How do renewable energy, gross capital formation, and natural resource rent affect economic growth in G7 countries? Evidence from the novel GMM-PVAR approach

This paper is to examine the dynamic causal relationship between economic growth, renewable energy consumption, and CO2 with a broad perspective. The study is analyzed by dividing into two main parts. Growth and energy consumption in the first part, and the relationship between renewable energy and CO2 in the second part, within the framework of the basic hypotheses in the literature. On the other hand, as an observation group, the G7 economies were examined in the 1997-2019 period. According to PVAR regression estimates, if GDPPC increases by 1%, REN decreases by 0.81%, while CO2 increases by 0.71%. However, CO2 and REN do not appear to have any influence on growth. According to the causality estimates, a unidirectional causal relation from GDPPC to CO2 and REN was determined. In this case, the conservation hypothesis is valid. Considering the relation between CO2 and REN, no significant relation was found between the two variables in both regression and causality estimations. In this case, the neutrality hypothesis is valid between the two variables. It is seen that the diversity of energy sources or the investments made in them are inefficient. Our study offers a different perspective on energy resources and air pollution for the G7 economies.

Hepatitis A in the Eastern Mediterranean Region: a comprehensive review

Introduction

With 583 million inhabitants, the Eastern Mediterranean Region (EMR) is a worldwide hub for travel, migration, and food trade. However, there is a scarcity of data on the epidemiology of the hepatitis A virus (HAV).

Methods

The MEDLINE and grey literature were systematically searched for HAV epidemiological data relevant to the EMR region published between 1980 and 2020 in English, French, or Arabic.

Results

Overall, 123 publications were extracted. The proportion of HAV cases among acute viral hepatitis cases was high. HAV seroprevalence rate ranged from 5.7% to 100.0% and it was decreasing over time while the average age at infection increased.

Conclusion

In the EMR, HAV remains a significant cause of acute viral hepatitis. The observed endemicity shift will likely increase disease burden as the population ages. Vaccinating children and adopting sanitary measures are still essential to disease prevention; vaccinating at-risk groups might reduce disease burden even further.

What is the context?

Hepatitis A is a viral liver disease caused by the hepatitis A virus.

It is generally transmitted by ingestion of contaminated food or water or through contact with an infected person.

Disease severity increases with age. Children under 6 years of age are usually asymptomatic, while adults are the most affected.

Limited information exists on the number of cases and transmission of hepatitis A in the Eastern Mediterranean region, which includes 21 countries and Palestine, as defined by the World Health Organization.

What is new?

We performed a literature review to summarize data on hepatitis A disease in the Eastern Mediterranean region over the last 40 years (1980-2020). As information for many countries is scarce or outdated, most of the data is from Egypt, Iran and Saudi Arabia.

We found that:

Hepatitis A virus is the most common cause of acute viral hepatitis.

Hepatitis A exposure varied according to the country’s income level.

Low- and middle-income countries showed a universal immunity to hepatitis A virus, although this is not the case anymore.

What is the impact?

Hepatitis A infections have decreased worldwide. Lower exposure to the virus has led to an increase in the susceptible population (including adolescent and adults).

Hepatitis A vaccination for children and high-risk groups such travelers should be considered in the Eastern Mediterranean region.

Meningococcal Disease and Immunization Activities in Hajj and Umrah Pilgrimage: a review

Invasive meningococcal disease (IMD) outbreaks associated with Hajj and Umrah pilgrimage events in the Kingdom of Saudi Arabia (KSA) are well recognized. Past outbreaks have been associated with substantial intercontinental spread of specific Neisseria meningitidis serogroups. The emergence of meningococcal serogroup W (MenW) was a global concern following the 2000/2001 Hajj outbreaks. Broader compulsory meningococcal serogroups A, C, W and Y (MenACWY) immunization strategies for pilgrims were introduced in response to these events and led to substantial declines in IMD cases associated with these mass gatherings. However, there remains potential for future outbreaks either within KSA during the Hajj or in local populations via pilgrim meningococcal transmission on their return. While the annual Hajj involves pilgrims from over 185 countries, two-thirds of these arrive from 13 countries, chiefly from across South-East Asia, the Middle East and North African (MENA) regions; for which we review the relevant epidemiology of IMD and meningococcal carriage. While disease surveillance is limited and data are often lacking, MenB is an important serogroup associated with IMD and carriage in a number of countries. Available literature suggests that most pilgrims receive polysaccharide MenACWY vaccines (which do not impact carriage and onward transmission) and incomplete compliance with visa/entry immunization regulations is reported. Existing preventative approaches for visiting pilgrims require continued oversight. More complete compliance and switching to the conjugated MenACWY vaccine can provide more robust and broader protection for pilgrims. Additional immunization options could also be considered.

