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Environmental pollution and agricultural productivity in Pakistan: new insights from ARDL and wavelet coherence approaches
No full text[[abstract]]The most serious challenge to the global facade is figuring out how to mitigate pollution levels without compromising agricultural productivity. The spillover effect of environmental change is predicted to be very high, although it will differ by region and crop. Considering this view, this study tries to address this issue by adopting comprehensive methodologies to assess the influence of carbon dioxide (CO2) emissions, agricultural labor, land, feeds, and fertilizers on agricultural productivity in Pakistan from 1961 to 2018. The autoregressive distributive lag (ARDL) and wavelet transform coherence (WTC) approaches are applied to estimate the long-run and short-run elasticity estimates. The empirical findings discover that CO2 emissions, agricultural land, labor, feed, and fertilizers exert high pressure on agricultural productivity which is backed up by the WTC findings. Furthermore, the gradual shift causality test results reveal the presence of a unidirectional causality relationship between all regressors and agriculture productivity, demonstrating that all the factors significantly influence agriculture productivity. Moreover, these findings are robust to different robustness tests that we perform to test the reliability/accuracy of our core results. From policy perspectives, regulations must be developed to explore a practicable expansion strategy that includes the use of efficient fertilizers and feed at optimal levels, as well as environmental protection through public–private investment in the agricultural sector
Survival Impact of Long-Term Tramadol Use on Breast Cancer for Patients with Chronic Pain: A Propensity Score-Matched Population-Based Cohort Study
No full text[[abstract]]Purpose: The impact of tramadol analgesic use before breast cancer diagnosis on survival in patients with chronic pain is unclear. Therefore, we designed a propensity score-matched population-based cohort study to compare the breast cancer-related survival of patients with chronic pain who received long-term tramadol analgesic treatment with that of those who did not receive such treatment.
Patients and methods: We included patients with chronic pain and categorized them into two groups according to their analgesic use, comparing their breast cancer-related survival; patients with breast cancer and chronic pain who were prescribed ?180 defined daily doses (DDDs) of tramadol analgesics per year >3 months before breast cancer diagnosis comprised the case group, and those who were prescribed non-tramadol analgesics before breast cancer diagnosis comprised the control group. Patients in both groups were matched at a ratio of 1:5.
Results: The matching process yielded a final cohort of 624 patients (104 and 520 in the case and control groups, respectively) who were eligible for further analysis. According to both univariate and multivariate Cox regression analyses, the adjusted hazard ratio for all-cause death in the case group compared with in the control group was 3.45 (95% confidence interval = 2.36-5.04; p < 0.001).
Conclusion: Long-term tramadol analgesic use prior to breast cancer diagnosis might be associated with poor overall survival in patients with chronic pain compared with such patients that did not receive long-term tramadol analgesic treatment
The nexus between environmental performance and economic growth: New evidence from the Middle East and North Africa region
No full text[[abstract]]Due to the importance of the environmental impacts of human activities on sustainable growth, the effect of environmental performance on economic growth was investigated for the Middle East and North Africa (MENA) countries from 2000 to 2015. Therefore, the Environmental Kuznets Curve (EKC) hypothesis is investigated using a Composite Index of Environmental Performance (CIEP) and Panel Autoregressive Distributed Lag (Panel ARDL) approach. The CIEP model is based on the Driving Force-Pressure-State- Exposure -Effects-Action (DPSEEA) framework and is generated by 19 indicators. The results of this study showed that the driving forces and pressure have negative impacts on environmental performance, thereby reducing the number of available resources. In addition, the results revealed that actions increase life expectancy while reducing the mortality rate and environmental impact. The average CIEP revealed that among MENA countries, Iran (?0.226), Algeria (?0.168), and Yemen (?0.134) had the lowest amounts, while Emirate (0.036), Kuwait (0.036), and Qatar (0.033) had the highest values. The results of the panel data model revealed a cubic polynomial correlation and an N-shaped pattern between economic growth and CIEP. Therefore, MENA countries must pay attention to sustainable development to preserve the environment
房貸需求與房屋供給對房價的影響
No full text[[abstract]]一直以來，國人受傳統文化與思想的影響，多認為擁房是人生重要甚至必要之事，因此房價高低便成為一般民眾、社會和國家所關注的議題。房價應同時由住宅的供給與需求來決定，故本研究在需求層面聚焦於房貸，供給層面聚焦於餘屋，並採用VAR向量自我迴歸模型來驗證各供需變數對房價的影響。實證結果顯示：五大銀行承做房貸總金額與房價、房貸利率與房價，皆為雙向因果關係；餘屋與房價間呈現同向變動；各變數以房貸利率對房價的影響最高。[[abstract]]Under the influence of traditional culture and ideas, Chinese people mostly consider possessing a house as an important?even essential?part of life. Consequently, house price level has become a matter of concern to citizens, the society, and the government alike. House price level should be determined by the supply and demand of housing. Accordingly, the present study investigates the supply (surplus houses) and demand (mortgage level) to verify their effects on house price level through the use of a vector autoregression model. The empirical results indicate that a two-way causal relationship exist between house price level and the total amount of mortgage lent by the five major banks in Taiwan, and between house price level and mortgage interest rate. Moreover, the number of surplus houses and house price level are positively correlated, and mortgage rate is the variable that influences house price levels the most
