A 56-year-old man presented with lower urinary tract obstructive symptoms, hemoptysis and progressive dyspnoea. Digital rectal examination showed an enlarged nodular prostate and a tru-cut biopsy confirmed carcinoma prostate. Chest x-ray showed multiple bilateral cannon ball opacities suggestive of metastases. He underwent bilateral orchidectomy and follow up assessment showed significant clearing of the cannon-ball lesions in the lungs. He remained asymptomatic at follow up that has extended to 8 years.
Permanent complete heart block (CHB) secondary to the loss of first septal perforator after percutaneous coronary intervention (PCI) of the left descending artery (LAD) is an extremely rare complication. We describe a case report where a patient underwent PCI of proximal LAD, complicated by loss of first septal perforator, septal infarction, and bifasicular block, which progressed to symptomatic delayed CHB. One week later, the patient required implantation of a permanent pacemaker following failure to wean off the transvenous temporary pacing maker.
Morocco is an energy-deficient country depending on almost 94% of energy imports to fuel its growing economy. Due to its fast-growing population, Morocco's energy consumption is projected to increase significantly, adding more pressure on the energy system. On the other hand, the rising tension of scarcity of resources, energy price fluctuations, and environmental issues have all made energy security one of its top priorities. Therefore, Morocco launched the National Energy Strategy (NES) in 2009 to reach 42% renewable generation by 2020, which was renewed to up to 52% by 2050. This study analyzes Morocco's energy security under the 4-As framework from 2000 to 2016.The 4-As methodology aims to assess and graphically illustrate the changes in Morocco's energy security by mapping these changes into four key dimensions: the availability of energy resources, the applicability of technology, the acceptability by the environment and society, and the affordability of energy resources. The quantitative analysis shows that Morocco's energy security performance was at its optimum during the first period of study (2000-2004) but then regressed for the remainder of the study period, as energy imports and prices increased, in addition to the low performance in applicability characterized by low energy efficiency. To improve Morocco's energy security status and move toward a sustainable energy transition, this study suggests integrating a higher share of renewable energy into the energy mix and boosting efficient technologies through a large scale of green finance and green investment projects.
Prior studies on environmental standards have highlighted the significance of urbanization and transportation in affecting environmental sustainability worldwide. As the empirical and theoretical debates are still unresolved and divisive, the argument of whether urbanization, transportation and economic growth in Association of Southeast Asian Nations (ASEAN) countries cause greenhouse gas (GHG) emissions remains unclear. This study aim is to examine dynamic linkage between transportation, urbanization, economic growth and GHG emissions, as well as the impact of environmental regulations on GHG emission reduction in ASEAN countries over the years 1995-2018. On methodological aspects, the study accompanies a few environmental studies that check the cross-sectional dependence and slope heterogeneity issues. Moreover, the new cross-sectionally augmented autoregressive distributed lags (CS-ARDL) methodology is also applied in the study to estimate the short-run and long-run effects of the factors on GHG emissions. Substantial evidence is provided that GHG emissions increase with transportation, urbanization and economic growth but decrease with the imposition of environmental-related taxations. Augmented mean group (AMG) and common correlated effect mean group (CCEMG) also support the findings of CS-ARDL estimates. Finally, the study calls for drastic actions in ASEAN countries to reduce GHG emissions, including environmentally friendly transportation services and environmental regulation taxes. This study also provides the guidelines to the regulators while developing policies related to control the GHG emission in the country.
There is a shred of evidence of environmental degradation in the form of carbon emissions to behave differently when tested with different macroeconomic variables. This paper aims to examine the long-run and short-run association between natural resource rent, financial development, and urbanization on carbon emission from the context of the USA during 1995-2015 with the help of a contemporary and innovative approach named quantile autoregressive distributed lagged model (QARDL). The stated approach is applied due to the fact that non-linearity is observed for the study variables. The findings indicated that the higher financial development (0.304), natural resource rent (0.102), and urbanization (0.489) have a positive impact on the environmental degradation in the region of USA during long-run estimation in the stated quantiles of the study. This would indicate that higher financial development, urbanization, and natural resources are putting more environmental pressure on the economy of the USA. Similarly, the findings under short-run estimation confirm that past and lagged values of carbon emission, financial development, natural resource rent, and urbanization are significantly determining the current values of the carbon emission. For this reason, it is suggested that the government requires some immediate steps of the USA to control the harmful effect of such financial development, more urbanization, and higher natural resource rent as well. This would indicate the reflection of some green strategies in all three explanatory variables to generate some fruitful environmental outcomes.
