The use of fossil fuel-based vehicles may gradually be replaced by electric vehicles in the future. The trend indicates that the number of users of electric vehicles, especially electric cars,... Show moreThe use of fossil fuel-based vehicles may gradually be replaced by electric vehicles in the future. The trend indicates that the number of users of electric vehicles, especially electric cars, continues to increase. Indonesia is well-positioned to take advantage of this opportunity as it has the world’s largest nickel reserves, an essential raw material for making electric vehicle batteries (EVB). The study examines the economic and environmental implications if Indonesia were to successfully set up electric vehicle (EV) production rather than exporting such raw materials overseas. We use an input–output model to estimate electric vehicle production’s economic and environmental impacts in Indonesia. This study assumes that nickel, which is usually exported, is absorbed by domestic economic activities, including being used in manufacturing batteries and electric vehicles in Indonesia. Our estimates include direct and indirect output, value-added, and employment changes. The same model is also used to estimate changes in emissions’ environmental costs. It is evident from the results that batteries and EV production are economically beneficial. Additional value-added is Rp. 100.57 trillion, 1.5% of GDP in 2010. At the same time, 538,658 additional jobs were created, which is about a 0.5% increase. Lastly, EV production will have extra external costs of emissions, around Rp. 2.23 trillion, or an increase of about 0.6%. Based on these findings, it is concluded that electric vehicle production increases productivity, gross value-added, and job creation with a relatively small impact on the environment. A limitation of this study is that we assumed EVs were produced for export only, and we did not assume a reduction in economic activities in the supply chain of conventional vehicles. Show less
Background The major complication of COVID-19 is hypoxaemic respiratory failure from capillary leak and alveolar oedema. Experimental and early clinical data suggest that the tyrosine-kinase... Show moreBackground The major complication of COVID-19 is hypoxaemic respiratory failure from capillary leak and alveolar oedema. Experimental and early clinical data suggest that the tyrosine-kinase inhibitor imatinib reverses pulmonary capillary leak.Methods This randomised, double-blind, placebo-controlled, clinical trial was done at 13 academic and non-academic teaching hospitals in the Netherlands. Hospitalised patients (aged >= 18 years) with COVID-19, as confirmed by an RT-PCR test for SARS-CoV-2, requiring supplemental oxygen to maintain a peripheral oxygen saturation of greater than 94% were eligible. Patients were excluded if they had severe pre-existing pulmonary disease, had pre-existing heart failure, had undergone active treatment of a haematological or non-haematological malignancy in the previous 12 months, had cytopenia, or were receiving concomitant treatment with medication known to strongly interact with imatinib. Patients were randomly assigned (1:1) to receive either oral imatinib, given as a loading dose of 800 mg on day 0 followed by 400 mg daily on days 1-9, or placebo. Randomisation was done with a computer-based clinical data management platform with variable block sizes (containing two, four, or six patients), stratified by study site. The primary outcome was time to discontinuation of mechanical ventilation and supplemental oxygen for more than 48 consecutive hours, while being alive during a 28-day period. Secondary outcomes included safety, mortality at 28 days, and the need for invasive mechanical ventilation. All efficacy and safety analyses were done in all randomised patients who had received at least one dose of study medication (modified intention-to-treat population). This study is registered with the EU Clinical Trials Register (EudraCT 2020-001236-10).Findings Between March 31, 2020, and Jan 4, 2021, 805 patients were screened, of whom 400 were eligible and randomly assigned to the imatinib group (n=204) or the placebo group (n=196). A total of 385 (96%) patients (median age 64 years [IQR 56-73]) received at least one dose of study medication and were included in the modified intention-to-treat population. Time to discontinuation of ventilation and supplemental oxygen for more than 48 h was not significantly different between the two groups (unadjusted hazard ratio [HR] 0.95 [95% CI 0.76-1.20]). At day 28, 15 (8%) of 197 patients had died in the imatinib group compared with 27 (14%) of 188 patients in the placebo group (unadjusted HR 0.51 [0.27-0.95]). After adjusting for baseline imbalances between the two groups (sex, obesity, diabetes, and cardiovascular disease) the HR for mortality was 0.52 (95% CI 0.26-1.05). The HR for mechanical ventilation in the imatinib group compared with the placebo group was 1.07 (0.63-1.80; p=0.81). The median duration of invasive mechanical ventilation was 7 days (IQR 3-13) in the imatinib group compared with 12 days (6-20) in the placebo group (p=0.0080). 