The Future Potential and Prospects of SAARC Regional Grouping: A Study

The renewed and reinvigorated engagement of India with the South Asian Association for Regional Cooperation (SAARC) over the past few years has been one of the significant factors leading to the gradual and irreversible transition of the regional organisation from a declaratory phase to one of implementation (Bhagwati, 2008). The recent developments in the South Asian region, especially the new growth momentum that is observed and increasing openness that brings a fresh look at the economic integration of the region. In this context the study examines the opportunities and commodity potential of trade between India and the SAARC countries by adopting a variety of trade indices of export intensity index and import intensity index along with Gini coefficient. The authors further study the commodity trade potential between India and the SAARC countries by adopting the revealed comparative advantage index and revealed import dependency index. The study concludes an increasing export intensity and import intensity of trade between India and the other SAARC member countries. Finally, the values of Gravity coefficient and commodity analysis find a high trade potential between them and the untapped trade and investment scenario that could be tapped by strengthening the regional block of SAARC.

Visuo-postural dependency index (VPDI) in human postural control

Background Computerized stabilometry has been utilized to investigate the effect of vision on the neuromechanisms of human postural control. However, this approach lacks operational methods to quantify visual dependency during upright stance. This study had three goals: (1) To introduce the concept of visuo-postural dependency indices (VPDI) representing balance sway characteristics in multiple analytical domains (spatial, temporal, frequency, and structural), (2) To investigate the age and gender effects on VPDIs, and (3) To investigate the degree of relationships between VPDI and both subjective visual vertical and horizontal perception (SVV and SVH, respectively). Methods 102 participants (16 to 80 years old) performed bipedal stances on a force platform with eyes open and closed. Response variables included the VPDIs computed for each postural index. In addition, 29 participants also performed SVV and SVH assessments. Results Fifteen VPDIs showed to be robust indicators of visual input modulation, and the variation across their magnitudes of modulation revealed a non-homogeneous response to changes in visual stimuli. Gender and age were not found to be a significant factor to VPDI modulation. Conclusions VPDIs revealed to be potential measures capable to quantitatively assess visuo-postural dependency and aid the assessment of fall risks and balance impairments.

Visuo-postural Dependency Index (VPDI) in Human Postural Control.

Background: Computerized stabilometry has been utilized to investigate the effect of vision on the neuromechanisms of human postural control. However, this approach lacks operational methods to quantify visual dependency during upright stance. Objectives: The study had three goals: (1) To introduce the concept of visuo-postural dependency indices (VPDI) representing balance sway characteristics in multiple analytical domains (spatial, temporal, frequency, and structural), (2) To investigate the age and gender effects on VPDIs, and (3) To investigate the degree of relationships between VPDI and both subjective visual vertical and horizontal perception (SVV and SVH, respectively). Methods: 102 participants (16 to 80 years old) performed bipedal stance on a force platform with eyes open and closed. Response variables included the VPDIs computed for each postural index. In addition, 29 participants also performed SVV and SVH assessments. Results: Fifteen VPDIs showed to be robust indicators of visual input modulation, and the variation across their magnitudes of modulation revealed a non-homogeneous response to changes in visual stimuli. Gender and age were not found to be a significant factor to VPDI modulation. Conclusions: VPDIs revealed to be potential measures capable to quantitatively assess visuo-postural dependency and aid the assessment of fall risks and balance impairments.

Effects of thiamine on vasopressor requirements in patients with septic shock: a prospective randomized controlled trial

Background Thiamine, an essential vitamin for aerobic metabolism and glutathione cycling, may decrease the effects of critical illnesses. The objective of this study was to determine whether intravenous thiamine administration can reduce vasopressor requirements in patients with septic shock. Methods This study was a prospective randomized double-blind placebo-controlled trial. We included adult patients with septic shock who required a vasopressor within 1–24 h after admission between March 2018 and January 2019 at a tertiary hospital in Thailand. Patients were divided into two groups: those who received 200 mg thiamine or those receiving a placebo every 12 h for 7 days or until hospital discharge. The primary outcome was the number of vasopressor-free days over 7 days. The pre-defined sample size was 31 patients per group, and the study was terminated early due to difficult recruitment. Results Sixty-two patients were screened and 50 patients were finally enrolled in the study, 25 in each group. There was no difference in the primary outcome of vasopressor-free days within the 7-day period between the thiamine and placebo groups (mean: 4.9 days (1.9) vs. 4.0 days (2.7), p = 0.197, mean difference − 0.9, 95% CI (− 2.9 to 0.5)). However, the reductions in lactate (p = 0.024) and in the vasopressor dependency index (p = 0.02) at 24 h were greater among subjects who received thiamine repletion vs. the placebo. No statistically significant difference was observed in SOFA scores within 7 days, vasopressor dependency index within 4 days and 7 days, or 28-day mortality. Conclusions Thiamine was not associated to a significant reduction in vasopressor-free days over 7-days in comparison to placebo in patients with septic shock. Administration of thiamine could be associated with a reduction in vasopressor dependency index and lactate level within 24 h. The study is limited by early stopping and low sample size. Trial registration TCTR, TCTR20180310001. Registered 8 March 2018, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=3330.

