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Introduction: Roux-en-Y gastric bypass (RYGB) related late gastro-jejunal (GJ) strictures are often resistant to endoscopic balloon dilations. Lumen-apposing metal stents (LAMSs) have been used to treat benign strictures with favorable results. However, the data remains limited to justify LAMS use for management of post-RYGB late GJ strictures. We aim to evaluate the safety and efficacy of LAMS placement for the management of late GJ strictures that are refractory to balloon dilations in post-RYGB patients. Methods: This was a single center retrospective study that included all post-RYGB patients who underwent LAMS placement for management of late GJ strictures that had previously failed balloon dilations. Primary outcomes were technical and clinical success, and secondary outcomes were LAMS-related adverse events. Results: A total of 28 patients underwent LAMS placement for management of GJ strictures. Median age was 60.5 (IQR 50.5, 67.0) years and majority were females (27, 96.4%). Median interval between surgery and first diagnosis of GJ stricture was 13 years (IQR 7, 17.5). 20 × 10 mm LAMS was the most used stent (n = 24, 85.7%). The median procedure time was 23.5 (IQR 14.5, 32.0) minutes. Technical and short-term clinical success of LAMS placement was 100% (95% CI 87.9–100.0). Long-term success was achieved in 19 out of 25 patients (76.0%, 95% CI 56.6–88.5) that had over 3 months follow-up after LAMS removal. Stent migration was noted in 2 (7.1%) patients, and 1 (3.6%) patient each experienced pain and minor bleeding without the need for additional interventions. No patient in our cohort required surgical revision of GJ anastomosis. Conclusion: Placement of LAMS is safe, technically feasible, and associated with a high clinical success rate in patients with late GJ strictures after RYGB who have failed prior balloon dilations. Placement of LAMS can be considered early in patients requiring multiple balloon dilations. [ABSTRACT FROM AUTHOR]

The study aims to comprehend sustainable behaviors in high-income nations, where human–environment interactions are crucial. Increased transportation needs in industrialized countries highlight the importance of environmental challenges affecting human well-being. Railway passenger carrier, automobile energy efficiency, technology breakthroughs, financial incentives, and public–private partnerships (PPPs) affect congestion and sustainability, which the study analyses for sound policy inferences in a panel of 28 high-income nations from 2000 to 2022. The panel ARDL estimates reveal that railway passenger carrier increases carbon emissions in the short run while it improves them over time, highlighting the importance of urban planning. Environmental pollution, energy use, transportation behavior (including PPPs), and technical innovation have an inverse connection, demonstrating the efficacy of energy-efficient transport methods, research and development, and renewable energy sources. However, economic incentives highly correspond with carbon-intensive habits, emphasizing the need for high-income countries to phase them out. [ABSTRACT FROM AUTHOR]

Background: Eating disorders (EDs) are a complex group of disorders that affect mental and physical health and pose a challenge for medical professionals to diagnose. This study aims to screen for eating disorders among Syrian university undergraduates. Methods and materials: A cross-sectional study was conducted among Syrian university students using a self-administered questionnaire. The questionnaire consisted of three sections: socio-demographic characteristics, dietary habits and barriers to healthy eating, and the Sick, Control, One, Fat, Food (SCOFF) score. The chi-square test was used to evaluate the factors related to eating disorders. Results: Of 728 students, 45.3% were males and 54.7% females. The majority of participants studied medicine 32.3%, followed by pharmacy 25.7% and dentistry 17.6%. Overweight and obese participants represented 21.4% and 6.8% respectively. Merely 36% of students reported adopting a healthy diet, a greater percentage of females 58.8% reported having snacks compared to males 48.5% (P = 0.006), a higher percentage of females 38.8% reported consuming fast food compared to males 26.6% (P < 0.001). Most of the students' eating habits worsened during exams 55.7%, females 60.6% markedly reported worse eating habits during exams compared to males 50% (P = 0.017). Lack of time 72.7%, not accessible 38.3%, and unenjoyable 31.6% were frequent barriers to healthy food. About 20.3% of students screened positive for probable eating disorders. Factors that elevate the likelihood of acquiring an ED encompass being female, having a lower or higher BMI, eating worse during exams, and psychological behaviors. Conclusions: Probable EDs were prevalent among Syrian undergraduates. The addressed socio-demographic and psychological factors were significantly affecting students' eating behaviors. These findings can be used to provide targeted lifestyle modification advice via health promotion programs for these specific groups. Plain Language Summary: We conducted this study between December 2020 and February 2021 to estimate the rate of eating disorders and their related factors among a Syrian university student during the war and COVID-19 epidemic. We gathered sociodemographic characteristics and psychological factors through a questionnaire. Of the 728 enrolled students, 45.3% were males and 54.7% were females. 20.3% of sample students potentially had an eating disorder, of those 66.9% were females. 66.9% of those who have potential eating disorders reported worse eating habits during exams, compared to those who had no change habits 27.2% or their habits became better 5.4%. Those who "ate because of feeling lonely" 58.8%, "felt out of control with food" 67.6%, "ate until stomach hurts" 66.9%, "ate because of feeling upset" 53.4%, and "ate because of feeling bored" 79.7%, all of these groups exhibited higher scores on the screening for eating disorders. [ABSTRACT FROM AUTHOR]

