The role of human resources on the economy: a study of the Balkan eu member states

In this paper we analyze the impact of the quality of human capital on the main economic indicators of South-Eastern Europe countries [SEE] at the NUTS 2 level. The subjects of this research are the human capital indicators of regional competitiveness. The quality of human capital depends largely on the age structure of the population and the quality of education. Those regions, which have the highest percentage of the working-age population and highly educated people, are able to achieve higher productivity and gain a competitive advantage over other regions. As main indicators of the quality of human capital we identified: population; persons aged 25-64 with tertiary education attainment; students in tertiary education and participation of adults aged 25-64 in education and training and human resources in science and technology. As main economic indicators, we identified: regional gross domestic product; employment and income of households. The aim of this paper is to determine whether there is a correlation between the indicators of the quality of human capital and economic indicators. As a main methodology we have used the correlation coefficient which shows interdependence of the analyzed indicators. As part of our analysis, we consider only EU member states that belong to the SEE countries: Slovenia, Croatia, Romania, Bulgaria and Greece. We conclude that in all countries there is a high multiple correlation coefficient between the indicators human resources in science and technology, number of students and employment.This paper is the result of the project No. 47007 III funded by the Ministry for Education, Science and Technological Development of Republic of Serbia

Real-time resource availability signaling in IP multimedia subsystem networks

IP Multimedia Subsystem (IMS) allows the use of unlicensed, non-dedicated and nondeterministic access networks for delivering IP multimedia services. Providing end-to-end Quality-of-Service (QoS) for resource demanding real-time services (e.g. real-time multimedia) over such networks is a challenging task due to varying resource availability of the network and the end-devicei during a single sessionii. A common solution to this problem is adapting service quality and type according to availability of system resources, which requires end-to-end monitoring and signaling of resource availability during a single session. This paper presents an extension of the IMS architecture for real-time resource availability monitoring and signaling. The novelty of the proposed extension is twofold. It takes into account uncontrolled access networks with no resource reservation on the one hand, and end devices on the other. Two system architecture components are introduced for monitoring and signaling of the real-time resource availability in both networks (e.g. bandwidth, buffer space), and end-devices (e.g. battery, CPU, memory, storage), namely a Resource Manager (RM) and a Resource Availability Server (RAS). Our solution does not require any modifications of the IMS architecture and can be implemented as a plug-in

Mucins and Asthma : Are We Headed to the Revolutionary Road?

Mucus represents the first line of defense of our respiratory tract and mucociliary clearance is essential for maintaining the homeostasis of airway epithelium. The latter mechanisms are altered in asthma and mucus plugging of proximal and distal airways is the main cause of death in cases of fatal asthma. Starting from the influential review performed by Luke R. Bonser and David J. Erle in 2017, we discuss the latest evidence in terms of mucins regulation and potential treatment of mucus hypersecretion and tissue remodeling in severe asthma

Example Ordinance for Compost Amending Soil in Urban Landscaping

Urban landscapes are commonly installed on a final grade consisting of fill material brought on-site during construction to elevate the land surface. This material is typically inert, lacking organic matter and nutrients, and becomes compacted during the construction process. UF/IFAS research and other studies have shown that incorporating compost into these soil conditions can increase water retention in the root zone and decrease the need for supplemental irrigation for turfgrass. As a result of this benefit, local governments may consider requiring amending of new landscapes. This publication describes an example ordinance that can be used by local governments as a starting point for developing a compost amendment ordinance tailored to their local situation and conditions. The example ordinance is divided into five sections. Section 1, Basis of Ordinance, provides the background information that supports the ordinance, while Section 2, Applicability, defines the situations and circumstances for which the ordinance shall be applied. Section 3, Compost-Amended Soil Requirements, specifies the procedure for amending soils with compost, while Section 4, Compliance and Enforcement Procedures, covers how compliance shall be assessed and how the ordinance is enforced. Section 5, Other Clauses, includes any information that does not fall under the other sections along with the effective date. The content within each of these sections should be evaluated and adapted to the local context, rather than using material “as-is.

Outcome of patients admitted with acute coronary syndrome on palliative treatment: insights from the nationwide AMIS Plus Registry 1997-2014.

OBJECTIVE: Compliance with guidelines is increasingly used to benchmark the quality of hospital care, however, very little is known on patients admitted with acute coronary syndromes (ACS) and treated palliatively. This study aimed to evaluate the baseline characteristics and outcomes of these patients. DESIGN: Prospective cohort study. SETTING: Eighty-two Swiss hospitals enrolled patients from 1997 to 2014. PARTICIPANTS: All patients with ACS enrolled in the AMIS Plus registry (n=45,091) were analysed according to three treatment groups: palliative treatment, defined as use of aspirin and analgesics only and no reperfusion; conservative treatment, defined as any treatment including antithrombotics or anticoagulants, heparins, P2Y12 inhibitors, GPIIb/IIIa but no pharmacological or mechanical reperfusion; and reperfusion treatment (thrombolysis and/or percutaneous coronary intervention during initial hospitalisation). The primary outcome measure was in-hospital mortality and the secondary measure was 1-year mortality. RESULTS: Of the patients, 1485 (3.3%) were palliatively treated, 11,119 (24.7%) were conservatively treated and 32,487 (72.0%) underwent reperfusion therapy. In 1997, 6% of all patients were treated palliatively and this continuously decreased to 2% in 2013. Baseline characteristics of palliative patients differed in comparison with conservatively treated and reperfusion patients in age, gender and comorbidities (all p<0.001). These patients had more in-hospital complications such as postadmission onset of cardiogenic shock (15.6% vs 5.2%; p<0.001), stroke (1.8% vs 0.8%; p=0.001) and a higher in-hospital mortality (25.8% vs 5.6%; p<0.001).The subgroup of patients followed 1 year after discharge (n=8316) had a higher rate of reinfarction (9.2% vs 3.4%; p=0.003) and mortality (14.0% vs 3.5%; p<0.001). CONCLUSIONS: Patients with ACS treated palliatively were older, sicker, with more heart failure at admission and very high in-hospital mortality. While refraining from more active therapy may often constitute the most humane and appropriate approach, we think it is important to also evaluate these patients and include them in registries and outcome evaluations. CLINICAL TRIAL NUMBER: ClinicalTrials.gov Identifier: NCT01 305 785