We report a 13-year-old girl diagnosed with systemic lupus erythematosus (SLE) who presented with left-sided chest pain, with ECG changes and elevation troponins that were suggestive of an acute inferior wall myocardial infarction (MI). Her multi-slice computed tomography coronary angiogram and standard angiogram were normal. The cardiac magnetic resonance imaging revealed an area of infarcted myocardium that was in the right coronary artery territory. We believe her MI was most likely secondary to coronary vasospasm. MI is rare and coronary vasospasm is an uncommon cause of MI in children and adolescents with SLE.
Globally, the interaction and vulnerability of tourism and climate change have recently been in focus. This study examines how carbon dioxide emissions respond to changes in the tourism development. Panel data from 2000 to 2017 for 70 countries are analyzed using spatial econometric method to investigate the spatial spillover effect of tourism development on environmental pollution. The direct, indirect, and overall impact of tourism on environmental pollution are estimated after the selection of the most appropriate GNS method. The findings reveal that tourism has a positive direct effect and a negative indirect effect; both are significant at the 1 % level. The negative indirect effect of tourism is greater than its direct positive effect, implying an overall significantly negative impact. Further, the outcome of financial development and carbon emissions have an inverted U-shaped and U-shaped relationship in direct and indirect impacts. Population density, trade openness and economic growth significantly influence on environmental pollution through spatial spill over. In addition, education expenditure and infrastructure play a significant moderating role in the relationship among tourism development and environmental pollution. The results have important policy implications as they establish an inverted-U-shaped relationship among tourism and environmental pollution and indicate that while a country's emissions initially rise with the tourism industry's growth, they begin declining after a limit.
Newcastle disease (ND) remains an important enzootic disease in chickens in several parts of the world. With the increasing reports of virulence and genetic diversity of the causative agent; Newcastle disease virus (NDV), there is a need to identify the circulating NDV in specific regions. In Oman, to this moment, such information is still lacking. The aim of this study was to isolate and characterize the NDV from ND outbreaks from commercial farms in Oman. Following suspected outbreaks of ND in three commercial farms in 2017, a total of 30 carcasses (10 from each flock) of adult chickens were subjected to necropsy for gross and histopathological examination, virus isolation and molecular methods. Specifically, haemagglutination inhibition (HI) test and reverse transcription-polymerase chain reaction (RT-PCR) assay were used for the virus detection and confirmation, respectively. Lesions were suggestive of viscerotropic velogenic form of ND based on gross and histopathological examinations. Isolation of NDV was present in 4 cases and further confirmed by RT-PCR following the target of the partial fusion protein gene of the viral genome. The sequence of the partial fusion gene was determined and phylogenetic tree was constructed based on the partial length F gene of 4 Omani isolates and 65 previously published NDVs. The findings predicted that the Omani isolates had high homology (99%) with the isolate from Pakistan belonging to genotype VII. Subsequently, the isolated pathotype was identified as the virulent NDV. This study serves as a basic work for further research on the analysis and phenotyping of NDV in the Sultanate of Oman. Improved monitoring and surveillance of the disease is important for proper preventive measures.
This study measures the energy rebound effects of Chinese energy and coal power use in Chinese energy-intensive industries by using latent class stochastic frontier models like LMDI, and other various econometric estimation approach for coal-supplying regions in China ranging between 1992 and 2018. The findings reveals that China's coal sector's average capacity consumption is 0.81%, with a pattern of first increasing and then decreasing, falling to 0.68% in 2016 specifically. The coal capacity operation rate concerning low as well as depleted regions is generally strong, with limited space for expansion. In 2015 and 2016, the utilization rate of coal production potential in moderate-producing areas fell about 42%. Economic development variables affect the capacity utilization levels of moderate, weak, and depleted generating regions. At the same time, the price volatility cannot induce a practical improvement in the ability utilization rate, which means that China's coal industry is mainly un-marketized. China's energy efficiency increased about 19.98% among 2000 and 2016, while the rapidest expansion pattern has been noted in the eastern province at 39.86%, next to central (11.71%) and western regions (9.59%). The take back impact via the renewable energy and renewable productivity channels is estimated as 12.34% and 25.40%, respectively. Therefore, the take back impact is of significant importance regarding energy preservation, as China's cumulative renewable energy use is equal to China's aggregate energy use. On such findings, recent research also contributed by presenting novel policy implications for key stakeholders.