A metal-insulator-metal (MIM) waveguide structure consists of semi-elliptical ring resonator (SERR) and a baffle was proposed and numerically investigated by using the finite element method (FEM). By changing the geometrical parameters such as the radii of SERR and the width of the baffle, the transmission characteristics and line shape can be easily tuned. The simulation results show that the proposed plasmonic system is used as a sensor by filling the insulator region with different refractive index. The sensitivity and figure of merit of this sensor can reach 1783 nm/RIU and 27, respectively. It is found that the proposed structure exhibits a slow light effect, and it is shown that the optical delay achieved is 0.887 ps. The results clarified that the developed structure could have a great potential in nanosensor devices and slow light systems. [ABSTRACT FROM AUTHOR]

The study acknowledges the web-based applications in maintaining the high-quality scientific and technical journal articles (STJA) every year that contributed to progressing the World's income per capita through providing solutions to the economic issues. The study collected the quarterly aggregated world data for 2000Q1 to 2020Q4 to analyze the IMPACT (Interactive, Mechanical, Powerful, Applicable, Controllable, and Technical) of STJA and research and development (R&D) expenditures on the World's income. The autoregressive distributed lag (ARDL) estimates show that the STJA and web-based IMPACT positively impact the World's per capita income in the short and long run. The one-to-one corresponding relationship found between the web IMPACT and the World's income in the short and long run. On the other hand, a 1% increase in the STJA brings a positive change of 0.937% (p<0.000) and 0.994% (p<0.000) on the World's income in the short and long run. The negative relationship found between R&D spending and World's income in the short run; however, this result evaporates in the long run. The innovation accounting matrix (IAM) estimates suggested that STJA and web-based IMPACT will likely increase the World's income for the next 10 years. The study concludes that web-based applications and their IMPACT positively contributed to an increase in the World's income, which confirmed the viability of web engineering in handling economic affairs and policy formulations. [ABSTRACT FROM AUTHOR]

The study in hand investigated the innovation performance (IP) of SMEs explaining the role of digital platforms (DPs), innovation strategy (IS), and innovation culture (IC). In the current study, we also tested the intervening role of IC. A total of 387 top management officials served in SMEs were approached for the purpose of data collection. For the purpose of data analysis, SPSS 25.0 and various statistical techniques were used for analysis. Results revealed that DPs significantly predicted IC and IP of SMEs. Moreover, the outcomes of analysis also revealed that IC plays a mediating role between DPs and IP. The SMEs of developing economies contribute significantly, however operating in a dynamic scenario which demanded continuous innovation in the business operation of the business entities. Only those businesses survive in the dynamic environment which updates its operation, methods, and products according to customers' demand. Hence, IP becomes critical for SMEs to flourish the business activities. Therefore, the current research endeavor highlights the role of DPs, IC, and IS on innovation activities of SMEs. [ABSTRACT FROM AUTHOR]

Environmental health is critical for the economy's social welfare and environmental sustainability. Using time series data from 1975 to 2020, the research examines the short- and long-run relationship between environmental pollutants and healthcare costs in the context of Pakistan. The study's results reveal that short-term and long-term efforts towards cleaner development in terms of carbon emissions, coal combustion, nitrous oxide (N2O) emissions, and industrial value-added have resulted in significant reductions in healthcare expenses due to improved management of industrial emissions. However, in the long run, particulate matter (PM2.5) has a detrimental effect on a country's sustainable healthcare agenda, leading to increased healthcare costs. Furthermore, the increased use of coal-fired power plants that release polycyclic aromatic hydrocarbons (PAH) and revenue generated by contaminated production lead to higher out-of-pocket healthcare costs, increasing a country's risk of morbidity and mortality. The study's Granger causality estimations demonstrate that carbon emissions are responsible for emissions-driven healthcare expenses in a nation. Additionally, economic growth leads to increased carbon emissions and industrial toxins, which are also emission-led. Through variance decomposition analysis (VDA), the study finds that carbon emissions have the highest variance shock of 32.702% on healthcare expenditures in the next ten years. This is followed by polluted income and continued economic growth, which have a variance shock of 13.243% and 8.858%, respectively, over the same period. The findings indicate that the maximum healthcare benefits may be acquired by mitigating environmental pollutants via stringent environmental regulations, reducing industrial toxins through solid waste management techniques, and minimizing coal combustion reliance through renewable fuels. Environmental research is still required to provide more sustainable solutions to the sustainability of the global healthcare agenda. [ABSTRACT FROM AUTHOR]

This study develops and assesses the application of a livelihood vulnerability index (LVI), LVI-IPCC and livelihood effect index for the natural and agricultural resources in Northwestern Pakistan. By using structured questionnaire, primary data were collected from the targeted households in the study region. Data on socio-demographics, water security, health, social networks and climate variability were collected from the targeted respondents in this study area, and combined into indices. The IPCC framework was utilized that characterizes vulnerability into exposure, sensitivity and its adaptive capacity. Findings of our study showed that tehsil Shabqadar was more vulnerable among three studied tehsils particularly in natural disasters, health, water and land holding status. Tehsil Tangi was the second high vulnerable tehsil followed by tehsil Charsadda relative to other LVI components with the exclusion of livelihood strategies and financial constraints. Findings of this study provide a better understanding of the social and behavioral trends as well as an integrated and holistic view of the agriculture, climate change and livelihoods process in assessing the vulnerability. The findings and this pragmatic approach will be helpful in intending specific strategies and policy effectiveness to lessen susceptibility of households to climatic variations. [ABSTRACT FROM AUTHOR]

