Energy security assessment provides a benchmark for policy analysis and identifies the challenges for ensuring energy supplies as well. This paper develops a composite index for assessing the oil ...supply risk of South Asian countries. The index is based on a comprehensive set of indicators including the ratio of imported oil over GDP, geopolitical risk, market liquidity, GDP per capita, ratio of oil imports over consumption, diversification, oil price volatility, US$ volatility and transportation risk. Results reveal that India is the least oil vulnerable country while Afghanistan and Bangladesh are the most oil vulnerable countries. India's leading score reflects a higher potential to change the oil suppliers while Afghanistan, Bangladesh, Bhutan, and Nepal have the least score confirming them as the highest supply risk associated countries. Policies such as adopting renewable energy technologies, generating nuclear power, diversifying export sources and cutting down oil subsidies can help reduce the impact of oil supply risk.
•We develop a composite index for assessing the oil supply risk of South Asian countries.•A mathematical programming approach is used to constructing the index.•India is found to be the least oil vulnerable country.•Afghanistan and Bangladesh are the most oil vulnerable countries.
The safety and efficacy of different anti-diabetic drugs are not clear because of the lack of sufficiently powered clinical trials. This network meta-analysis was conducted to compare the efficacy ...and safety of three anti-diabetic drugs (insulin, glyburide, and metformin), and rank them as per their efficiency to control glucose levels, pregnancy, and neonatal outcomes. The study design is a systematic review, meta-analysis, and network meta-analysis. After a systematic search of existing databases, 34 randomized controlled trials were selected for inclusion in the analysis. We did pairwise network meta-analysis to calculate standardized mean difference and odds ratio (OR) as the summary measures for numerical and dichotomous variables, respectively, by using random-effects model. Our key outcomes were incidence of neonatal hypoglycemia, respiratory distress syndrome, macrosomia, C-section, admission to neonatal intensive care unit (NICU) and mean differences in the birth weight of neonates, gestational age at birth, HbA1C levels, fasting blood sugar, large at gestational age, and post-prandial glucose. It was found that metformin significantly lowered the post-prandial levels of glucose as compared with both glyburide and insulin in pairwise analysis (SMD = 14.11 23-4.8; SMD = 22.45 30-14), respectively. There was a significant reduction in birth weights of babies whose mothers were administered metformin as compared with either glyburide or insulin. The proportion of neonates admission to NICU was significantly lower for metformin when compared with insulin Log OR = 0.334 (0.0184, 0.6814)). Large at gestational age was significantly lower for metformin as compared with both glyburide and insulin log OR = 0.6882 (0.171, 1.329), log OR = 0.393 (0.00179, 0.8218), respectively. Oral anti-diabetic drugs especially metformin performed better than both glyburide and insulin for all neonatal and maternal outcomes except that it significantly lowered the neonatal birth weight.
Present study examined the influence of high-temperature stress and different biochar and phosphorus (P) fertilization treatments on the growth, grain yield and quality of two rice cultivars (IR-64 ...and Huanghuazhan). Plants were subjected to high day temperature-HDT (35 °C ± 2), high night temperature-HNT (32 °C ± 2), and control temperature-CT (28 °C ± 2) in controlled growth chambers. The different fertilization treatments were control, biochar alone, phosphorous (P) alone and biochar + P. High-temperature stress severely reduced the photosynthesis, stomatal conductance, water use efficiency, and increased the leaf water potential of both rice cultivars. Grain yield and its related attributes except for number of panicles, were reduced under high temperature. The HDT posed more negative effects on rice physiological attributes, while HNT was more destructive for grain yield. High temperature stress also hampered the grain appearance and milling quality traits in both rice cultivars. The Huanghuazhan performed better than IR-64 under high-temperature stress with better growth and higher grain yield. Different soil fertilization treatments were helpful in ameliorating the detrimental effects of high temperature. Addition of biochar alone improved some growth and yield parameters but such positive effects were lower when compared with the combined application of biochar and P. The biochar+P application recorded 7% higher grain yield (plant−1) of rice compared with control averaged across different temperature treatments and cultivars. The highest grain production and better grain quality in biochar+P treatments might be due to enhanced photosynthesis, water use efficiency, and grain size, which compensated the adversities of high temperature stress.