This research aims to look into the effect of COVID-19 on emerging stock markets in seven of the Association of Southeast Asian Nations' (ASEAN-7) member countries from March 21, 2020 to April 31, 2020. This paper uses a ST-HAR-type Bayesian posterior model and it highlights the stock market of this ongoing crisis, such as, COVID-19 outbreak in all countries and related industries. The empirical results shown a clear evidence of a transition during COVID-19 crisis regime, also crisis intensity and timing differences. The most negatively impacted industries were health care and consumer services due to the Covid-19 drug-race and international travel restrictions. More so, study results estimated that only a small number of sectors are affected by COVID-19 fear including health care, consumer services, utilities, and technology, significance at the 1%, 5%, and 10%, that measure current volatility's reliance on weekly and monthly variables. Secondly, it is found that there is almost no chance that the COVID-19 pandemic would positively affect the stock market performance in all the countries, mainly Indonesia and Singapore were the countries most affected. Thirdly, results shown that Thailand's stock market output has dropped by 15%. Results shows that COVID-19 fear causes an eventual reason of public attention towards stock market volatility. The study presented comprehensive way forwards to stabilize movement of ASEAN equity market's volatility index and guided the policy implications to key stakeholders that can better help to mitigate drastic impacts of COVID-19 fear on the performance of equity markets.
Lameness is a major welfare issue in dairy cows. This study was aimed at investigating the cow- and herd -level factors associated with lameness in dairy farms from four states in Peninsular Malaysia. The study population was 1001 lactating cows from 28 dairy farms located in Selangor (n = 9), Perak (n = 8), Negeri Sembilan (n = 6) and Johor (n = 5). Lameness was assessed by locomotion scoring. Individual cow characteristics such as breeds, parity, body condition score (BCS), hock condition, leg hygiene, presence of claw lesion and claw overgrowth were recorded. Data on herd characteristics, management practices and housing design were collected by on-farm inspection and farmers' interview. Mixed-eff ;ects logistic regressions were used to model the data and to assess the factors associated with lameness. Cow-level lameness prevalence was 34.2 % (95 % CI 22.2-50.0 %), with all the farms having at least one case of lameness. Claw lesions were recorded in 470 cows (46.9 %; CI 33.3-63.3 %) of which 296 (62.9 %) of them were lame. Of these, 78.9 % of the lesions were present on the rear feet and 25.5% of the cows had more than one foot affected. The proportion of cows having non-infectious and infectious claw lesions were 81.9 % and 18.1 %, and the predominant claw lesions were sole ulcers (24.9 %), white line disease (19.6 %), sole haemorrhage (10.2%), swelling of coronet (9.6 %), toe ulcers (8.4 %), and digital dermatitis (5.6%). Cows at third or more parities had higher odds of lameness (OR = 2.2; 95 % CI 1.2-4.1) compared to primiparous cows. Low BCS (< 2.5) increased the odds of lameness (OR = 4.8; 95 % CI 2.9-7.9) relative to cows with moderate BCS, and cows with hair loss around the hock (OR = 1.4; 95 % CI 1.1-1.9) relative to those with normal hock condition. Greater odds of being lame was observed in cows having claw lesion (OR = 15.2; 95 % CI 10.4-19.2) and those with overgrown claw (OR = 3.3; 95 % CI 2.4-4.5). There was increased odds of lameness in farms with high stocking density (OR = 1.8; 95 % CI 1.1-3.1), concrete floored walkways (OR = 1.9; 95 % CI 1.0-3.6), dirty floors (OR = 2.3; 95 % CI 1.9-3.7), and practicing preventive claw trimming (OR = 2.3; 95 % CI 1.9-4.6). Based on the high lameness prevalence, these findings could assist dairy farmers to make informed decisions on areas to implement on-farm changes to reduce lameness in the studied herds.