This article investigates the pandemic risk coverage within the European Union member states through insurance securitization. This strategy allows the transfer of health risks from the insurance market to the financial markets. We focus on the financial market crisis caused by the COVID-19 pandemic to securitize the losses caused by the latter. Over the period from 24/01/2020 (the first proven case of contamination in Europe) to 31/03/2020 (end of the dramatic decrease in financial markets), we apply the extreme value theory allowing the selection of the trigger threshold. We identify an immediate reaction of the financial markets following a pandemic shock, the effect of which fades after a few days. The response of stock market indices, measured by the fluctuation of return rates, is not very high. Nevertheless, the reaction of the financial markets is sufficient for the corona bond triggering, provided that the threshold for triggering the incidence rate is optimal. In addition, the securitization of insurance risk could be an alternative process to the classic risk transfer techniques such as co-insurance and reinsurance. Finally, a reinsurance pool dedicated to the insurance scheme's management against the effects of a pandemic is crucial for insurance securitization. These results could have implications for various actors such as insurers, financial investors, and States. [ABSTRACT FROM AUTHOR]

The logistics business is a crucial contributor to economic development, yet it is also the leading source of carbon emissions. Economic growth at the expense of environmental deterioration is a challenging issue; this phenomenon offered a new avenue for scholars and policymakers to investigate and address these issues. The recent study is one of the attempts to explore this intricate subject. The goal of this research is to determine whether or not the Chinese logistics sector has an impact on Pakistan's GDP and carbon emissions as a result of CPEC. The research utilized data from 2007Q1 to 2021Q4 using the ARDL approach for an empirical estimate. Due to the mixed order of variable integration and finite data set, the ARDL technique is well deserved, which helps reach sound policy inferences. The study's key results indicated that China's logistic business enhances Pakistan's economic development and carbon emissions in the short and long term. Similarly, China's energy usage, technology, and transportation contribute to Pakistan's economic progress at the price of environmental damage. The empirical study may be a model for other developing nations, given Pakistan's viewpoint. With the support of the empirical results, policymakers in Pakistan and other associated countries would be able to plan for sustainable growth in conjunction with CPEC. [ABSTRACT FROM AUTHOR]

2,4-Bis (2-hydroxy-3-methoxybenzaldehyde) diiminotoluene Schiff base (SB) derived from 2,4-diaminotoluene and 2-hydroxy-3-methoxybenzaldehyde was synthesized and characterized using spectroscopic analysis: the Nuclear Magnetic Resonance (1H, 13C NMR), the Fourier Transform Infrared and the ultraviolet–visible. This synthesized compound was evaluated using the spectrophotometric chemical tests including the β-carotene bleaching test, hydroxyl radical scavenging, reducing power test, DPPH test, ABTS test and the electrochemical test (superoxide radical scavenging test). These tests were used to specify the ability of the ligand SB to scavenge the free radicals. The results illustrate that SB is useful as an antioxidant. Moreover, the structure–activity was explained utilizing the Density Functional Theory to determine the Frontier Molecular Orbital, Mulliken, Natural Bond Orbital atomic charges and Molecular Electrostatic Potential. The cyclic voltammetry was used to set the electrochemical properties of the Schiff base. [ABSTRACT FROM AUTHOR]

Purpose: Poor ergonomics and acute stress can impair surgical performance and cause work-related injuries. Robotic assistance may optimize these psychophysiological factors during UKA. This study compared surgeon physiologic stress and ergonomics during robotic-assisted UKA (rUKA) and conventional UKA (cUKA). Methods: Cardiorespiratory and postural data from a single surgeon were recorded during 30 UKAs, (15 rUKAs, 15 cUKAs). Heart rate (HR), HR variability, respiratory rate (RR), minute ventilation and calorie expenditure were used to measure surgical strain. Intraoperative ergonomics were assessed by measuring flexion/extension/rotation of the neck and lumbar spine, and shoulder abduction/adduction. Results: Mean operative time was 32.0 ± 7 min for cUKA and 45.9 ± 9 min for rUKA (p < 0.001). Mean neck flexion was − 23.4° ± 13° for rUKA and − 49.1° ± 18 for cUKA (p < 0.001), while mean lumbar flexion was − 20.3° ± 30° for rUKA and − 0.4° ± 68° for cUKA (p = 0.313). Mean lumbar flexion was similar; however, a significantly greater percentage of time was spent in lumbar flexion > 20° during cUKA. Bilateral shoulder abduction was significantly higher for rUKA. Mean calorie expenditure was 154 cal for rUKA and 89.1 cal for cUKA (p < 0.001). Mean HR was also higher for rUKA (88.7 vs. 84.7, p = 0.019). HR variability was slightly lower for rUKA (12.4) than for cUKA (13.4), although this did not reach statistical significance (p = 0.056). No difference in RR or minute ventilation was observed. Conclusion: rUKA resulted in less neck flexion but increased shoulder abduction, heart rate, and energy expenditure. The theoretical ergonomic and physiologic advantages of robotic assistance using a handheld sculpting device were not realized in this study. Level of evidence: II. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) is used for various purposes that are critical to human life. However, most state-of-the-art AI algorithms are black-box models, which means that humans cannot understand how such models make decisions. To forestall an algorithm-based authoritarian society, decisions based on machine learning ought to inspire trust by being explainable. For AI explainability to be practical, it must be feasible to obtain explanations systematically and automatically. A usual methodology to explain predictions made by a (black-box) deep learning model is to build a surrogate model based on a less difficult, more understandable decision algorithm. In this work, we focus on explaining by means of model surrogates the (mis)behavior of black-box models trained via federated learning. Federated learning is a decentralized machine learning technique that aggregates partial models trained by a set of peers on their own private data to obtain a global model. Due to its decentralized nature, federated learning offers some privacy protection to the participating peers. Nonetheless, it remains vulnerable to a variety of security attacks and even to sophisticated privacy attacks. To mitigate the effects of such attacks, we turn to the causes underlying misclassification by the federated model, which may indicate manipulations of the model. Our approach is to use random forests containing decision trees of restricted depth as surrogates of the federated black-box model. Then, we leverage decision trees in the forest to compute the importance of the features involved in the wrong predictions. We have applied our method to detect security and privacy attacks that malicious peers or the model manager may orchestrate in federated learning scenarios. Empirical results show that our method can detect attacks with high accuracy and, unlike other attack detection mechanisms, it can also explain the operation of such attacks at the peers' side. [ABSTRACT FROM AUTHOR]

