Ecological Modernization at the Intersection of Environment and Energy

Contemporary environmental policy is marked by an emphasis on the fight against climate change. Technological improvements for energy efficiency and transition to a low carbon economy are seen as principal environmental policy measures. Has this been the case 40 years ago when modern environmental policy took its first leap? Or has it been the result of a particular twist in the course of the development of environmental policy? Taking sides with the latter approach, it is argued that the intertwining of environmental and energy policy is attributable to ecological modernization that has become the dominant interpretation of sustainable development. Accordingly, this article focuses on ecological modernization theory and policy strategy in an aim to capture this turn. Empirical evidence will be provided through an analysis of European Union (EU) environmental policy. It will be demonstrated how EU environmental policy takes its direction from ecological modernization and how energy efficiency lies at its core. Keywords: sustainable development; ecological modernization; fight against climate change JEL Classifications: Q01; Q54; Q5

Investigation of sperm chromatin condensation by aniline blue staining in infertile men with normal and abnormal semen parameters

Aim: To evaluate the relationship between sperm chromatin condensation assessed by aniline blue staining and semen parameters in infertile men. Methods: Infertile men applied to our urology clinics and diagnosed with normozoospermia (n=50), asthenozoospermia (n=17), oligozoospermia (n=3), teratozoospermia (n=2) oligoasthenoteratozoospermia (OAT) (n=10) according to their semen analysis were included in the study. Semen samples were evaluated for sperm chromatin condensation by aniline blue staining. Results: The percentage of aniline-positive spermatozoa in the OAT and teratozoospermia group was found to be higher than in the normozoospermic and asthenozoospermic infertile groups (p=0.002, p=0.044 with normozoospermia group and p=0.026, p=0.007 with asthenozoospermia group, respectively). Sperm chromatin condensation was negatively correlated with sperm concentration (p=0.003, r=-0.322), total sperm count (p=0.004, r=-0.313), total progressive motile sperm count (p=0.005, r=-0.307), and normal morphology (p<0.0001, r=-0.554); and positively correlated with the percentage of immotile sperm (p=0.037, r=0.230). Conclusion: Sperm chromatin condensation was found to be different in infertile men differently diagnosed based on their semen analysis. The results of the study suggest that chromatin condensation, together with routine sperm parameters, may constitute a valuable parameter in the evaluation of male fertility

Kartlı ödeme sistemlerinin finansal davranış ve tutum üzerindeki etkisi: Elazığ-Malatya ili AVM müşterileri örneği

Günümüzde insanların ihtiyaçları geçmişe nazaran oldukça farklılaşmış ve çeşitlilik kazanmıştır. Çeşitlenen bu ihtiyaçların giderilmesi amacıyla da birçok yenilik hayatımıza dahil olmuştur. Bu yeniliklerden biri ve belki de en yaygın olanı kartlı ödeme sistemleridir. Toplumun her kesimini ilgilendiren, dolayısıyla AVM müşterilerini de yakından ilgilendiren kartlı ödeme sitemlerinin finansal davranış ve tutum üzerinde ki etkisi önemli bir konu olarak karşımıza çıkmaktadır. Bu kapsamda, çalışmanın temel amacı AVM müşterilerinin kullandıkları kredi kartlarının bireylerin finansal davranış ve tutum üzerindeki etkisini belirlemektir. Finansal davranış ve tutum düzeyleri, frekans yüzde dağılımlarıyla belirlenmeye çalışılmıştır. Ki-kare testiyle demografik özellikler ile finansal davranış ve tutum vekartlı ödeme sistemleri arasındaki ilişkiler araştırılmıştır. Yapılan analizlerin sonucunda finansal tutum ile finansal davranış arasında ilişki olduğu ve AVM müşterilerinin kredi kartına olan tutum ve davranışları ile kredi kartı kullanım durumu arasında anlamlı bir ilişki olduğu belirlenmiştir.Today, people's needs are highly differentiated and diversified compared to the past. Many innovations have been incorporated into our lives in order to overcome these varied needs. One of these innovations and perhaps the most common is card payment systems. The effect of the card payment systems on financial attitudes and attitudes that interested in every segment of the society and that closely related to the shopping center customers is an important issue. In this context, the main purpose of the study is to determine the effect of the credit cards used by the shopping center customers on the financial behavior and attitude of the individuals. Financial behavior and attitude levels were tried to be determined by frequency percent distributions. The relationship between demographic characteristics and financial behavior and attitude and card payment systems was investigated by chi-square test. As a result of the analysis, it is determined that there is a relationship between financial attitude and financial behavior and that there is a meaningful relationship between the attitudes and behaviors of shopping center customers to their credit cards and the usage of credit cards

Factors influencing the prognosis in Braf wild-type metastatic malignant melanoma and the role of novel inflammation indices