The Epidemiology of Invasive Meningococcal Disease in the Kingdom of Saudi Arabia: A Narrative Review with Updated Analysis

Reducing invasive meningococcal disease (IMD) through MenACWY immunization is a critical healthcare strategy in the Kingdom of Saudi Arabia (KSA). Robust IMD surveillance is essential to help assess the need for additional immunization initiatives in target populations. This is particularly important in KSA, where mass gatherings accompanying Hajj/Umrah pilgrimages have been associated with IMD outbreaks within the local KSA population, and subsequent intercontinental spread via returning pilgrims. This narrative review of the published literature describes the changing epidemiology of IMD in KSA to provide a perspective on the impact of current immunization strategies and potential gaps. As recent published surveillance data are lacking, we also evaluated publicly reported data from the KSA Ministry of Health (MoH) for 2012–2019 to inform more recent IMD trends. Between 1995 and 2011, national surveillance data indicate that 1103 IMD cases were reported in KSA: 60% in 2000–2001, involving two (mainly MenW) outbreaks involving KSA citizens/residents and pilgrims focused in Mecca and Medina. Across 2002–2011, 184 cases of IMD were reported, with a higher proportion occurring in KSA citizens/residents, and with less focus within pilgrimage centers than apparent in previous years. Our analysis of MoH data found that, between 2012 and 2019, 44 IMD cases were reported, all in KSA citizens/residents, and chiefly in children or infants. No pilgrimage-associated outbreaks have occurred since 2001. Serogroup data were available for 62.5% of all cases for 2002–2011; MenW (40.0%), MenA (35.7%), and MenB (16.5%). Serogroup data for 2012–2019 remain incompletely reported, and the existing surveillance system could be improved, as some element of underestimation/underreporting of IMD may exist. While existing MenACWY immunization strategies for KSA citizens/residents and visiting pilgrims have been successful in reducing IMD due to specific serogroups, disease due to MenB remains a potential risk, and additional immunization strategies should be considered.

A review of the experience of childhood hepatitis A vaccination in Saudi Arabia and Turkey: implications for hepatitis A control and prevention in the Middle East and North African region

In most countries of the Middle East and Northern African (MENA) region, a high hepatitis A virus (HAV) endemicity has been documented. Few others, such as Saudi Arabia and Turkey, are transitioning from high to intermediate endemicity. There is a paucity of recently published HAV disease burden that could be useful to inform or strengthen relevant national hepatitis A vaccination policy and other prevention strategies in the region. This review summarizes information on HAV epidemiology before and after the implementation of a childhood hepatitis A vaccination program in Saudi Arabia and Turkey. In both countries, a clear shift in the age of first HAV exposure has been documented, with more homogeneous trends across regions in Saudi Arabia compared to Turkey. Utilizing the experience of Saudi Arabia and Turkey with hepatitis A vaccination, countries in the region are encouraged to foster discussions on potential vaccination strategies suitable for their own setting.

Vaccine confidence: the keys to restoring trust

During the 20^th century, the discovery of modern vaccines and ensuing mass vaccination dramatically decreased the incidence of many infectious diseases and in some cases eliminated them. Despite this, we are now witnessing a decrease in vaccine confidence that threatens to reverse the progress made. Considering the different extents of low vaccine confidence in different countries of the world, both developed and developing, we aim to contribute to the discussion of the reasons for this, and to propose some viable scientific solutions to build or help restore vaccine confidence worldwide.