The massive rise in the world's average temperature has created major economic and environmental issues that must be addressed by strict environmental legislation. Carbon pricing is seen as a sustainable instrument capable of assisting in the reduction of negative environmental externalities associated with global carbon emissions. The race-to-the-bottom (RTB) hypothesis describes a competitive environment in which economies sacrifice environmental quality standards to undercut competitors, thus undermining the ecological sustainability objective. The study contributed to the evaluation of the RTB hypothesis by examining the role of emissions cap trading instruments in conjunction with inbound foreign direct investment, economic growth, renewable energy demand, and trade openness in reducing carbon emissions, using aggregated data from high-income countries from 1975 to 2019. The linear and non-linear ARDL estimator is used for empirical analysis. The results show that emissions cap trading lowers carbon emissions in the long run while increasing in the short run. Inbound FDI confirmed the "pollution halo hypothesis" in the long run while verifying the "pollution haven hypothesis" in the short run. The per capita income and its associated positive shocks substantially decrease carbon emissions in the short and long runs. Renewable energy demand and trade openness increases carbon emissions in the short and long runs, respectively. On the other hand, trade openness decreases carbon emissions in the short run. The results confirmed the RTB hypothesis in the short run. At the same time, it substantiates the "race-to-the top" (RTT) in the long run, by imposing stringent environmental policies to the way forward towards green and clean development. The study concludes that emissions cap trading and investment in cleaner technologies played a decisive role in reducing environmental pollution. As a result, it is desired to make environmental regulations more environmentally friendly by adopting carbon pricing and technology transfer that will lower the average world temperature. [ABSTRACT FROM AUTHOR]

Since industrialization, the world has been under great strain from rising temperatures. Economies work hard to boost economic growth by sacrificing natural surroundings that are degrading owing to increased carbon emissions from unsustainable production and consumption. The race-to-the-bottom strategy is seen in different parts of the globalized world, corroborating the pollution haven concept and energy-related emissions. The study assumed that once affluent nations reached a particular economic level, they would concentrate on environmental reforms to safeguard environmental and natural resources. The study built a model of the emissions-growth nexus by controlling inward FDI, information and communication technology, research and development expenditures, and renewable energy using aggregated data from high-income nations from 1976 to 2019. The study verified the N-shaped environmental Kuznets curve using a three-degree polynomial factor of per capita income. On the other hand, inward FDI was assessed as having the potential to support the pollution haven hypothesis (PHH) by increasing carbon emissions. The data show that the square and cubic forms of per capita income have a significant negative and positive effect on carbon emissions in the long run, corroborating the short-peak V-shaped EKC hypothesis. However, the N-shaped EKC hypothesis between income and emissions is verified in the short run. The PHH confirmed that more inward FDI is associated with higher long-term carbon emissions. For decreasing global carbon emissions and unclean production, stringent and incentive-based regulations are preferable. [ABSTRACT FROM AUTHOR]

Purpose: There is currently no consensus regarding the optimal treatment for stiffness following total knee arthroplasty (TKA). With the increased utilization of value-based models, it is important to determine the most effective treatments that will reduce the need for further intervention and additional expenditure. A systematic review was performed to compare the outcomes of manipulation under anaesthesia (MUA), arthroscopic lysis of adhesions (aLOA), and revision TKA (rTKA) for arthrofibrosis and stiffness following TKA.Methods: PubMed and MEDLINE databases were reviewed for articles published through October 2020. Studies were included if they reported patient-reported outcome measures (PROMs) following MUA, aLOA, or rTKA. The primary endpoint was PROMs, while secondary outcomes included range of motion and the percentage of patients who pursued further treatment for stiffness.Results: A total of 40 studies were included: 21 on rTKA, 7 on aLOA, and 14 on MUA. The mean or median post-operative arc ROM was > 90° in 6/20 (30%) rTKA, 5/7 (71%) aLOA, and 7/10 (70%) MUA studies. Post-operative Knee Society (KSS) clinical and functional scores were the greatest in patients who underwent MUA and aLOA. As many as 43% of rTKA patients required further care compared to 25% of aLOA and 17% of MUA patients.Conclusion: Stiffness following TKA remains a challenging condition to treat. Nonetheless, current evidence suggests that patients who undergo rTKA have poorer clinical outcomes and a greater need for further treatment compared to patients who undergo MUA or aLOA. [ABSTRACT FROM AUTHOR]