Environmental degradation is significantly studied both in the past and the current literature; however, steps towards reducing the environmental pollution in carbon emission and haze pollution like PM2.5 are not under rational attention. This study tries to cover this gap while considering the carbon emission and PM2.5 through observing the role of renewable energy, non-renewable energy, environmental taxes, and ecological innovation for the top Asian economies from 1990 to 2017. For analysis purposes, this research considers cross-sectional dependence analysis, unit root test with and without structural break (Pesaran, 2007), slope heterogeneity analysis, Westerlund and Edgerton (2008) panel cointegration analysis, Banerjee and Carrion-i-Silvestre (2017) cointegration analysis, long-short run CS-ARDL results, as well as AMG and CCEMG for robustness check. The empirical evidence in both the short- and long-run has confirmed the negative and significant effect of renewable energy sources, ecological innovation, and environmental taxes on carbon emissions and PM2.5. Whereas, non-renewable energy sources are causing environmental degradation in the targeted economies. Finally, various policy implications related to carbon emission and haze pollution like PM2.5 are also provided to control their harmful effect on the natural environment.
The objective of this study was to compare the impact of the functional hoof trimming (HT) method to an adaptation that results in increased modelling of the weight bearing claw on time to lameness and lesion prevalence in housed dairy cows. A total of 418 non-lame cows at early and late lactation were enrolled in the study and randomly allocated into 3 groups: functional HT (TRIM1), adaptation method (TRIM2), and an untrimmed group (CON). Locomotion scores (LS; 5-point scale) and animal-based welfare measures were assessed monthly from enrolment until the following 270 days in milk. Cows were considered lame when 2 consecutive LS = 3, or any assessment with a score of 4 or 5. Kaplan-Meier analysis was used to evaluate the difference in time to lameness between the groups. Multivariable CC Cox regression models were fitted to assess associations between covariates and time to lameness event, while associated factors for lesion prevalence were estimated using logistic regression models. The incidence rate of lameness was 29.3 cases/100/month, with corresponding rates of 28.7, 15.8 and 42.8 cases/100/months, in TRIM1, TRIM2 and CON, respectively. Time to first lameness event was higher in TRIM2 (mean ± S.E; 8.26 ± 0.16, P = 0.03) than CON (7.32 ± 0.2) and tended to be higher than TRIM1 (7.83 ± 0.19; P = 0.07). The risk of new lameness event was higher in cows with low BCS (≤2.5) (Hazard ratio; HR = 1.5; 95 % CI 1.1-2.1), while trimming all feet was a protective factor (HR = 0.58; 95 % CI 0.38-0.90). The prevalence of hoof lesions in the study population was 36.3 %, with the highest prevalence in CON (45.6 %), followed by TRIM1 (34.6 %) and TRIM2 (28.1 %). Seventy-eight per cent of hoof lesions were non-infectious and the majority of cows with hoof lesion in TRIM1 (72.3 %), CON (74.6 %) and TRIM2 (55.6 %) were lame. The odds of having a non-infectious hoof lesion were higher in CON (OR = 2.1; 95 % CI 1.2-3.7) compared to TRIM2, and in cows with hock injury (OR = 3.1; 95 % 1.1-9.7) relative to healthy hock, and tended to be higher in cows with low BCS (P = 0.09) relative to those with moderate BCS. Our results suggest that the adaptation to the functional method reduced the risk of lameness during lactation, however, proper management of under-conditioned cows is equally important.
Objectives: There is little evidence in the medical literature about safety of PDA device closure and its effects on aortic root diameter in Marfan patients. We reported on nine Marfan patients whose ducts were occluded by coil or Amplatzer Duct Occluder.
Patients and interventions: Two patients had aneurismal type E ducts which were closed by a single coil, respectively. The others had conical ducts for which even Amplatzer occluder, stiff, or double coils were used.
Results: No untoward consequence was found during a median follow up period of 18.5 months (range 3 months to 6.33 years). Two patients had small residual shunts. The observed change in the mean ratio of aortic root diameter to its estimated value was statistically insignificant in seven patients who had complete data on their aortic root diameter before PDA closure and during the follow up.
Conclusions: We concluded that PDA device closure in Marfan patients is safe. Risk of residual shunt is higher even after closure of small ducts.