The effect of a multidisciplinary approach for smoking cessation in patients with Crohn's disease : results from an observational cohort study

Introduction: Cigarette smoking is the most important risk factor for Crohn's disease (CD). The effectiveness of smoking cessation programs (SCPs) in patients with CD is still poorly understood. Methods: This was a retrospective, observational, single-centre, cohort study of 136 active smokers with mean age 55 years (SD=11), 58% males, including 27 (19.8%) patients with CD who entered the multidisciplinary SCP of the Luigi Sacco University Hospital of Milan from January 2017 through January 2019. A pulmonologist was responsible for the clinical and pharmacological management, while a psychiatrist and a psychologist conducted the counselling and assessed the motivation to quit, anxiety and depression using the Brief Psychiatric Rating Scale (BPRS) and the nicotine dependence with the Fagerstr\uf6m test. Patients were defined as quitters after 12 months. Results: Demographic and clinical characteristics, and Fagerstr\uf6m score, did not differ in patients with and without CD. At baseline, patients with CD had a higher BPRS (median: 27, IQR: 22-32; vs 25 and 22-28.5; p=0.03), and a lower motivation to quit score (median: 10, IQR: 9-13; vs 14 and 12-15; p<0.001). After 12 months, the quitting rate of smokers with CD was significantly lower (14.8% vs 36.7%; p<0.022) and the chance of quitting was negatively associated with the baseline BPRS (r=-0.256; p<0.003). Varenicline and nicotine replacement therapy tended to be less effective in patients with CD. Conclusions: The lower efficacy of SCPs in patients with CD might be secondary to a higher prevalence of anxiety and depression. Psychological issue recognition and support should be enhanced to increase SCP effectiveness in CD

Helmet CPAP to Treat Acute Hypoxemic Respiratory Failure in Patients with COVID-19 : a Management Strategy Proposal

Since the beginning of March 2020, the coronavirus disease 2019 (COVID-19) pandemic has caused more than 13,000 deaths in Europe, almost 54% of which has occurred in Italy. The Italian healthcare system is experiencing a stressful burden, especially in terms of intensive care assistance. In fact, the main clinical manifestation of COVID-19 patients is represented by an acute hypoxic respiratory failure secondary to bilateral pulmonary infiltrates, that in many cases, results in an acute respiratory distress syndrome and requires an invasive ventilator support. A precocious respiratory support with non-invasive ventilation or high flow oxygen should be avoided to limit the droplets' air-dispersion and the healthcare workers' contamination. The application of a continuous positive airway pressure (CPAP) by means of a helmet can represent an effective alternative to recruit diseased alveolar units and improve hypoxemia. It can also limit the room contamination, improve comfort for the patients, and allow for better clinical assistance with long-term tolerability. However, the initiation of a CPAP is not free from pitfalls. It requires a careful titration and monitoring to avoid a delayed intubation. Here, we discuss the rationale and some important considerations about timing, criteria, and monitoring requirements for patients with COVID-19 respiratory failure requiring a CPAP treatment

The airways' mechanical stress in lung disease: Implications for COPD pathophysiology and treatment evaluation

The airway epithelium stretches and relaxes during the normal respiratory cycle, and hyperventilation exaggerates this effect, resulting in changes in lung physiology. In fact, stretching of the airways influences lung function and the secretion of airway mediators, which in turn may cause a potentially injurious inflammatory response. This aim of the present narrative review was to illustrate the current evidence on the importance of mechanical stress in the pathophysiology of lung diseases with a particular focus on chronic obstructive pulmonary disease (COPD) and to discuss how this may influence pharmacological treatment strategies. Overall, treatment selection should be tailored to counterpart the effects of mechanical stress, which influences inflammation both in asthma and COPD. The most suitable treatment approach between a long-acting \u3b22-agonists/long-acting antimuscarinic-agonist (LABA/LAMA) alone or with the addition of inhaled corticosteroids should be determined based on the underlying mechanism of inflammation. Noteworthy, the anti-inflammatory effects of the glycopyrronium/indacaterol combination on hyperinflation and mucociliary clearance may decrease the rate of COPD exacerbations, and it may synergistically improve bronchodilation with a double action on both the cyclic adenosine monophosphate (cAMP) and the acetylcholine pathways