Climate finance and carbon pricing are regarded as sustainable policy mechanisms for mitigating negative environmental externalities via the development of green financing projects and the imposition of taxes on carbon pollution generation. Financial literacy indicates that it is beneficial to invest in cleaner technology to advance the environmental sustainability goal. The current wave of the COVID-19 epidemic has had a detrimental effect on the world economies' health and income. The pandemic crisis dwarfs previous global financial crises in terms of scope and severity, collapsing global financial markets. The study's primary contribution is constructing a climate funding index (CFI) based on four critical factors: inbound foreign direct investment, renewable energy usage, research and development spending, and carbon damages. In a cross-sectional panel of 43 nations, the research evaluates the effect of climate funding, financial literacy, and carbon pricing in lowering exposure to coronavirus cases. The study utilized Newton–Raphson and Marquardt steps to estimate the current parameter estimates while evaluating the COVID-19 prediction model with level regressors using the robust least squares regression model (S-estimator). Additionally, the innovation accounting matrix predicts estimations over a specific period. The findings indicate that climate finance significantly reduces coronavirus exposure by introducing green financing initiatives that benefit human health, which eventually strengthens the immune system's ability to fight infectious illnesses. Financial literacy and carbon pricing, on the other hand, are ineffectual in controlling coronavirus infections due to rising economic activity and densely inhabited areas that enable the transmission of coronavirus cases across countries. Similar findings were obtained using the alternative regression apparatus. The COVID-19 predicted variable was used as a "response variable," and climate financing was shown to have a favorable impact on containing coronavirus exposure. As shown by the innovation accounting matrix, carbon pricing would drastically decrease coronavirus cases' exposure over a time horizon. The study concludes that climate finance and carbon pricing were critical in improving air quality indicators, which improved countries' health and wealth, allowing them to reduce coronavirus infections via sustainable healthcare reforms. [ABSTRACT FROM AUTHOR]

Site selection for organizations is a complex and unstructured problem that must be analyzed carefully and properly since a localization error could drive to bankruptcy. This problem has been discussed widely and effectively using multi-criteria decision-making methods in a manufacturing context, but it has been little studied in the agricultural industry. The aim of this study is to proposing a methodological approach to evaluate the fifty states in the United States (US) in terms of wheat processing plant locations. To do so, a literature review is searched to determine the ten sub-criteria under financial, environmental, and spatial dimensions. To overcome the uncertainty of experts' judgment in criteria prioritization, interval type-2 fuzzy (IT2F)-analytic hierarchy process is used. The method of complex proportional assessment of alternatives is used to obtain the final rank of states. The results and verification of the methodology are carried out throughout a sensitivity analysis of the weights. The results of sensitivity analysis indicated that when financial aspects are focused upon, California is the best alternative, followed by Texas and Oklahoma. In addition, from the environmental and spatial perspectives, Vermont and California are the best choices, respectively. The findings of this study can provide useful information to wheat plant decision-makers and serve as a reference for US policy. [ABSTRACT FROM AUTHOR]

Climate change and increased greenhouse gas emissions boost the global average temperature to less than 2°C, which is the estimated breakeven point. The globe is moving into blue pollution economies as the environmental sustainability objective becomes more distorted. The study looked at three United Nations Sustainable Development Goals, namely (i) affordable and clean energy; (ii) industry, innovation, and infrastructure; and (iii) climate change, to see how far the Chinese economy has progressed toward green and clean development strategy. In the context of China, the "pollution damage function" was intended to refer to carbon damages related to carbon pricing, technological variables, sustained economic growth, incoming foreign investment, and green energy. The data was collected between 1975 and 2019 and analyzed using various statistical approaches. The results of the autoregressive distributed lag model suggest that carbon taxes on industrial emissions reduce carbon damages in the short and long run. Furthermore, a rise in inbound foreign investment and renewable energy demand reduces carbon damages in the short term, proving the "pollution halo" and "green energy" hypotheses; nonetheless, the results are insufficient to explain the stated results in the long run. In the long run, technology transfers and continued economic growth are beneficial in reducing carbon damages and confirming the potential of cleaner solutions in pollution mitigation. The causal inferences show the one-way relationship running from carbon pricing and technology transfer to carbon damages, and green energy to high-technology exports in a country. The impulse response estimates suggested that carbon tax, inbound foreign investment, and technology transfers likely decrease carbon damages for the next 10 years. On the other hand, continued economic growth and inadequate green energy sources are likely to increase carbon pollution in a country. The variance decomposition analysis suggested that carbon pricing and information and communication technology exports would likely significantly influence carbon damages over time. To keep the earth's temperature within the set threshold, the true motivation to shift from a blue to a green economy required strict environmental legislation, the use of green energy sources, and the export of cleaner technologies. Source: Authors' self-extract [ABSTRACT FROM AUTHOR]

All-optical logic gates OR, XOR, AND, and NOT based on two-dimensional (2D) plasmonic metal-insulator-metal (MIM) coupled with an elliptical ring resonator (ERR) are presented, simulated, and investigated by using the numerical method of the FEM (finite elements method). The results are compared and validated with the finite difference time domain (FDTD) method. The proposed logic gates are achieved with the same structure using the constructive and destructive optical interferences between a control signal and input signal(s). Their characterization was mainly done for two spectral regions, visible and near-infrared. A high-intensity contrast ratio (CR) between the logic states ("1" and "0") can be achieved (28 dB) at these spectral regions. We introduce a new parameter, "gap-threshold ratio (GTR)," to characterize the gap between the maximum and minimum of the transmitted signal intensity for all logic gates. The suggested value of transmission threshold between logic "0" and logic "1" states is T th = 0.2 . A comparison of the two parameters, CR and GTR, with previous works shows that the proposed structure gives very good results for all logic gates configurations. The proposed all-optical logic gates configuration can be a key component in optical processing and telecommunication devices. [ABSTRACT FROM AUTHOR]

