Introduction: India–East Asia Relations in the Post-COVID-19 Era

This article argues that India-East Asia relations are likely to enter a new phase in the post-COVID-19 era. The COVID-19 pandemic has hastened the decline of the post-Cold War liberal order that has so far promoted mutual trust and cooperation and underpinned peace and prosperity. This development has enormous implications for East Asia’s international relations. Indeed, significant changes appear to have occurred in the region during the pandemic. On the one hand, the pandemic has accelerated China's growing supremacy, but on the other hand, it has also enhanced its rivalry with all major liberal powers, including the US, India, Japan and Australia. Moreover, the geo-economic front has also witnessed drastic changes as pandemic-induced economic nationalism, economic retaliation, and supply chain restructuring have swept across the region. Hence, it is not premature to proclaim the post-pandemic East Asia will differ from the post-Cold War liberal era. That, in turn, raises important questions: How has the COVID-19 influenced India–East Asia relations? Will the post-COVID-19 era transform India's ties with East Asia? If so, how will this relationship change, and to what extent? This article, and this special issue more broadly, seek to answer these questions. In doing so, we first examine the major geopolitical and geo-economic issues between India and East Asia. Thereafter, we analyze India's relations with South Korea, China, Japan and ASEAN.

Informal Caregivers in Amyotrophic Lateral Sclerosis: A Multi-Centre, Exploratory Study of Burden and Difficulties

Amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND) is a systemic and fatal neurodegenerative condition for which there is currently no cure. Informal caregivers play a vital role in supporting the person with ALS, and it is essential to support their wellbeing. This multi-centre, mixed methods descriptive exploratory study describes the complexity of burden and self-defined difficulties as described by the caregivers themselves. Quantitative and qualitative data were collected during face-to-face interviews with informal caregivers from centres in the Netherlands, England, and Ireland. Standardised measures assessed burden, quality of life, and psychological distress; furthermore, an open-ended question was asked about difficult aspects of caregiving. Most caregivers were female, spouse/partners, and lived with the person with ALS for whom they provided care. Significant differences between national cohorts were identified for burden, quality of life, and anxiety. Among the difficulties described were the practical issues associated with the caregiver role and emotional factors such as witnessing a patient’s health decline, relationship change, and their own distress. The mixed-methods approach allows for a more nuanced understanding of the burden and difficulties experienced. It is important to generate an evidence base to support the psychosocial wellbeing and brain health of informal caregivers.

The Impact of Financial Hoarding on Economic Growth in China

In recent years, more and more funds circulate internally in the financial field, which is called “financial hoarding”. After calculations, the scale of China's financial hoarding was 242178 billion yuan in the first quarter of 2003 and jumped to 1801706 billion yuan in the fourth quarter of 2016, which increased by nearly 7.4 times in the past 14 years and accelerated after 2014. The phenomenon that large amounts of money deviate from the real economy to virtual economy is called “shift from real economy to virtual economy”. The large scale of financial hoarding will inevitably influence the economic growth in China. Does financial hoarding promote or inhibit the economy? Does the relationship change with the economic growth rate? To address this issue, this paper first provided theoretical analysis of the relationship between financial hoarding and economic growth. Then, it used the data of the first quarter of 2003 through the fourth quarter of 2016 in China for empirical analysis. The results revealed two facts. Firstly, the simultaneous equations model showed that financial hoarding and economic growth promote each other in the long run and financial hoarding can be conducive to economic growth. Secondly, the MS-VAR model showed that the relationship between financial hoarding and economic growth changed with the economic growth rate. In addition, financial hoarding had a positive effect on the economic growth under both medium and high economic growth regimes, but to a greater extent in high economic growth regimes.