Renal Autotransplantation in a Patient with Bilateral Renal Artery Stenosis Secondary to Takayasu Arteritis

Involvement of the renal artery is common in Takayasu arteritis. We, herein, present on a patient with Takayasu arteritis causing severe renal failure and a successful auto-transplantation. This case shows that early diagnosis and immediate appropriate interventions are life-saving in patients with Takayasu arteritis. Renal auto-transplantation performed in selected cases increases dialysis-free survival.

Systematic review of the rotavirus infection burden in the WHO-EMRO region

Rotavirus gastroenteritis imposes a heavy burden on low- and middle-income countries. The World Health Organization defines the Eastern Mediterranean region (WHO-EMRO) as a diverse area in terms of socioeconomic status and health indicators. Rotavirus vaccination has been introduced, at least partially, in 19 out of the 22 EM countries; however, vaccine coverage remains low, and data on rotavirus disease burden is scarce.Available data on rotavirus prevalence, seasonality, vaccination status, and genotype evolution was systematically compiled following a literature review that identified 165 relevant WHO-EMRO epidemiology studies published between 1990 and 2017.Although the infectious agents responsible for acute gastroenteritis vary over time, rotavirus remained the leading cause of acute gastroenteritis in children, as seen in 76.3% of reviewed publications. Younger children (<2 years old) were at higher risk and thus increased vaccination coverage and surveillance systems are required to reduce the rotavirus gastroenteritis burden in WHO-EMRO countries.

Influenza surveillance in Western Turkey in the era of quadrivalent vaccines: A 2003-2016 retrospective analysis

Human influenza is predominantly caused by influenza A virus (IAV) - A/H1N1 and/or A/H3N2 - and influenza B virus (IBV) - B/Victoria and/or B/Yamagata, which co-circulate each season. Influenza surveillance provides important information on seasonal disease burden and circulation, and vaccine content for the following season. To study the circulating influenza subtypes/lineages in western Turkey. Community-based sentinel surveillance results during 2003-2016 (weeks 40-20 each season; but week 21, 2009 through week 20, 2010 during the pandemic) were analyzed. Nasal/nasopharyngeal swabs from patients with influenza-like illness were tested for influenza virus and characterized as A/H1N1, A/H3N2, or IBV. A subset of IBV samples was further characterized as B/Victoria or B/Yamagata. Among 14,429 specimens (9,766 collected during interpandemic influenza seasons; 4,663 during the 2009-2010 pandemic), 3,927 (27.2%) were positive. Excluding the pandemic year (2009-2010), 645 (27.4%) samples were characterized as A/H1N1 or A/H1N1/pdm09, 958 (40.7%) as A/H3N2, and 752 (31.9%) as IBV, but the dominant subtype/lineage varied widely each season. During the pandemic year (2009-2010), 98.3% of cases were A/H1N1/pdm09. IBV accounted for 0-60.2% of positive samples each season. The IBV lineages in circulation matched the vaccine IBV lineage >50% in six seasons and <50% in four seasons; with an overall mismatch of 49.7%. IBV cases tended to peak later than IAV cases within seasons. These results have important implications for vaccine composition and optimal vaccination timing. Quadrivalent vaccines containing both IBV lineages can reduce B-lineage mismatch, thus reducing the burden of IBV disease.

Staged repair of severe open abdomens due to high-energy gunshot injuries with early vacuum pack and delayed tissue expansion and dual-sided meshes

BACKGROUND

Open abdomen is a salvage procedure that prevents catastrophes after severe intraabdominal traumas. However, following this life saving attempt, it is mostly not feasible to close the abdomen immediately after the recovery of intraabdominal injuries. Consequently, a staged reconstruction is required, and the first stage is usually a temporary closing approach. At the end of this stage, resulting giant "ventral hernia" is a burden for both the patient and the surgeon. Therefore a permanent repair is subsequently needed. Although there are many treatment modalities described for this goal, etiologies like high-energy gunshots may cause an exactly nuisance scene which can limit treatment options and reduce final success. Herein, it was the objective of this study to present our staged protocol to restore the abdominal wall defect and strategy for optimizing the results in such conundrum cases.

METHODS

Treatment was performed on nine male patients suffering from severe open abdomen due to high-energy gunshot injury. In all patients, temporary closure was provided by negative pressure wound treatment applied directly to the viscera and followed by skin grafting. Late permanent closure was performed with the lamination of expanded abdominal skin and dual-sided meshes.