Key message: The first insight into the genome of Ficus carica L. with a gene target marker (conserved DNA-derived polymorphism (CDDP)) and assessment of genetic diversity mostly related to functional domains of plant genes. To improve the molecular database of Ficus carica L. species, we report for the first time the use of conserved DNA-derived polymorphism (CDDP) as a gene-targeted marker to assess molecular diversity, and establish relationships among 62 Tunisian cultivated and wild fig trees. The mapping process for the in silico analysis of CDDP primers against the whole F. carica genome cv Dottato verified the specificity of the CDDPs and the stringency of PCR conditions. Overall, a set of twelve CDDP primers were tested revealing 200 markers. Based on the polymorphic information content (PIC = 0.90), resolving power (Rp = 8.13) and the level of polymorphisms (98.04%) CDDP markers were found to highly discriminant and informative compared to other non-targeted methods. The UPGMA dendrogram revealed that Tunisian figs could be differentiated into three main groups, which was also supported by the principal coordinate analysis. The analysis of molecular variance (AMOVA) suggested that the maximum genetic variation was within groups (86.10%) with less variation among groups (19%) indicating that there is a limited diversity that distinguishes fig groups. Here, we present the first report in which a targeted DNA region molecular marker successfully clustered the Tunisian fig germplasm depending on the sex, the botanical classification of figs and consistently in agreement, with their geographic origin). The results highlight that the CDDP markers are able to characterize wild and cultivated Ficus carica L. species and provide a new valuable tool for further genome investigation and will guide the development of conservation and management strategies for existing fig tree germplasm. [ABSTRACT FROM AUTHOR]

The coronavirus disease (COVID-19) is a highly transmitted disease that spreads all over the globe in a short period. Environmental pollutants are considered one of the carriers to spread the COVID-19 pandemic through health damages. Carbon emissions, PM2.5 emissions, nitrous oxide emissions, GHG, and other GHG emissions are mainly judged separately in the earlier studies in different economic settings. The study hypothesizes that environmental pollutants adversely affect healthcare outcomes, likely to infected people by contagious diseases, including coronavirus cases. The subject matter is vital to analyze the preventive healthcare theory by using different environmental pollutants on the COVID-19 factors: total infected cases, total death cases, and case fatality ratio, in a large cross-section of 119 countries. The study employed the generalized least square (GLS) method for robust inferences. The results show that GHG and CO2 emissions are critical factors likely to increase total coronavirus cases and death rates. On the other hand, nitrous oxide, carbon, and transport emissions increase the case fatality ratio through healthcare damages. The study concludes that stringent environmental policies and improving healthcare infrastructure can control coronavirus cases across countries. [ABSTRACT FROM AUTHOR]

Cement is a common candidate for soil treatment when stabilization is required. Its employment in compacted earth blocks requests curing the product as efficiently as possible to obtain satisfactory performances. In this context, many practitioners' recommendations exist. However, no studies have stated clearly optimum curing method required to achieve best possible strength for cement stabilized compacted earth. In this study, an exploratory analysis was used to assess the influence of moist curing duration on strength development in cement stabilized compacted earth. For this investigation, two natural earths stabilized with different types of cement were considered. The main differences between the chosen cements are their clinker content and strength class. The applied moist curing method consists of conditioning samples in moist environment (99.8% ± 0.2%RH) at ambient temperature (21 °C). Curing duration was varied between 0 (no curing) and 21 days. The uniaxial compressive strength was used as a practical indicator to inspect strength development in dry and wet conditions. Results demonstrate that moist curing is profitable until 7 days regardless of the formulation. In addition, results show that efficiency of cement stabilization depends on earth characteristics rather than cement composition. To discuss moist curing in more detail, accelerated curing conditions performed at 60 °C in ambient and moist environment were analyzed. In conclusion, some recommendations on the optimization of cement usage in compacted earth were provided. [ABSTRACT FROM AUTHOR]

Background and aims: Verrucous esophageal carcinoma (VEC) is a rare malignancy that presents a diagnostic challenge. We aim to characterize the clinical and genomic features, tumor behavior, and treatment outcomes of VEC to guide clinical practice. Methods: We performed a systematic review of the literature and identified additional cases from Massachusetts General Hospital records and The Cancer Genome Atlas (TCGA). We obtained individual VEC patient data and analyzed publicly available clinicogenomic data from TCGA. We performed a regression analysis comparing cases of VEC to esophageal squamous cell carcinoma (ESCC) to identify factors influencing survival. Results: A total of 135 patients were reported in 82 publications, and four unpublished cases from Massachusetts General Hospital (median age 65 years, 69% males, 48% smokers, 33% consumed alcohol). Symptoms were present at diagnosis in 95% of patients, most commonly dysphagia and weight loss. Median symptom onset to diagnosis time was 11.5 months with frequent misdiagnosis as Candida esophagitis. Among VEC cases with pathologic staging, lymph node metastases were rare (5%) compared to ESCC (40%). VEC was genomically characterized by enrichment of SMARCA4 missense mutations and a lack of pathogenic TP53 mutations. Despite its diagnostic elusiveness, in a multivariate regression analysis, VEC was detected at earlier stages (p = < 0.001) compared to ESCC, and advanced stage was the only significant factor affecting survival (p = 0.013). Conclusions: VEC is a rare, clinically and genomically distinct subtype of ESCC. Recognition and diagnosis of this lesion may allow the pursuit of curative and less morbid treatment strategies. [ABSTRACT FROM AUTHOR]