REGIONAL DISPARITIES RELATED TO SOCIO-ECONOMIC DETERMINANTS OF AGRICULTURE IN THE ROMANIAN PLAIN

The structure and pattern of agriculture in Romania has been facing significant changes over the past decades in relation to the contextual social, political and economic transformations. The current study is seeking to assess the determinants of agriculture in the main agricultural region of Romania (Romanian Plain) based on selected socio-economic factors. The authors selected nine socio-economic indicators (agricultural surface, labour renewal index, economic dependency index, economically active population, employment in agriculture, vitality index, share of young labour, share of female population and roads and railway density) which were aggregated into an index of socio-economic determinants of agriculture. Overall, the final index values revealed spatial differences which enabled a certain separation between the eastern, central and western parts of the Romanian Plain: socio-economic favourability for agriculture in the central and, to some extent, in the eastern parts and a significantly reduced favourability in the western area. The current research could become an important step for in-depth assessments of environmental and socio-economic determinants of agriculture, developing strategies and supporting policies at different spatial scales.

Prospectiva estratégica: Herramientas tecnológicas para la toma de decisiones en el orden gerencial hospitalario

La toma de decisiones se ha convertido en un complejo desafío para el orden gerencial hospitalario, debido al creciente protagonismo del sector de la salud en la economía de Ecuador. El análisis prospectivo permite la determinación de escenarios probabilísticos mediante el procesamiento de cuestiones claves focalizadas en los establecimientos de salud del sector privado. Con base a esta situación, se aplica el software Lipsor compuesto por tres métodos; Mic Mac: identificación de variables claves con mayor índice de influencia y dependencia, Mactor: análisis de 24 actores involucrados para la consecución de objetivos estratégicos y Smic Prob Expert: aplicación de la metodología Delphi a médicos especialistas, información que presenta los diferentes escenarios futuros con mayor probabilidad de ocurrencia, siendo posible para las Entidades proveedoras del servicio de salud analizar su proyección a futuro, y promover su desarrollo mediante una propuesta estratégica a través del Árbol de pertinencia. Palabras clave: administración estratégica; análisis estructural; gestión médica; variables clave; escenarios probabilísticos. Abstract Decision-making has become a complex challenge for the hospital management order, due to the rising role of the health sector in Ecuador’s economy. Prospective analysis empowers determination of probabilistic scenarios by processing key issues focused on private sector health facilities. Based on the above, Lipsor software composed by three methods is applied; Mic Mac: recognition of key variables with higher influence and dependency index, Mactor: analysis of 24 involved actors to achieve strategic objectives and Smic Prob Expert: Metodology Delphi survey enforcement to specialists doctors, information that brings different future scenarios with greater occurrence probability, making it possible for Health Services Providers Entities analyze its future projection, and promote its growth by means of a strategic proposal through the Pertinence Tree. Keywords: strategic administration; structural analysis; medical management; key variables; probabilistic scenarios.

Detection of early cytokine storm in patients with septic shock after abdominal surgery

Objectives: To explore the characteristics of cytokine storm in patients with septic shock after abdominal surgery, examine its relationship with clinical data, and determine intervention timings.Materials and Methods: We prospectively observed a cohort of patients with abdominal infection admitted to the surgical intensive care unit (ICU) after surgery (shock group). A control group of healthy individuals was used for comparison. Plasma samples and clinical data recorded at 0, 12, 24, 48, and 72 h after surgery were collected. Cytokines (tumor necrosis factor-α, interleukin [IL]-6, IL-8, IL-10, monocyte chemotactic protein [MCP]-1, IL-1 β, interferon-γ, IL-12p70, MCP-1α, IL-4, IL-2, and IL-13) were detected using the Luminex® technique.Results: Concentrations of most cytokines were significantly higher in the shock group. When a cytokine storm intensity curve was considered with the vasopressor dependency index and a Sequential Organ Failure Assessment (SOFA) score, time point of maximum cytokine storm intensity was earlier than that of the maximum vasopressor dependency index and SOFA score in the shock group.Conclusions: Cytokine storm occurred in patients with septic shock shortly after the abdominal surgery and may be a main mechanism leading to septic shock. Cytokine storm interventions should ideally be initiated within 24 h after surgery and be guided by cytokine storm biomarkers.

The Relationship between Future Self-Continuity and Mobile Phone Dependence of College Students: Mediating Role of Self-Control

The problem of mobile phone dependence is becoming more and more serious. Therefore, it is very important to explore the causes of mobile phone dependence and its psychological mechanism. One of the important characteristics of mobile phone dependence is the loss of control, which shows that self-control is an important factor affecting mobile phone dependence. Self-continuity is closely related to cell phone dependence. Mobile phone addicts usually use mobile phones to temporarily relieve the pressure and negative emotions, but it will lead to more pressure and negative emotions in the future. In order to examine the situation of college students’ future self-continuity, self-control and mobile phone addiction as well as their relationships, especially mediating effect of self-control, a total of 482 college students were assessed with Future Self-Continuity Scale (FSC), Self-Control Scale (SCS), and Mobile Phone Dependency Index (MPAI). The results showed that: (1) The future self-continuity, self-control and mobile phone dependence of the college students in this study were all at a medium level, and there was no significant difference in demographic variables (such as gender, grade, etc.); (2) Both future self-continuity and self-control were negatively correlated with mobile phone dependence; (3) There was a significant positive correlation between future self-continuity and self-control; (4) Self-control played a partial mediating role between future self-continuity and mobile phone dependence. Therefore, improving self-continuity and self-control can be an effective way to intervene mobile phone dependence. In addition research implication, limitations and future directions were discussed.