Is the MENA banking sector competitive?

The purpose of this paper is to investigate the competitive conditions and revenue drivers of commercial banks in the MENA region in the context of Panzar–Rosse model. It is the first study of its kind that examines a large sample of MENA banks for an extensive period (1999–2012) during an era of political and economic unrest and transformation that includes the the global financial crisis (2007–2009). Panel data analysis using fixed effects was employed in order to examine whether the competitive conditions in MENA banks is explained by monopoly, monopolistic competition or perfect competition. Findings show that MENA banks operate under monopolistic competition, and bank-specific variables show a positive impact on revenue. These findings indicate that policymakers should relax capital adequacy requirements to guarantee the stability of the financial system. They also raise a concern that commercial banks in the MENA economies tend to concentrate on traditional lending activities, where their competitive position may be eroded in the long run by the decreasing state role of Islamic banks and by mergers that are not empirically justified for MENA banks during this period

Antibody-mediated procoagulant platelets in SARS-CoV-2-vaccination associated immune thrombotic thrombocytopenia

The COVID-19 pandemic has resulted in significant morbidity and mortality worldwide. To prevent severe infection, mass COVID-19 vaccination campaigns with several vaccine types are currently underway. We report pathological and immunological findings in 8 patients who developed vaccine-induced immune thrombotic thrombocytopenia (VITT) after administration of SARS-CoV-2 vaccine ChAdOx1 nCoV-19. We analyzed patient material using enzyme immune assays, flow cytometry and heparin-induced platelet aggregation assay and performed autopsies on two fatal cases. Eight patients (5 female, 3 male) with a median age of 41.5 years (range, 24 to 53) were referred to us with suspected thrombotic complications 6 to 20 days after ChAdOx1 nCoV-19 vaccination. All patients had thrombocytopenia at admission. Patients had a median platelet count of 46.5 x109/L (range, 8 to 92). Three had a fatal outcome and 5 were successfully treated. Autopsies showed arterial and venous thromboses in various organs and the occlusion of glomerular capillaries by hyaline thrombi. Sera from VITT patients contain high titer antibodies against platelet factor 4 (PF4) (OD 2.59±0.64). PF4 antibodies in VITT patients induced significant increase in procoagulant markers (P-selectin and phosphatidylserine externalization) compared to healthy volunteers and healthy vaccinated volunteers. The generation of procoagulant platelets was PF4 and heparin dependent. We demonstrate the contribution of antibody-mediated platelet activation in the pathogenesis of VITT

Do Investigations Of Competition Authorities Really Increase The Degree Of Competition? An Answer From Turkish Cement Market

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Acil Serviste Uzun Süreli Yatışlar: Acilin Uygunsuz Kullanımı Mı, Yaşlılığın Sonucu Mu?