The objectives of this cross-sectional study were to estimate the prevalence of lameness, claw lesions, and associated risk factors in dairy farms in Selangor, Malaysia. The sample population was 251 lactating cows from 8 farms assessed for lameness and claw lesions by locomotion scoring and claw assessment respectively while specific animal-based measures were hypothesized as cow-level risk factors. The Wilcoxon rank test and logistic regression were applied to assess the prevalence of lameness, claw lesions, and association with potential risk factors, respectively. The prevalence of lameness was 19.1% ranging from 10.0 to 33.3% while 31.1% of cows had claw lesions and ranged from 16.3-40%. Claw lesions were recorded in 87.5% of the lame cows with highest being those affected with sole lesions (54.2%) and white line disease (61.2%). Overall, the occurrence of overgrown claws, sole lesions, white line disease, and digital dermatitis were 37, 18.2, 10.9, and 8.3%, respectively. More than one claw lesion per cow was present in 71.8% of the affected cows. Lameness was associated with early lactation (OR = 3.3; 95% CI 2-7), injured hocks (OR = 4.8; 95% CI 5-17), and dirty legs hygiene (OR = 2.6; 95% CI 1.3-6.2), whereas presence of claw lesions was associated with dirty legs hygiene (OR = 4.7; 95% CI 4-11) and overgrown claw (OR = 2.7; 95% CI 1.4-5.3). To reduce the prevalence of lameness, farmers need to improve the management of cows with overgrown claw, injured hocks, and cleanliness by establishing routine claw trimming and efficient stall design.
Dairy cow welfare is an important consideration for optimal production in the dairy industry. Lameness affects the welfare of dairy herds by limiting productivity. Whilst the application of LS systems helps in identifying lame cows, the technique meets with certain constraints, ranging from the detection of mild gait changes to on-farm practical applications. Recent studies have shown that certain animal-based measures considered in welfare assessment, such as body condition, hock condition and leg hygiene, are associated with lameness in dairy cows. Furthermore, behavioural changes inherent in lame cows, especially the comfort in resting and lying down, have been shown to be vital indicators of cow welfare. Highlighting the relationship between lameness and these welfare indicators could assist in better understanding their role, either as risk factors or as consequences of lameness. Nevertheless, since the conditions predisposing a cow to lameness are multifaceted, it is vital to cite the factors that could influence the on-farm practical application of such welfare indicators in lameness studies. This review begins with the welfare consequences of lameness by comparing normal and abnormal gait as well as the use of LS system in detecting lame cows. Animal-based measures related to cow welfare and links with changes in locomotion as employed in lameness research are discussed. Finally, alterations in lying behaviour are also presented as indicators of lameness with the corresponding welfare implication in lame cows.
The aim of the study is to estimate the nexus between energy insecurity and energy poverty with the role of climate change and other environmental concerns. We used DEA like WP methods and properties of MCDA, a most common form of data envelopment analysis (DEA) to estimate the nexus between constructs. This paper presents a measurement and analysis of G7 countries' energy, economic, social, and environmental performance associated with energy poverty indexes. The study used the multiple, comprehensive, and relevant set of indicators, including energy economics and environmental consideration of energy poverty. The net energy consumption of al G7 economies is equal to 34 percent of the entire world along with the net estimate GDP score of around 50 percent. Using DEA modelling and estimation technique, our research presented valuable insights for readers, theorists and policy makers on energy, environment, energy poverty and climate change mitigation. For this reasons, all these indicators combined in a mathematical composite indicator to measure energy, economic, social, and environmental performance index (EPI). Results show that Canada has the highest EPII score, which shows that Canada's capacity to deal with energy self-sufficiency, economic development, and environmental performance is greater than the other G7 countries. France and Italy rank second and third. Japan comes next with 0.50 EPI scores, while the USA has the lowest average EPI score environment vulnerable even though have higher economic development among the G7 group countries. We suggest a policy framework to strengthen the subject matter of the study.
This paper investigates the effect of different categories of essential COVID-19 data from 2020 to 2021 towards stock price dynamics and options markets. It applied the hypothetical method in which investors develop depression based on the understanding suggested by various green finance divisions. Furthermore, additional elements like panic, sentiment, and social networking sites may impact the attitude, size, and direction of green finance, subsequently impacting the security prices. We created new emotion proxies based on five groups of information, namely COVID-19, marketplace, lockdown, banking sector, and government relief using Google search data. The results show that (1) if the proportional number of traders' conduct exceeds the stock market, the effect of sentimentality indexes on jump volatility is expected to change; (2) the volatility index component jump radically increases with the COVID-19 index, city and market lockdown index, and banking index; and (3) expanding the COVID-19 index gives rise to the stock market index. Moreover, all indexes decreased in jump volatility but only after 5 days. These findings comply with the hypotheses proposed by our model.