Assessing older adults' intentions to use a smartphone: Using the meta–unified theory of the acceptance and use of technology
No full text[[abstract]]Barriers to smartphone use often exist among older adults, and increasing smartphone use is beneficial to increasing older adults’ quality of life. Studies of older adults’ smartphone use intentions have mostly adopted the technology acceptance model or unified theory of acceptance and use of technology (UTAUT). However, these models have their limitations. A meta-UTAUT has been developed, but it has not been extensively verified with older adults. This study used the meta-UTAUT model to explore the influences on older adults’ smartphone use intentions and behaviors. A total of 311 adults aged 60 to 75 years who had minimal experience with smartphones were recruited. They participated in a 16 h smartphone training and then completed a questionnaire. The results demonstrated that the meta-UTAUT model can predict older adults’ smartphone use intentions and behaviors. Performance expectancy (PE) and social influence significantly influenced behavioral intention (BI) and attitude toward using smartphones (AT). PE was the strongest factor influencing BI. AT also affected BI. Although facilitating conditions did not significantly affect BI, they had a high influence on AT. To increase smartphone use among older adults, training can be implemented to teach smartphone skills and emphasize the benefits of using smartphones
Associations of hyperglycemic emergency and severe hypoglycemia incidences with seasonality and ambient temperature among pregnant women with diabetes: a nested case-control study in Taiwan
No full text[[abstract]]BACKGROUND: Associations of acute glycemic complications with season and ambient temperature have been reported in general population with diabetes. However, little is known about the risks of acute glycemic complications in relation to season and ambient temperature in pregnant women, who are likely to be even more vulnerable. This work aimed to investigate the associations of season and ambient temperature with pregnancies complicated with hyperglycemia emergency or severe hypoglycemia. METHODS: Two separate case-control studies were nested within 150,153 pregnancies by women with type 1, type 2, or gestational diabetes between 2009 and 2014 in Taiwan. Hyperglycemia emergency (mainly diabetic ketoacidosis and hyperosmolar hyperglycemic state) and severe hypoglycemia occurred in 77 and 153 diabetic pregnancies (cases), respectively. Ten control pregnancies were randomly selected for each case by matching each case pregnancy on type of diabetes (i.e., T1DM, T2DM, or GDM), maternal age on the date of acute glycemic complication occurrence (i.e., index date), and "length of gestation at risk" (i.e., period between conception and index date). Meteorological parameters were retrieved from 542 meteorological monitoring stations across Taiwan during 2008-2014. Conditional logistic regression analysis with generalized estimation equation was separately performed to estimate the covariate adjusted odds ratios (ORs) of each of the two acute glycemic complications in association with season and ambient temperature within 30 days prior to the index date. RESULTS: Compared to summer, winter season was associated with a significantly elevated risk of severe hypoglycemia with an OR of 1.74 (95% confidence interval (CI) 1.08-2.79). The OR of hyperglycemic emergency was also elevated in winter season at OR of 1.88, but the significance is only marginal (95% CI 0.97-3.64, p = 0.0598). Subgroup analyses further noted that such seasonal variation was also observed in pregnancies with pre-pregnancy type 1 diabetes and gestational diabetes. On the other hand, ambient temperature was not significantly associated with the two acute glycemic complications. CONCLUSIONS: A moderately but significantly elevated risk of severe hypoglycemia was found in pregnant women with diabetes during winter season, and such increased risk was more evident in pregnancies with T1DM
Comparing the Effectiveness of Flexi?Bar and Multi?Component Exercises on Improving the Physical Health of Older Adults: A Randomized Controlled Trial
No full text[[abstract]]Background: Both Flexi-Bar and Multi-Component exercises can improve an individual's physical fitness and musculoskeletal discomfort. However, determining which is more effective in enhancing the physical fitness, and musculoskeletal discomfort of older adults remains controversial.
Objective: This study aims to investigate differences in the effectiveness of Flexi-Bar and Multi-Component exercises in improving the frailty, physical fitness, and musculoskeletal discomfort of older adults after 12 weeks of intervention. Methods: A single-blind randomized controlled trial was conducted to collect data in central Taiwan. Participants were randomly assigned into a Flexi-Bar group (FB group) and a Multi-Component exercise group (MCE group). Participants in the FB group performed a 60-minute Flexi-Bar exercise every week for 12 consecutive weeks; participants in the MCE group performed a 60-minute Multi-Component exercise every week for 12 consecutive weeks. Before and after the intervention, the assessment was conducted using the Kihon Checklist, Senior Fitness Test, and Nordic Musculoskeletal Questionnaire.