91 (46%) of 197 patients in the imatinib group and 82 (44%) of 188 patients in the placebo group had at least one grade 3 or higher adverse event. The safety evaluation revealed no imatinib-associated adverse events.Interpretation The study failed to meet its primary outcome, as imatinib did not reduce the time to discontinuation of ventilation and supplemental oxygen for more than 48 consecutive hours in patients with COVID-19 requiring supplemental oxygen. The observed effects on survival (although attenuated after adjustment for baseline imbalances) and duration of mechanical ventilation suggest that imatinib might confer clinical benefit in hospitalised patients with COVID-19, but further studies are required to validate these findings. Copyright (C) 2021 Elsevier Ltd. All rights reserved. Show less
The desire to include environmental information in national accounts has resulted in the construction of a system of environmental-economic accounting (SEEA). As the international statistical... Show moreThe desire to include environmental information in national accounts has resulted in the construction of a system of environmental-economic accounting (SEEA). As the international statistical standard for environmental-economic accounting, the SEEA can provide valuable support for monitoring Sustainable Development Goals (SDGs). This study assesses the potential use of the SEEA for monitoring SDGs. This paper shows that, in theory, the potential for this system is significant. However, based on a literature review and survey of SEEA experts, practical problems in implementing the SEEA are significant, especially in developing countries. Such issues include data availability and quality, as well as the availability of funding and human resources. Capacity development is key to establishing successful implementation of the SEEA in developing countries. For example, the World Bank’s WAVES program (Wealth Accounting and Valuation of Ecosystem Services) has been instrumental in capacity building in developing countries, which, however, still show great variation in how they implement SEEA. Show less
BACKGROUND\nSchizophrenia is associated with lower intelligence and poor educational performance relative to the general population. This is, to a lesser degree, also found in first-degree... Show moreBACKGROUND\nSchizophrenia is associated with lower intelligence and poor educational performance relative to the general population. This is, to a lesser degree, also found in first-degree relatives of schizophrenia patients. It is unclear whether bipolar disorder I (BD-I) patients and their relatives have similar lower intellectual and educational performance as that observed in schizophrenia.\nMETHOD\nThis cross-sectional study investigated intelligence and educational performance in two outpatient samples [494 BD-I patients, 952 schizophrenia spectrum (SCZ) patients], 2231 relatives of BD-I and SCZ patients, 1104 healthy controls and 100 control siblings. Mixed-effects and regression models were used to compare groups on intelligence and educational performance.\nRESULTS\nBD-I patients were more likely to have completed the highest level of education (odds ratio 1.88, 95% confidence interval 1.66-2.70) despite having a lower IQ compared to controls (β = -9.09, s.e. = 1.27, p < 0.001). In contrast, SCZ patients showed both a lower IQ (β = -15.31, s.e. = 0.86, p < 0.001) and lower educational levels compared to controls. Siblings of both patient groups had significantly lower IQ than control siblings, but did not differ on educational performance. IQ scores did not differ between BD-I parents and SCZ parents, but BD-I parents had completed higher educational levels.\nCONCLUSIONS\nAlthough BD-I patients had a lower IQ than controls, they were more likely to have completed the highest level of education. This contrasts with SCZ patients, who showed both intellectual and educational deficits compared to healthy controls. Since relatives of BD-I patients did not demonstrate superior educational performance, our data suggest that high educational performance may be a distinctive feature of bipolar disorder patients. Show less
