. While oil rents, coal rents, and natural gas rents have a significant contribution to the region's economic performance. Results further illustrate a bidirectional causal association between economic performance and other variables except for coal rents, which is unidirectional. Based on the empirical findings, the current study acclaims some practical implications that could potentially reduce the negative influence of natural resources volatility on economic performance.

Does political stability contribute to environmental sustainability? Evidence from the most politically stable economies.

The study evaluates the effect of political risk on CO2 emission in the top 10 most politically stable economies (Australia, Canada, Germany, Finland, Denmark, Norway, Netherlands, New Zealand, Sweden, and Switzerland) from 1991/Q1 and 2019/Q4. To the investigators' understanding, this is the first empirical analysis that inspects the effect of political risk on CO2 emissions in the top 10 most politically stable economies. Therefore, the current paper fills a gap in the existing literature. Innovative quantile-on-quantile regression and quantile causality approaches are applied to explore this nexus. The quantile-on-quantile regression results reveal that in the majority of the quantiles, political risk enhances environmental quality for the case of Norway, Sweden, Canada, and Switzerland. Moreover, political risk degrades the quality of the environment in Australia, Germany, and Denmark, while the outcomes were mixed for the rest. Since political stability has encouraged international corporations to invest. As a result, guaranteeing political stability will attract more foreign investment, pressuring the governments of these countries to treat the climate catastrophe more urgently. Moreover, reforms should be aimed at sustaining existing environmental policies related to the green economy, while local and international firms should vigorously pursue investments in renewable energy sources and energy-saving-efficient technologies.