Scopu

Destekli Travma Tahtası: Fizyomekanik Bir Çalışma

Introduction: The use of backboard is a widely-accepted practice for the stabilization of major trauma cases. Discomfort and pressure pain due to the use of backboard are common complications. In this study, we aimed to reduce the discomfort and pressure pain due to the use of backboard. Materials and methods: The study was carried out with 20 healthy volunteers. In the first stage, the volunteers were placed in the supine position for 5 minutes on the standard backboard(STB) and on the supported backboard(SUB). The pressures in the occipital, scapular, and sacral regions were measured while lying on an STB and an SUB. In the second stage, the volunteers were placed in the supine position on an STB or an SUB as two episodes of 60 minutes. Visual Analog Scale(VAS) was used for evaluation of the pain at 10,15,30,45 and 60th minutes. Results: When the VAS scores while lying on an STB and an SUB were compared in the volunteers, general pain and pain in the occipital, scapular, and sacral regions were found to be statistically significantly decreased at all minutes while lying on an SUB. When the pressures while lying on an STB and an SUB were compared in the volunteers, there was no statistically significant difference between the areas exposed to the pressure above the capillary filling pressure in the occipital and scapular regions. However, as a positive result, the area exposed to the pressure below the capillary filling pressure in the sacral region while lying on an SUB was found to be high at a statistically significant level. Conclusion:Although it is needed to be slightly improved in terms of the pressure due to lengthened transport time and lengthened waiting time on a backboard, the SUB, which we used to reduce pressure pain, was demonstrated to provide significant benefits.Giriş: Travma tahtası kullanımı major travma olgularının stabilizasyonu ic?in genis? o?lc?u?de kabul edilmis? bir uygulamadır. Travma tahtası kullanımına bag?lı olus?an rahatsızlık hissi ve bası ag?rısı sık kars?ılas?ılan komplikasyonlardandır. Bu c?alıs?mamızdaki amacımız travma tahtası kullanımına bag?lı olus?an rahatsızlık hissi ve bası ag?rısının azaltılmasıdır. Gereç ve Yöntem: çalışma 20 adet gönüllü ile yapılmıştır. Birinci as?amada go?nu?llu?ler, standart travma tahtası (STT) ve bu c?alıs?mada olus?turulan destekli travma tahtasına(DTT) 5 dakika su?re ile supin pozisyonda yatırılmıs?tır. STT ve DTT u?zerinde yatarken oksipital, skapular ve sakral bo?lgelerdeki olus?an basınc?lar o?lc?u?lmu?s?tu?r. I?kinci as?amada ise 60’ar dakikalık iki bo?lu?m halinde go?nu?llu?ler STT ve DTT u?zerinde supin pozisyonda yatırılmıs?tır. Bu iki bo?lu?mu?n ilk 10 dakikası olay anındaki gibi ambulans ic?erisinde gec?mis? olup, sonraki 50 dakika boyunca da kis?iler supin pozisyonda STT ve DTT u?zerinde acil serviste yatmaya devam etmis?tir. Ag?rının deg?erlendirilmesi ic?in 10, 15, 30, 45 ve 60. dakikalarda Visual Analog Skala (VAS) kullanılmıs?tır. Bulgular: Go?nu?llu?lerin DTT ve STT u?zerinde VAS kars?ılas?tırmasında tu?m sorgulama dakikalarında genel ag?rının ve oksipital bo?lge, skapular bo?lge ve sakral bo?lgelerdeki ag?rının DTT u?zerindeyken istatistiksel olarak anlamlı du?zeyde azaldıg?ı saptanmıs?tır. DTT ve STT u?zerindeyken olus?an basınc?lar kars?ılas?tırıldıg?ında; oksipital bo?lge ve skapular bo?lgelerde kapiller dolum basıncının u?zerinde basıya ug?rayan alanlar arasında istatistiksel fark bulunmamakla beraber, olumlu bir sonuc? olarak DTT u?zerindeyken sakral bo?lgede kapiller dolum basıncının altında basıya ug?rayan alan oranının anlamlı du?zeyde yu?ksek oldug?u saptanmıs?tır. Sonuc?: Travma tahtası u?zerinde transfer sırasında ve travma tahtası u?zerinde bekleme su?resinin uzaması nedeniyle olus?acak basınc? ac?ısında biraz daha gelis?tirilmeye ihtiyac? duyulmakla beraber bası ag?rılarının azaltılmasında kullanmıs? oldug?umuz DTT’nın o?nemli fayda sag?ladıg?ı ortaya konmus?tur

Vaccine Side Effects in Health Care Workers after Vaccination against SARS-CoV-2: Data from TüSeRe:exact Study

As the Corona Disease 2019 (COVID-19) caused by SARS-CoV-2 persists, vaccination is one of the key measures to contain the spread. Side effects (SE) from vaccination are one of the reasons for reluctance to vaccinate. We systematically investigated self-reported SE after the first, second, and booster vaccinations. The data were collected during the TüSeRe: exact study (Tübinger Monitoring Studie zur exakten Analyse der Immunantwort nach Vakzinierung). Employees of health and research institutions were invited to participate. Study participants were asked to fill out an online questionnaire and report their SE after each dose of SARS-CoV-2 vaccination. A total of 1046 participants (mean age: 44 ± 12.9 years; female, n = 815 (78%); male, n = 231 (22%)) were included in the analysis. Local and systemic SE were more frequent after receiving the vector-based vaccine ChAdOx1 nCoV-19 in the first vaccination. However, local and systemic SE were more common after receiving mRNA vaccines (BNT162b2, mRNA-1273) in the second vaccination. Compared to the BNT162b2 vaccine, more SE have been observed after receiving the mRNA-1273 vaccine in the booster vaccination. In multivariate analysis, local and systemic side effects were associated with vaccine type, age and gender. Local and systemic SE are common after SARS-CoV-2 vaccines. The frequency of self-reported local and systemic SE differ significantly between mRNA and vector-based vaccines