P–705 Basal FSH and AMH profiles impact embryo morphokinetics in a maternal age-dependent manner

Study question Do maternal AMH and basal FSH profiles impact embryo morphokinetics and does this relationship change with maternal age? Summary answer Embryo morphokinetics varies with basal FSH and AMH levels and this relationship changes in advanced maternal age (AMA). What is known already Basal FSH and AMH levels have been utilised as markers of ovarian reserve/response and IVF/ICSI outcomes. Basal FSH better reflects post-IVF/ICSI live birth occurrence in pre-AMA patients, while AMH appears more robust in AMA patients. Whilst plasma AMH levels reflect oocyte yield, recent data suggest that plasma basal FSH and intrafollicular AMH levels specifically reflect oocyte quality. Oocyte and embryo developmental competence is associated with faster fertilisation and embryonic morphokinetics. The assessment of the relationship between developmental morphokinetics and maternal basal FSH and AMH plasma profiles shall contribute for a better understanding of their roles as fertility markers and regulators. Study design, size, duration Retrospective cohort study including 1961 first autologous ICSI cycles performed from 2014 to 2020, providing 10774 embryos grouped according to maternal AMH and basal FSH levels in: CF [concordant favourable; AMH>1 (ng/mL), FSH≤10 (IU/L); n = 8055)]; DFA (discordant with favourable AMH; AMH>1, FSH>10; n = 768); DFF (discordant with favourable FSH; AMH≤1, FSH≤10; n = 1362) and CU (concordant unfavourable; AMH≤1, FSH>10; n = 589). Morphokinetic parameters were compared among groups in total, ≤35 (pre-AMA) and >35 (AMA) years old patients, separately. Participants/materials, setting, methods Patients aged 20 to 45 with FSH and AMH levels measured on menstrual cycle day 2 underwent ovarian stimulation, ovum pick-up and ICSI. Embryos were cultured in a time-lapse incubator (Embryoscope). Fertilisation and cleavage morphokinetic parameters [tPNa (time of pronuclei appearance, tPNf (time of pronuclei fading), t2, t3, t4, t5 and t8] were annotated and compared among AMH/FSH groups with the Kruskal-Wallis nonparametric test, followed by a post hoc multiple comparison with Bonferroni correction. Main results and the role of chance In overall embryos, tPNa, tPNf, t2 and t3 varied between AMH/FSH groups. CF were faster than CU embryos for all these parameters [(mean±SEM; hours); tPNa: 6.8±0.02 vs. 7.1±0.08; tPNf: 24.13±0.04 vs. 24.49±0.14; t2: 27.05±0.05 vs. 27.36±0.16; t3: 36.94±0.07 vs. 37.54±0.22 (p < 0.001)]. In addition, CF were faster than DFA (p < 0.001), but not than DFF embryos, for tPNf (CF: 24.13±0.04; DFF: 24.23±0.14; DFA: 24.57±0.14) and t2 (CF: 27.05±0.05; DFF: 27.22±0.12, DFA: 27.42±0.15). In AMA patients, faster morphokinetics was observed when one or both hormonal values were favourable; tPNf, t2 and t3 were reached earlier in CF compared to CU (tPNf: 24.17±0.05 vs. 24.52±0.15; t2: 27.13±0.06 vs. 27.43±0.17; t3: 37.09±0.08 vs. 37.63±0.24; p < 0.05), but not to DFF (tPNf: 24.22±0.12; t2: 27.27±0.14, t3: 36.92±0.19) or DFA embryos (tPNf: 24.39±0.14; t2: 27.34±0.17, t3: 37.26±0.23). Differently, in pre-AMA patients, faster morphokinetics was associated with favourable basal FSH regardless of AMH levels; tPNa and tPNf were reached earlier in CF compared to DFA and CU (p < 0.005), but not to DFF embryos (tPNA: 6.68±0.03, 6.96±0.13, 7.13±0.14, 7.12±0.19; tPNf: 24.05±0.07, 24.27±0.21, 25.14±0.34, 24.37±0.36; for CF, DFF, DFA and CU, respectively). Limitations, reasons for caution Our study is subjected to the intrinsic limitations of a retrospective analysis and the results could have been affected by variables that were not controlled for. Wider implications of the findings: The findings suggest that lower basal FSH levels are associated with faster early morphokinetics likely reflecting superior oocyte quality in pre-AMA patients. The present data may contribute to improve ART prognostic strategies and provide valuable clues for a better understanding of hormonal regulation of oocyte developmental competence. Trial registration number Not applicable