Background and Design: This study aims to investigate the prognostic factors in BRAF wild-type metastatic cutaneous melanoma and the prognostic role of inflammation indices. Materials and Methods: Metastatic BRAF wild-type cutaneous melanoma patients who presented to our clinic between 2011 and 2021 were enrolled. To investigate their prognostic roles, age, gender, performance status, first immunotherapy regimen received by the patient, metastatic sites, and seven inflammation indices [C-reactive protein (CRP)/albumin ratio (CAR), neutrophil lymphocyte ratio (NLR), prognostic nutritional index (PNI), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and advanced lung cancer inflammation index (ALI) and hemoglobin, albumin levels, lymphocyte and platelet counts (HALP)] were studied. Results: Fourty-seven patients, consisting of 22 (46.8%) females and 25 (53.2%) males, were included in this study. Mean patient age was 54 (18-88) years. In our study, there were 16 (34%) patients with liver metastasis, 17 (36.2%) patients with lung metastasis, and 9 (19.1%) patients with brain metastasis. As immunotherapy, 34 (72.3%) patients had received Nivolumab, while 13 (27.7%) patients had received Ipilimumab therapy. When the relationships of the prognostic variables with overall survival were inspected in univariate and multivariate analyses, brain metastasis was found to be an independent prognostic factor (p=0.02). Lung metastasis approached the threshold of statistical significance in univariate analysis (p=0.09) and liver metastasis in multivariate analysis (p=0.07). The seven inflammation indices examined in the analyses [CAR, NLR, PNI, PLR, SII ALI and HALP] were found to have no prognostic role in both univariate and multivariate analyses. Conclusion: Our study determined that brain metastasis is an independent poor prognostic factor in BRAF wild-type metastatic melanoma. Prognostic roles of the CAR, NLR, PNI, PLR, SII ALI and HALP indices could not be demonstrated

Effects of immunosuppressive drugs on COVID-19 severity in patients with autoimmune hepatitis