Metal–insulator–metal waveguide structure, which has a fascinating feature to confine the signal far beyond the diffraction light is numerically investigated by the finite difference time domain and the finite element methods. In this study, the MIM waveguide is both coupled with a half-elliptical groove (HEG) and an elliptical cavity resonator (ECR), and it can support the propagation of light in the nanoscale regime at the visible and near-infrared ranges. The interaction between these last elements gives rise to Fano resonance modes. Thanks to its interesting characteristics, a high sensitivity value, a factor of merit and interesting value of the group index are obtained for the proposed structure. We show that the transmission of the Fano system and the group index can reach 90% and a value of 63, respectively. We also report an investigation of the influence of the both geometrical HEG and ECR's parameters on optical properties. Hence, the proposed structure could find a potential for applications in the integrated optical circuits such as optical storage, ultrafast plasmonic switchers, high performance filters and slow light devices. [ABSTRACT FROM AUTHOR]

The aim of this in vivo study was to test the diagnostic accuracy of a pen-type laser fluorescence (LFpen) device in detecting approximal caries lesions, in posterior permanent teeth, at the cavitation and non-cavitation thresholds, and compare it with that of digital bitewing radiography. Thirty patients (aged 18-37), who attended the Faculty of Dentistry at Damascus University for a dental examination, were consecutively screened. Ninety approximal surfaces of posterior permanent teeth without frank cavitations, enamel hypoplasia or restorations were selected and examined using the LFpen (DIAGNOdent pen) and digital bitewing radiography. The reference standard was the visual-tactile inspection, after performing temporary tooth separation, using orthodontic rubber rings, placed for 7 days. The status of included approximal surfaces was recorded as intact/sound, with white/brown spots or cavitated. One trained examiner performed all examinations. There were statistically significant differences in LFpen readings between the three types of approximal surface status (P < 0.001). The optimal cut-off values for detecting approximal caries lesions in posterior permanent teeth were >16 and 8 at the cavitation and non-cavitation thresholds respectively. The sensitivity, specificity and accuracy (measured by the area under the receiver-operating characteristic curve) were 100, 85 and 95 and 92, 90 and 95% at the cavitation and non-cavitation thresholds respectively. The intra-class correlation coefficient for intra-examiner reliability was 0.95. The diagnostic accuracy of the LFpen was significantly higher than that of digital bitewing radiography (P < 0.001). The LFpen's diagnostic performance was accurate and significantly better than digital bitewing radiography in detecting approximal caries lesions, in posterior permanent teeth. [ABSTRACT FROM AUTHOR]

Background: Four commercially available intragastric balloons have been used for the management of obesity and underwent randomized controlled trials (RCTs), and we aimed to compare them using a network meta-analysis approach.Methods: Several databases were queried from inception to May 26, 2017, and we included RCTs enrolling patients treated with Orbera, Heliosphere, ReShape Duo, and Obalon compared with another balloon, sham, or open-label control group. Two investigators independently abstracted data. A random effects frequentist network meta-analysis and relative ranking of agents using surface under the cumulative ranking probabilities were performed.Results: We included 15 trials at low risk of bias (only two were head-to-head). Compared to control groups, the two fluid-filled devices were associated with significant outcome (% total body weight loss) at 6 months: Orbera, 6.72% (95% CI, 5.55, 7.89) and ReShape Duo 4% (95% CI 2.69, 5.31). Only one of the two gas-filled devices was associated with significant outcome at 6 months: Obalon 3.3% (95% CI 2.30, 4.30), and not the second: Heliosphere 6.71% (95% CI − 0.82, 14.23). Fluid-filled devices had the highest likelihood of superiority in achieving the outcome at 6 months (96.8%) and at 12 months (96.6%). The quality of evidence was high for comparisons against control.Conclusions: Fluid-filled balloons are more likely to produce weight loss compared to gas-filled balloons or lifestyle intervention. However, they may be associated with a higher rate of intolerance and early removal. This information will aid clinicians in device selection and engaging patients in shared decision-making. [ABSTRACT FROM AUTHOR]

Background: The prevalence of obesity in patients with inflammatory bowel disease (IBD) has increased over the past decades. Data to support the safety of bariatric surgery (BAR) in IBD remain scarce. Our aim was to evaluate the safety and early postoperative complications of BAR in IBD patients.Methods: We used the Nationwide Inpatient Sample (NIS) 2011, 2012, and 2013 to perform a cohort study. The study group was all hospitalized patients between ages 18-90 years who underwent BAR with a discharge diagnosis of IBD as per the Ninth International Classification of Diseases codes (ICD-9). Adults who underwent BAR without ICD-9 codes of IBD were identified as the comparison group. Complications were compared using multivariate logistic regression analysis.Results: We identified 314,864 adult patients who underwent BAR between 2011 and 2013. Mean age was 45.5 ± 0.11 years, and 79% were females. Seven hundred and ninety patients had underlying IBD; 459 had Crohn’s disease and 331 had ulcerative colitis. The remaining patients formed the comparison group. Mean length of hospital stay (LOS) was longer in the IBD group by 1 day (p = 0.01). The IBD group had a significantly higher risk of perioperative small bowel obstruction (SBO) (adjusted odds ratio, 4.0; 95%, CI; 2.2-7.4). Other technical and systemic complications were similar between the two groups, with no mortality reported in the IBD group.Conclusions: BAR in IBD patients has an acceptable safety profile, with immeditae risk limited to perioperative SBO and an apparently low risk of mortality or other major immediate postoperative complications. [ABSTRACT FROM AUTHOR]