Specific support needs and experiences of carers of people with frontotemporal dementia: A systematic review

Introduction Frontotemporal dementia (FTD) is one of the most common types of dementia in persons younger than 65 years of age. Diagnosis is often delayed due to slow, gradual decline and misinterpretation of ‘non-typical’ dementia symptoms. Informal carers of people with FTD experience greater levels of overall burden than carers of people with other forms of dementia. The aim of this systematic review was to describe the subjective experience of being an informal carer of a person with FTD and to identify the specific needs, coping strategies and helpful support resources of this carer population. Methods Four electronic databases were used to search for published literature presenting experiences of carers of people with FTD between January 2003 and July 2019. Search strategy followed PRISMA guidelines. Findings were analysed using framework analysis, employing five stages of analysis to develop a coding index and thematic framework that included key aspects of the carer experience, which were grouped into themes and presented in a narrative format. Results 1213 articles were identified in total. Twelve studies were included in the final synthesis of the review. Six themes were identified: ‘Challenging road to and receipt of diagnosis’, ‘relationship change and loss’, ‘challenging experiences in caring’, ‘positive experiences and resilience’, ‘coping’ and ‘support needs’. Discussion Findings highlight an increased need for carers of people with FTD to receive support during the pre-diagnostic stage, including support to manage symptoms. Further research should explore relationship changes and loss amongst carers to inform approaches for carer support. In conclusion, the lack of knowledge and unique needs of carers highlight the importance of public awareness campaigns and healthcare professional education to support carers with FTD symptom impact.

Dependence between oil price changes and sectoral stock returns in Pakistan: Evidence from a quantile regression approach

This study explores the dependence between changes in world crude oil prices and the performance of the Pakistan Stock Exchange, at the aggregate as well as sectoral levels for the period from July 1997 to December 2016. Quantile regression approach is employed for a detailed examination of the structure and degree of dependence for three sub-periods corresponding to normal, rising, and falling oil price periods. We found that the dependence between changes in crude oil price and the sectoral stock returns is heterogeneous across industries and it exists in both bullish and bearish market trends. The dependence at the upper and lower quantiles is found to be a common feature across industries. Moreover, the dependence and direction of the relationship change at times of structural breaks. The findings highlight an external channel through which fluctuations in stock returns may impede the liquidity of the stock market of an oil-importing country such as Pakistan, thereby affecting the domestic economy.

Relationship and Social Network Change in People With Impaired Social Cognition Post Right Hemisphere Stroke

Purpose This article investigated relationship and social network change in the presence of a social cognition impairment post right hemisphere (RH) stroke. Impaired emotion perception and inferential reasoning are sources of interpersonal difficulty in people with social cognition impairment after traumatic brain injury. People with an RH stroke have also been identified as vulnerable to interpersonal relationship change. However, the influence of impairments in particular domains of communication or cognition on relationship and social network maintenance is yet to be explored. Method A multiple-case study methodology allowed for testing of theoretically developed propositions by exploring social networks and relationships within and between seven participant–proxy dyads. Purposeful recruitment was based on first-onset RH stroke and impaired social cognition, as determined by The Awareness of Social Inference Test. Results Social network size reduction (71.4%, n = 5) and interpersonal relationship change (85.7%, n = 6) were attributed to altered communication style, impairments in social cognition, and reduced insight and/or motivation. The spouse emerged as a facilitator of social engagement. Conclusion This study contributes to our understanding of the challenges experienced by people with impaired social cognition post RH stroke in maintaining relationships and their social networks.