•Influence of high temperature stress and soil fertilization treatments on morpho-physiological growth, yield and quality of rice.•HDT posed more negative effects on rice physiological attributes, while HNT was more destructive for grain formation and yield.•HHZ performed better than IR-64 under high-temperature stress.•Combined application of biochar+P recorded was the most effective treatments.•Enhanced A, WUE, and grain size in biochar+P treatments compensated the adversities of high temperature stress.
Pancreatic cancer is an aggressive malignancy with a poor prognosis. The disease and its treatment can cause significant nutritional impairments that often adversely impact patient quality of life ...(QOL). The pancreas has both exocrine and endocrine functions and, in the setting of cancer, both systems may be affected. Pancreatic exocrine insufficiency (PEI) manifests as weight loss and steatorrhea, while endocrine insufficiency may result in diabetes mellitus. Surgical resection, a central component of pancreatic cancer treatment, may induce or exacerbate these dysfunctions. Nutritional and metabolic dysfunctions in patients with pancreatic cancer lack characterization, and few guidelines exist for nutritional support in patients after surgical resection. We reviewed publications from the past two decades (1995-2016) addressing the nutritional and metabolic status of patients with pancreatic cancer, grouping them into status at the time of diagnosis, status at the time of resection, and status of nutritional support throughout the diagnosis and treatment of pancreatic cancer. Here, we summarize the results of these investigations and evaluate the effectiveness of various types of nutritional support in patients after pancreatectomy for pancreatic adenocarcinoma (PDAC). We outline the following conservative perioperative strategies to optimize patient outcomes and guide the care of these patients: (1) patients with albumin < 2.5 mg/dL or weight loss > 10% should postpone surgery and begin aggressive nutrition supplementation; (2) patients with albumin < 3 mg/dL or weight loss between 5% and 10% should have nutrition supplementation prior to surgery; (3) enteral nutrition (EN) should be preferred as a nutritional intervention over total parenteral nutrition (TPN) postoperatively; and, (4) a multidisciplinary approach should be used to allow for early detection of symptoms of endocrine and exocrine pancreatic insufficiency alongside implementation of appropriate treatment to improve the patient's quality of life.
Summary Background Acute exposure to air pollution has been linked to myocardial infarction, but its effect on heart failure is uncertain. We did a systematic review and meta-analysis to assess the ...association between air pollution and acute decompensated heart failure including hospitalisation and heart failure mortality. Methods Five databases were searched for studies investigating the association between daily increases in gaseous (carbon monoxide, sulphur dioxide, nitrogen dioxide, ozone) and particulate (diameter <2·5 μm PM2·5 or <10 μm PM10 ) air pollutants, and heart failure hospitalisations or heart failure mortality. We used a random-effects model to derive overall risk estimates per pollutant. Findings Of 1146 identified articles, 195 were reviewed in-depth with 35 satisfying inclusion criteria. Heart failure hospitalisation or death was associated with increases in carbon monoxide (3·52% per 1 part per million; 95% CI 2·52–4·54), sulphur dioxide (2·36% per 10 parts per billion; 1·35–3·38), and nitrogen dioxide (1·70% per 10 parts per billion; 1·25–2·16), but not ozone (0·46% per 10 parts per billion; −0·10 to 1·02) concentrations. Increases in particulate matter concentration were associated with heart failure hospitalisation or death (PM2·5 2·12% per 10 μg/m3 , 95% CI 1·42–2·82; PM10 1·63% per 10 μg/m3 , 95% CI 1·20–2·07). Strongest associations were seen on the day of exposure, with more persistent effects for PM2·5 . In the USA, we estimate that a mean reduction in PM2·5 of 3·9 μg/m3 would prevent 7978 heart failure hospitalisations and save a third of a billion US dollars a year. Interpretation Air pollution has a close temporal association with heart failure hospitalisation and heart failure mortality. Although more studies from developing nations are required, air pollution is a pervasive public health issue with major cardiovascular and health economic consequences, and it should remain a key target for global health policy. Funding British Heart Foundation.