Results: A total of 80 participants (16 males) were recruited (age = 75.7 ± 7.3 years). The results showed that the improvements of the FB group participants in the 2-minute step test, back scratch test, and number of body parts with discomfort were more significant than those of the participants in the MCE group.
Conclusion: This study found that the cardiopulmonary function, upper body flexibility, and musculoskeletal discomfort of the FB group participants improved more significantly than those in the MCE group. This finding indicated that a Flexi-Bar exercise was a more effective intervention for older adults than a Multi-Component exercise
Comparison of ultrasound and dorsal tangential view for dorsal cortex screw penetration in volar plating of the distal radius
No full text[[abstract]]We compared the accuracy of the fluoroscopic dorsal tangential view (DTV) and an ultrasound (US) examination in detecting dorsal screw penetration during volar distal radius plating. In six fresh cadaveric distal radii, seven periarticular locking screws in two rows for each plate were inserted according to the measured length using a depth gauge and then replaced with another that was 1 and 2 mm longer, respectively. The actual protruded length of each screw was determined using computed tomography (CT) images. The accuracy of US and DTV measurements was determined using the intraclass correlation coefficient (ICC), as both measurements were compared with CT measurements. The ICC of US and DTV was 0.96 and 0.75, respectively, for all screws. After excluding the data for proximal-row screws, the ICC of US remained unchanged at 0.96, and that of DTV improved to 0.86. The ICC of US was significantly higher than that of DTV (p < 0.01). US had a 100% detection rate for screw protrusion of more than 1.0 mm. US examination showed excellent consistency with CT measurements and its accuracy was not affected by screw location. US might thus be a practical tool for detecting dorsal cortex screw penetration during volar distal radius plating
Optical coherence tomography angiography compared with optical coherence tomography for detection of early glaucoma with high myopia
No full text[[abstract]]Purpose: To investigate the diagnostic abilities of the perfusion density (PD) and structural thickness parameters in the peripapillary and macular regions measured by optical coherence tomography angiography (OCTA) and optical coherence tomography (OCT) and to test if their diagnostic abilities of early glaucoma are different between highly myopic (HM) and non-highly myopic (NHM) patients. Methods: A total of 75 glaucoma patients and 65 controls were included in the analyses. The glaucoma detection abilities of macular PD and peripapillary PD, along with macular ganglion cell-inner plexiform layer (mGCIPL) thickness and peripapillary retinal nerve fiber layer (pRNFL) thicknesses were compared between the HM and NHM group. Diagnostic ability was assessed by area under the receiver operating characteristics (AUC) curves, adjusted by age, axial length, and signal strength. Results: The diagnostic ability of macular PD and mGCIPL thickness had no significant difference in both HM and NHM groups. However, the diagnostic ability of peripapillary PD except in the temporal section was significantly lower in the HM group than in the NHM group (all p < 0.05). The diagnostic ability of the superior, nasal, and average pRNFL thickness was also significantly lower in the HM group than in the NHM group (all p < 0.05). Conclusion: This study demonstrated that although peripapillary PD and macular PD were both significantly reduced in patients with highly myopia, the diagnostic ability of peripapillary PD in HM patients was significantly lower than that in NHM patients, while macular PD was not. Macular OCTA along with OCT imaging should be included in the imaging algorithm in early glaucoma diagnosis in highly myopic patients
Schizophrenia, but not depression or bipolar affective disorder, adds additional risk of aspiration pneumonia among stroke survivors: A national cohort study in Taiwan
No full text[[abstract]]Objective: Few studies have assessed the sex-specific and age-specific risk of aspiration pneumonia (AP) in patients with stroke and evaluated whether mental disorders may increase this risk. In this population-based cohort study, we investigated the sex-specific and age-specific risk of AP in association with stroke and the joint effects of stroke and mental disorders on the risk of AP.
Methods: We included 23,288 patients with incident stroke admitted between 2005 and 2017 and 68,675 matched nonstroke controls. Information on mental disorders was obtained from medical claims data within the 3 years before the stroke incidence. Cox proportional hazards models considering death as a competing risk event were constructed to estimate the hazard ratio of AP incidence by the end of 2018 associated with stroke and selected mental disorders.
Results: After ?14 years of follow-up, AP incidence was higher in the patients with stroke than in the controls (11.30/1000 vs. 1.51/1000 person-years), representing a covariate-adjusted subdistribution hazard ratio (sHR) of 3.64, with no significant sex difference. The sHR significantly decreased with increasing age in both sexes. Stratified analyses indicated schizophrenia but not depression or bipolar affective disorder increased the risk of AP in the patients with stroke.
Conclusion: Compared with their corresponding counterparts, the patients with schizophrenia only, stroke only, and both stroke and schizophrenia had a significantly higher sHR of 4.01, 5.16, and 8.01, respectively. The risk of AP was higher in younger stroke patients than those older than 60 years. Moreover, schizophrenia was found to increase the risk of AP in patients with stroke