Trade-offs between the conflicting aspects of corporate sustainability (CS) have hindered the realization of win-win opportunities that advance both sustainable development and the bottom line. The question today is no longer whether these trade-offs are encountered in the pursuit of CS, but under which circumstances they occur, with which responses, and how best to navigate them. This study conducted a systematic review and content analysis of the trade-off literature published to-date at both conceptual and applied levels. Through this process, a hierarchical framework is proposed for the analysis of trade-offs based on their different categories, their root tensions, their interconnections, and where they are encountered in the practice of CS, from policy to implementation. Based on this, a number of recommendations are provided on how managers may better navigate the hierarchy of trade-off decision-making, to ultimately transform trade-offs into synergies. Several suggestions for future trade-off research are also provided. [ABSTRACT FROM AUTHOR]

Indium-doped zinc oxide nanorods were electrochemically deposited at low temperature on ITO substrates. The synthesized ZnO-arrayed layers were investigated by using X-ray diffraction, scanning electron microscopy, UV-vis transmittance, electrochemical impedance spectroscopy, and photocurrent spectroscopy. X-ray diffraction analysis demonstrates that the electrodeposited films are crystalline and present the hexagonal Würtzite ZnO phase with preferential (002) orientation. The ZnO films obtained forms aligned hexagonal nanorods, and depending on the increasing In concentration, the surface morphologies of the films are changed. The ln-doped ZnO nanorods (NRs) are well-aligned with the c-axis being perpendicular to the substrates when the ln concentration was between 0 and 2 at.%. of In, the grown films with In contents up to 4 at.%, changes in the optical band gap from 3.31 to 3.39 eV, and the blue shift in the band gap energy was attributed to the Burstein-Moss effect. The effect of In concentration on the photocurrent generated by films shows that the obtained thin films can be used as a photovoltaic material. Changes in the photocurrent response and the electronic disorder were also discussed in the light of In doping. It was found that the carrier density of IZO thin films varied between 1.06 × 10 and 1.88 × 10 cm when the In concentration was between 0 and 4 at.%. [ABSTRACT FROM AUTHOR]

Thin TiO2 films obtained by cathodic electrosynthesis from an acidic aqueous bath containing TiOSO4, H2O2 and KNO3 on conductive glass indium tin oxide have been physically and electrochemically characterised. Secondary ion mass spectroscopy profile of the crystallised gel after heat treatment at 400 °C shows the presence of TiO2 with traces of TiO and oxygen. X-ray patterns confirm the presence of anatase nanocrystallites for the annealed film and an amorphous structure for the non-annealed gel. Scattering electron microscopy surface micrographies reveal an opened porous nanostructure of the deposits. Cyclic voltammetry and impedance spectroscopic measurements reveal the different behaviour of the films obtained before and after the annealing, showing an important electrical activity of the non-annealed films. The dependence of capacitance values with potential in the anodic domain of depletion is obviously remarked from impedance plots for both gel and crystal forms of the film, which confirmed the fact that films obtained in this way have n-type properties. The potential of flat band equals −0.6 V/Ag/AgCl in pH range of 6.5 has been estimated according to Mott–Shottky curves for the crystallised oxide; meanwhile, the Mott–Shottky curve for the hydrated gel was nonlinear. [ABSTRACT FROM AUTHOR]

Abstract  The crystal structure of a new symmetrical pentadentate N2O3 Schiff base: di[4-(phenylimino)pentan-2-one] ether (H2L) is described. In the solid state, the ligand appears as a keto-imine tautomer, while in DMSO solution, the eneamine form is observed. This ligand coordinates cobalt(II), nickel(II), copper(II) and cadmium(II). The structures of these new complexes are described using infrared and electronic spectroscopy, 1H-n.m.r. and d.s.c. The cyclic voltammograms of the ligand and the complexes in DMF are discussed. [ABSTRACT FROM AUTHOR]

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Background: Infestation with Ascaris lumbricoides is seen worldwide. Recently, there has been much interest in the pancreatic-biliary complications of Ascaris infection. In this study, we present our experience of 300 patients seen in a tertiary referral center. Materials and Methods: Case charts of patients seen in the Department of Gastroenterology, University of Damascus, Syria, were analyzed, retrospectively, over a 5-yr period (September of 1988 to August of 1993). During this period, 1666 endoscopic retrograde cholangiopancreatographic studies were performed and pancreatic-biliary ascariasis was diagnosed in 300 patients (18%). Results: The most common presenting symptom was abdominal pain, seen in 98% of patients (294 patients). Complications observed were ascending cholangitis (48 patients; 16%), acute pancreatitis (13 patients; 4.3%), and obstructive jaundice (4 patients; 1.3%). History of worm emesis was present in 25% of patients (76 patients). Most patients (240 patients; 80%) had previously undergone a cholecystectomy or an endoscopic sphincterotomy (232 patients; 77%). Worms were successfully extracted endoscopically in all except two patients, and there were no procedure-related complications. Conclusions: in endemic countries, ascariasis should be suspected in patients with pancreatic-biliary disease, especially if a cholecystectomy or sphincterotomy has been performed in the past. Endoscopic management results in rapid resolution of symptoms and prevents development of complications. [ABSTRACT FROM AUTHOR]