RESULTS

The follow-up period ranged between 24 months to 4.5 years (mean, 3 years). During this period, no recurrence of ventral hernia, enteric fistula formation, abdominal infection and seroma formation was observed in any patient.

CONCLUSION

In this study, NPWT, tissue expansion and dual-sided mesh were used together as a staged procedure for optimizing the results in the clinical scenario of an open abdomen due to high-energy gunshot wound. Results were highly satisfactory for patients and acceptable aesthetically.

[Neodymium magnet injury causing nasal fracture: a case report]

In parallel with technological developments, small size but strong magnets are commonly used in modern devices. In terms of foreign body injuries, magnet injuries are quite rare. However, due to their unique characteristics, there are some difficulties in their management. The magnetic field generated by the magnet affects the surgical instruments and make treatment difficult. In this case report, a nasal injury due to neodymium magnet and our alternative approach for its management was reported.

Caliber of the common bile duct: effect of cholecystectomy and other factors in a ultrasonographic study of 8534 patients

OBJECTIVE

The objective of the present study was to analyze the effects of different factors impacting the caliber of the common bile duct (CBD) and a comparison of maximum extrahepatic bile duct caliber in patients with and without a history of cholecystectomy.

MATERIAL AND METHODS

A retrospective data analysis was undertaken of 8534 patients (4480 females; 4054 males; average age: 59.2±18.0 years) with sonographic documentation of bile duct caliber. Maximum intra- and extrahepatic bile duct diameters were studied. The normal maximum diameter of the extrahepatic bile duct was defined as 7 mm. In patients who had undergone prior cholecystectomy, a maximum bile duct diameter<10 mm was considered normal.

RESULTS

The average maximum diameter of the CBD amounted to 5.3±3.0 mm for the overall collective. In patients who had undergone prior cholecystectomy, maximum CBD diameters in the normal range (<7 mm) were documented in 55%, while larger diameters (>7 mm) were observed in 45%. In the collective of patients without prior cholecystectomy, CBD diameters in the normal range (<7 mm) were found in 81%, with larger diameters observed in only 18.4% of patients. In both subgroups, there was a significant association between age and bile duct diameter (for those with prior cholecystectomy, p=0.0003; without prior cholecystectomy, p<0.0001). No statistically significant influence on CBD diameter was observed for either prior cholecystectomy (p=0.2116) or time interval since cholecystectomy (p=0.3537). Females, both with and without a history of prior cholecystectomy, showed a 1.4-1.5-fold higher risk of exhibiting a CBD diameter>7 mm (for those with prior cholecystectomy, p=0.0485; without prior cholecystectomy, p<0.001).

CONCLUSIONS

Our data show a positive correlation between age and CBD diameter. There was no statistically significant relationship between CBD diameter and prior cholecystectomy, postoperative interval and BMI.

The importance of the mean platelet volume in the diagnosis of supraventricular tachycardia

BACKGROUND

This retrospective study aimed to investigate the diagnostic relation between the mean platelet volume (MPV) and supraventricular tachyarrhythmia (SVT) in patient with documented atrial tachyarrhythmia in the emergency department (ED).

METHODS

Two study groups were compared; a SVT group with arrive at the ED with documented SVT (n=122) and 100 healthy adult without any palpitation symptom, arrhythmic disease, and with normal physical examination results that were brought for checkups to the cardiology polyclinic were classified as control group. Blood samples were obtained from all patients for determining the hematologic counts and MPV during first hour in ED period.

RESULTS

In terms of the focus of the study, hemoglobin, neutrophil count, mean cell volume (MCV), red cell distribution width (RDW), platelet, white blood cell (WBC), and lymphocyte counts were similar in both group (p>0.05). MPV in the SVT group was significantly higher than in the control group (9.12 ± 1.22 flvs 8.64 ± 0.89 fl, p<0.001). Multivariate logistic regression analysis showed that just MPV was independent predictor of SVT in patients with palpitation in ED (odds ratio [OR] 8.497, 95% confidence interval (6.181 to 12.325), p=0.012).

CONCLUSION

The present study described that MPV is helpful parameter for the diagnosis of SVT in emergency department, for the first time in the literature.