Background: We investigated associations between baseline use of immunosuppressive drugs and severity of Coronavirus Disease 2019 (COVID-19) in autoimmune hepatitis (AIH). Patients and methods: Data of AIH patients with laboratory confirmed COVID-19 were retrospectively collected from 15 countries. The outcomes of AIH patients who were on immunosuppression at the time of COVID-19 were compared to patients who were not on AIH medication. The clinical courses of COVID-19 were classified as (i)-no hospitalization, (ii)-hospitalization without oxygen supplementation, (iii)-hospitalization with oxygen supplementation by nasal cannula or mask, (iv)-intensive care unit (ICU) admission with non-invasive mechanical ventilation, (v)-ICU admission with invasive mechanical ventilation or (vi)-death and analysed using ordinal logistic regression. Results: We included 254 AIH patients (79.5%, female) with a median age of 50 (range, 17-85) years. At the onset of COVID-19, 234 patients (92.1%) were on treatment with glucocorticoids (n = 156), thiopurines (n = 151), mycophenolate mofetil (n = 22) or tacrolimus (n = 16), alone or in combinations. Overall, 94 (37%) patients were hospitalized and 18 (7.1%) patients died. Use of systemic glucocorticoids (adjusted odds ratio [aOR] 4.73, 95% CI 1.12-25.89) and thiopurines (aOR 4.78, 95% CI 1.33-23.50) for AIH was associated with worse COVID-19 severity, after adjusting for age-sex, comorbidities and presence of cirrhosis. Baseline treatment with mycophenolate mofetil (aOR 3.56, 95% CI 0.76-20.56) and tacrolimus (aOR 4.09, 95% CI 0.69-27.00) were also associated with more severe COVID-19 courses in a smaller subset of treated patients. Conclusion: Baseline treatment with systemic glucocorticoids or thiopurines prior to the onset of COVID-19 was significantly associated with COVID-19 severity in patients with AIH.Fil: Efe, Cumali. Harran University Hospita; TurquíaFil: Lammert, Craig. University School of Medicine Indianapolis; Estados UnidosFil: Taşçılar, Koray. Universitat Erlangen-Nuremberg; AlemaniaFil: Dhanasekaran, Renumathy. University of Stanford; Estados UnidosFil: Ebik, Berat. Gazi Yasargil Education And Research Hospital; TurquíaFil: Higuera de la Tijera, Fatima. Hospital General de México; MéxicoFil: Calışkan, Ali R.. No especifíca;Fil: Peralta, Mirta. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas "Dr. Francisco Javier Muñiz"; ArgentinaFil: Gerussi, Alessio. Università degli Studi di Milano; ItaliaFil: Massoumi, Hatef. No especifíca;Fil: Catana, Andreea M.. Harvard Medical School; Estados UnidosFil: Purnak, Tugrul. University of Texas; Estados UnidosFil: Rigamonti, Cristina. Università del Piemonte Orientale ; ItaliaFil: Aldana, Andres J. G.. Fundacion Santa Fe de Bogota; ColombiaFil: Khakoo, Nidah. Miami University; Estados UnidosFil: Nazal, Leyla. Clinica Las Condes; ChileFil: Frager, Shalom. Montefiore Medical Center; Estados UnidosFil: Demir, Nurhan. Haseki Training And Research Hospital; TurquíaFil: Irak, Kader. Kanuni Sultan Suleyman Training And Research Hospital; TurquíaFil: Melekoğlu Ellik, Zeynep. Ankara University Medical Faculty; TurquíaFil: Kacmaz, Hüseyin. Adıyaman University; TurquíaFil: Balaban, Yasemin. Hacettepe University; TurquíaFil: Atay, Kadri. No especifíca;Fil: Eren, Fatih. No especifíca;Fil: Alvares da-Silva, Mario R.. Universidade Federal do Rio Grande do Sul; BrasilFil: Cristoferi, Laura. Università degli Studi di Milano; ItaliaFil: Urzua, Álvaro. Universidad de Chile; ChileFil: Eşkazan, Tuğçe. Cerrahpaşa School of Medicine; TurquíaFil: Magro, Bianca. No especifíca;Fil: Snijders, Romee. No especifíca;Fil: Barutçu, Sezgin. No especifíca;Fil: Lytvyak, Ellina. University of Alberta; CanadáFil: Zazueta, Godolfino M.. Instituto Nacional de la Nutrición Salvador Zubiran; MéxicoFil: Demirezer Bolat, Aylin. Ankara City Hospital; TurquíaFil: Aydın, Mesut. Van Yuzuncu Yil University; TurquíaFil: Amorós Martín, Alexandra Noemí. No especifíca;Fil: De Martin, Eleonora. No especifíca;Fil: Ekin, Nazım. No especifíca;Fil: Yıldırım, Sümeyra. No especifíca;Fil: Yavuz, Ahmet. No especifíca;Fil: Bıyık, Murat. Necmettin Erbakan University; TurquíaFil: Narro, Graciela C.. Instituto Nacional de la Nutrición Salvador Zubiran; MéxicoFil: Bıyık, Murat. Uludag University; TurquíaFil: Kıyıcı, Murat. No especifíca;Fil: Kahramanoğlu Aksoy, Evrim. No especifíca;Fil: Vincent, Maria. No especifíca;Fil: Carr, Rotonya M.. University of Pennsylvania; Estados UnidosFil: Günşar, Fulya. No especifíca;Fil: Reyes, Eira C.. Hepatology Unit. Hospital Militar Central de México; MéxicoFil: Harputluoğlu, Murat. Inönü University School of Medicine; TurquíaFil: Aloman, Costica. Rush University Medical Center; Estados UnidosFil: Gatselis, Nikolaos K.. University Hospital Of Larissa; GreciaFil: Üstündağ, Yücel. No especifíca;Fil: Brahm, Javier. Clinica Las Condes; ChileFil: Vargas, Nataly C. E.. Hospital Nacional Almanzor Aguinaga Asenjo; PerúFil: Güzelbulut, Fatih. No especifíca;Fil: Garcia, Sandro R.. Hospital Iv Víctor Lazarte Echegaray; PerúFil: Aguirre, Jonathan. Hospital Angeles del Pedregal; MéxicoFil: Anders, Margarita. Hospital Alemán; ArgentinaFil: Ratusnu, Natalia. Hospital Regional de Ushuaia; ArgentinaFil: Hatemi, Ibrahim. No especifíca;Fil: Mendizabal, Manuel. Universidad Austral; ArgentinaFil: Floreani, Annarosa. Università di Padova; ItaliaFil: Fagiuoli, Stefano. No especifíca;Fil: Silva, Marcelo. Universidad Austral; ArgentinaFil: Idilman, Ramazan. No especifíca;Fil: Satapathy, Sanjaya K.. No especifíca;Fil: Silveira, Marina. University of Yale. School of Medicine; Estados UnidosFil: Drenth, Joost P. H.. No especifíca;Fil: Dalekos, George N.. No especifíca;Fil: N.Assis, David. University of Yale. School of Medicine; Estados UnidosFil: Björnsson, Einar. No especifíca;Fil: Boyer, James L.. University of Yale. School of Medicine; Estados UnidosFil: Yoshida, Eric M.. University of British Columbia; CanadáFil: Invernizzi, Pietro. Università degli Studi di Milano; ItaliaFil: Levy, Cynthia. University of Miami; Estados UnidosFil: Montano Loza, Aldo J.. University of Alberta; CanadáFil: Schiano, Thomas D.. No especifíca;Fil: Ridruejo, Ezequiel. Universidad Austral; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; ArgentinaFil: Wahlin, Staffan. No especifíca

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Ecological modernization at the intersection of environment and energy

Sezgin, Zeynep (Dogus Author)Contemporary environmental policy is marked by an emphasis on the fight against climate change. Technological improvements for energy efficiency and transition to a low carbon economy are seen as principal environmental policy measures. Has this been the case 40 years ago when modern environmental policy took its first leap? Or has it been the result of a particular twist in the course of the development of environmental policy? Taking sides with the latter approach, it is argued that the intertwining of environmental and energy policy is attributable to ecological modernization that has become the dominant interpretation of sustainable development. Accordingly, this article focuses on ecological modernization theory and policy strategy in an aim to capture this turn. Empirical evidence will be provided through an analysis of European Union (EU) environmental policy. It will be demonstrated how EU environmental policy takes its direction from ecological modernization and how energy efficiency lies at its core