G 20 - A STEPPING STONE TOWARDS A NEW WORLD ORDER?

The paper examines the main decisions made at the 24 - 25 September 2009 Pittsburg Summit of G20 and their implications on the design and implementation of a new world order. The analysis reflects the long term trends and changes in the world economy that have led to the necessity of significant changes in the institutions and procedures that govern international economic relations.economic crisis, world order, G20, G8, peer review, 21st century international economic architecture

KYOTO PROTOCOL - A MILESTONE ON THE ROAD TO A LOW CARBON ECONOMY

Human activities have had an impact on environment since immemorial times but significant effects could be traced since about 500 years. The world is getting rapidly warmer, and there is an overwhelming consensus among the leading climate scientists that this is being caused mainly by carbon dioxide and other 'greenhouse gases' emitted by human activities. the responsibility of various countries vis-à-vis environment pollution is not equal. At the same time, neither the resources and scientific capabilities of various countries which can be used for the control of pollution are not equal. The need for international cooperation and coordination is self-evident because less developed countries cannot by themselves find solutions to environment pollution and at the same time they cannot be condemned to underdevelopment.environment, global warming, pollution, ecological footprint

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Credit Scoring Prediction using Graph Features

Small and medium enterprises (SMEs) bring a significant contribution to each country’s economy, ensuring both a high employment rate and financial prosperity. Despite their essential role, these type of companies presents a higher vulnerability to default than large corporates. The default event implies that the SME could not properly reimburse the money owned to its suppliers. If their default could be forecast, experts could adopt measures in order to prevent it or its impactful consequences. For this reason, developing a credit scoring model which is able to predict which SMEs are endangered of default is crucial. There are plenty of credit scoring prediction models available in the literature. However, most of them are only relying on the financial status of one company. In this work, we are presenting a novel method for credit scoring prediction which does not only take into account the SMEs’ financial situation, but also their position and role within a transactional network. A transactional network is a graph, whereby the nodes are represented by SMEs and the edges show that between two nodes there should be at least one transaction. In our work, we highlight the limitations that traditional models face and provide an alternative to overcome them. Furthermore, our findings show that combining network features with financial features could lead to a more accurate prediction and increase the robustness of the model. For this reason, we believe that the transactional network carries significant insights and could be a meaningful addition to financial based credit scoring prediction models

Lipid profile and comorbidities in patients with psoriasis vulgaris

Background and Aim: Psoriasis is an inflammatory skin disorder with important influence on the lipid profile, insulin resistance and cardiovascular disease. The aim of this study is to compare the lipid profile of classical therapy versus anti-TNFs patients and asses the associated diseases. Methods: We conducted a prospective study. Patients’ data were collected from two Romanian Dermatology Clinics, during the period January 2015 – June 2016. The patients were divided into two groups: study group (on TNF inhibitors) and control group (on classical treatment). Results: The subjects in the study group had more associated diseases and much more patients suffered from dyslipidemia. There were not statistically significant differences in the lipid profile between the two groups. But eliminating patients treated with Acitretin and Methotrexate, a p-value of 0.0259 (significant statistically) was observed when comparing the values of triglycerides in the two groups. Conclusions: We did not observe a beneficial effect of the TNF inhibitors therapy in psoriatic patients on the lipid profile. Subjects on biological treatment suffer from a more severe form of psoriasis vulgaris and associate much more comorbidities