Primary graft dysfunction (PGD) is the main cause of early morbidity and mortality after lung transplantation. Previous studies have yielded conflicting results for PGD risk factors.
We sought to ...identify donor, recipient, and perioperative risk factors for PGD.
We performed a 10-center prospective cohort study enrolled between March 2002 and December 2010 (the Lung Transplant Outcomes Group). The primary outcome was International Society for Heart and Lung Transplantation grade 3 PGD at 48 or 72 hours post-transplant. The association of potential risk factors with PGD was analyzed using multivariable conditional logistic regression.
A total of 1,255 patients from 10 centers were enrolled; 211 subjects (16.8%) developed grade 3 PGD. In multivariable models, independent risk factors for PGD were any history of donor smoking (odds ratio OR, 1.8; 95% confidence interval CI, 1.2-2.6; P = 0.002); FiO2 during allograft reperfusion (OR, 1.1 per 10% increase in FiO2; 95% CI, 1.0-1.2; P = 0.01); single lung transplant (OR, 2; 95% CI, 1.2-3.3; P = 0.008); use of cardiopulmonary bypass (OR, 3.4; 95% CI, 2.2-5.3; P < 0.001); overweight (OR, 1.8; 95% CI, 1.2-2.7; P = 0.01) and obese (OR, 2.3; 95% CI, 1.3-3.9; P = 0.004) recipient body mass index; preoperative sarcoidosis (OR, 2.5; 95% CI, 1.1-5.6; P = 0.03) or pulmonary arterial hypertension (OR, 3.5; 95% CI, 1.6-7.7; P = 0.002); and mean pulmonary artery pressure (OR, 1.3 per 10 mm Hg increase; 95% CI, 1.1-1.5; P < 0.001). PGD was significantly associated with 90-day (relative risk, 4.8; absolute risk increase, 18%; P < 0.001) and 1-year (relative risk, 3; absolute risk increase, 23%; P < 0.001) mortality.
We identified grade 3 PGD risk factors, several of which are potentially modifiable and should be prioritized for future research aimed at preventative strategies. Clinical trial registered with www.clinicaltrials.gov (NCT 00552357).
The present study was undertaken to explore the effect of piperine in obesity-induced dyslipidemia.
Male Sprague Dawley rats were fed high-fat diet (HFD) for the first eight weeks, to develop ...obesity-induced dyslipidemia. Later on piperine (40 mg / kg) and sibutramine (5 mg / kg) were administered for three weeks along with the continuation of HFD to two separate groups, which served as the test and standard groups, respectively. Body weight, food intake, serum triglyceride, total cholesterol, LDL, VLDL, and HDL were measured at the end of the fourth, eighth (before treatment), and eleventh (after treatment) week, while the fat mass was measured at the end of the eleventh week in the normal, HFD-control, test, and standard groups.
Supplementing piperine with HFD significantly reduced not only body weight, triglyceride, total cholesterol, LDL, VLDL, and fat mass, but also increased the HDL levels, with no change in food intake.
The above results suggest that piperine possesses potential fat reducing and lipid lowering effects, without any change in food appetite, at a small dose of 40 mg / kg. The mechanism of action for such an activity needs to be determined. However, looking to structural similarity with the presently known Melanocortin-4 (MC-4) agonists, involvement of MC-4 receptors in its activity can be guessed.
Since polymeric materials do not decompose easily, disposal of waste polymers is a serious environmental concern. Widespread studies on the biodegradation of rubbers have been carried out in order to ...overcome the environmental problems associated with rubber waste. This report provides an overview on the microbial degradation of natural and synthetic rubbers. Rubber degrading microbes, bacteria and fungi, are ubiquitous in the environment especially soil. The qualitative data like plate assay, scanning electron microscopy (SEM), attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR) and Sturm test indicated that both natural and synthetic rubbers can be degraded by microorganisms. It has confirmed that the enzymes latex clearing protein (Lcp) and rubber oxygenase A (RoxA) are responsible for the degradation of natural and synthetic rubbers. Lcp was obtained from Gram-positive bacterium Streptomyces sp. strain K30 and RoxA from Gram-negative bacterium Xanthomonas sp. strain 35Y. Analysis of degradation products of natural and synthetic rubbers indicated the oxidative cleavage of double bonds in polymer backbone. Aldehydes, ketones and other carbonyl groups were detected as degradation products from cultures of various rubber degrading strains. This review emphasizes the importance of biodegradation in environmental biotechnology for waste rubber disposal.