Effect of different modifications of BEA-zeolites on operational characteristics of conductometric biosensor

Effect of different modifications of zeolite Na(+)-BEA on working characteristics of urease-based conductometric biosensor was studied. As the biosensor sensitive elements were used bioselective membranes based on urease and various zeolites immobilised with bovine serum albumin on the surface of conductometric transducers. Influence of zeolites on sensitivity of urea biosensor was investigated as well as reproducibility of biosensor signal and reproducibility of activity of the bioselective element after different variants of urease immobilisation on the surface of conductometric transducer. The biosensors based on zeolites (NH4(+)-BEA 30 and H(+)-BEA 30) were shown to be the most sensitive. Concentration of these zeolites in the bioselective membrane was optimized. Use of zeolites modified with methyl viologen and silver was ascertained to be of no prospect for urea conductometric biosensors. It was demonstrated that characteristics of urea biosensors can be regulated, varying zeolites modifications and their concentrations in bioselective membranes.

Evaluation of chitosan gel containing liposome-loaded epidermal growth factor on burn wound healing

The objective of this study is to develop a chitosan gel formulation containing liposomes loaded with epidermal growth factor (EGF) and to evaluate their effects on the healing of second-degree burn wounds in rats by immunohistochemical, histochemical and histological methods. EGF-containing multilamellar liposomes which were carried in chitosan gel, EGF gel and EGF-loaded liposome formulations were prepared. The in vivo experiments were performed on female Sprague Dawley rats. Second-degree standard burn wounds were formed on rats and liposomes containing 10 µg/ml EGF in 2% chitosan gel, EGF-chitosan gel and EGF-loaded liposome formulations were applied daily to the burn wounds and biopsies were taken at the 3rd, 7th and 14th day of the treatment. When the results were evaluated immunohistochemically, there were significant increases in cell proliferation observed in the EGF-containing liposome in chitosan gel (ELJ) formulation applied group (P < 0·001). The histochemical results showed that the epithelisation rate in the ELJ group was the highest compared with the other group results (P < 0·001). The histological results indicated and supported these findings and faster epithelisation was observed in the ELJ group compared with the other groups.

Synthesis and structural investigation of (4-methoxy-phenyl)-[4-(4-methoxy-phenyl)-1-(1-phenylethylidene-amino)-2-thioxo-1,2-dihydro-pyrimidin-5-yl]-methanone

The crystal structure of (4-methoxy-phenyl)-[4-(4-methoxy-phenyl)-1-(1-phenylethylideneamino)-2-thioxo-1,2-dihydro-pyrimidin-5-yl]-methanone, has beeen determined by single-crystal X-ray diffraction at 183(2) K. The compound crystallizes in the monoclinic system, space group P21/c. The O3 and C19 atoms in the methoxy group shows conformational disorder. In the title compound, the pyrimidine ring is slightly nonplanar. The angle between the planes formed by the ring atoms N2–C2–C3 and C1–N1–C4 is 4.0 (1)°. The three phenyl rings form dihedral angles of 147.9 (1), 113.0 (1) and 103.2 (1)° with the pyrimidine ring. The structure is stabilized by weak intermolecular C–H...O interactions.

Reconstruction of Acquired Partial Auricular Defects by Porous Polyethylene Implant and Superficial Temporoparietal Fascia Flap in Adult Patients

BACKGROUND

Six patients with acquired partial auricular defects with various causes were treated with porous polyethylene implants and superficial temporoparietal fascia flaps.

METHODS

The mean of the auricular defects was 39 percent (range, 27 to 61 percent). The defects were situated in different parts of the auricles. Helical rim implants and/or ultrathin sheet implants were used as frameworks and covered with superficial temporoparietal fascia flaps.

RESULTS

The symmetry of the reconstructed ears was satisfactory, and the cosmetic appearance was acceptable for all patients. Neither skeletal collapse nor flattening of the lateral helical rim was seen in any of the patients. Minor revision was required for debulking of the pedicle in one early patient. No additional complications were encountered.

CONCLUSION

The authors recommend using this single-stage combined technique for reconstruction of various types of partial auricular defects in adult patients.