•Degradation of rubber by various bacterial and fungal species have been discussed.•Methods used for analysis of biodegradation of plastics have been discussed.•Role of different enzymes in degradation of rubbers has also been discussed.•Pathway of degradation of rubbers has been explained.
Phosphate-solubilizing bacteria (PSB) reduce the negative effects of soil calcification on soil phosphorus (P) nutrition. In this incubation study, we explored the ability of PSB (control and ...inoculated) to release P from different P sources single super phosphate (SSP), rock phosphate (RP), poultry manure (PM) and farm yard manure (FYM) with various soil lime contents (4.78, 10, 15 and 20%) in alkaline soil. PSB inoculation progressively enriched Olsen extractable P from all sources compared to the control over the course of 56 days; however, this increase was greater from organic sources (PM and FYM) than from mineral P sources (SSP and RP). Lime addition to the soil decreased bioavailable P, but this effect was largely neutralized by PSB inoculation. PSB were the most viable in soil inoculated with PSB and amended with organic sources, while lime addition decreased PSB survival. Our findings imply that PSB inoculation can counteract the antagonistic effect of soil calcification on bioavailable P when it is applied using both mineral and organic sources, although organic sources support this process more efficiently than do mineral P sources. Therefore, PSB inoculation combined with organic manure application is one of the best options for improving soil P nutrition.
There is limited evidence on the use of high-sensitivity C-reactive protein (hsCRP) as a biomarker for selecting patients for advanced cardiovascular (CV) therapies in the modern era. The prognostic ...value of mildly elevated hsCRP beyond troponin in a large real-world cohort of unselected patients presenting with suspected acute coronary syndrome (ACS) is unknown. We evaluated whether a mildly elevated hsCRP (up to 15 mg/L) was associated with mortality risk, beyond troponin level, in patients with suspected ACS.
We conducted a retrospective cohort study based on the National Institute for Health Research Health Informatics Collaborative data of 257,948 patients with suspected ACS who had a troponin measured at 5 cardiac centres in the United Kingdom between 2010 and 2017. Patients were divided into 4 hsCRP groups (<2, 2 to 4.9, 5 to 9.9, and 10 to 15 mg/L). The main outcome measure was mortality within 3 years of index presentation. The association between hsCRP levels and all-cause mortality was assessed using multivariable Cox regression analysis adjusted for age, sex, haemoglobin, white cell count (WCC), platelet count, creatinine, and troponin. Following the exclusion criteria, there were 102,337 patients included in the analysis (hsCRP <2 mg/L (n = 38,390), 2 to 4.9 mg/L (n = 27,397), 5 to 9.9 mg/L (n = 26,957), and 10 to 15 mg/L (n = 9,593)). On multivariable Cox regression analysis, there was a positive and graded relationship between hsCRP level and mortality at baseline, which remained at 3 years (hazard ratio (HR) (95% CI) of 1.32 (1.18 to 1.48) for those with hsCRP 2.0 to 4.9 mg/L and 1.40 (1.26 to 1.57) and 2.00 (1.75 to 2.28) for those with hsCRP 5 to 9.9 mg/L and 10 to 15 mg/L, respectively. This relationship was independent of troponin in all suspected ACS patients and was further verified in those who were confirmed to have an ACS diagnosis by clinical coding. The main limitation of our study is that we did not have data on underlying cause of death; however, the exclusion of those with abnormal WCC or hsCRP levels >15 mg/L makes it unlikely that sepsis was a major contributor.
These multicentre, real-world data from a large cohort of patients with suspected ACS suggest that mildly elevated hsCRP (up to 15 mg/L) may be a clinically meaningful prognostic marker beyond troponin and point to its potential utility in selecting patients for novel treatments targeting inflammation.
ClinicalTrials.gov - NCT03507309.
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