New policy challenges from financial integration and deepening in the emerging areas of Asia and Central and Eastern Europe

Since the mid-nineties international financial integration has advanced gradually in the emerging areas of Asia, while it has progressed rapidly in Central and Eastern Europe. This process has helped provide long-term benefits for the economies of the two regions in terms of faster productivity growth and deepening of domestic financial markets. The strong surge of international capital inflows since the early years of the current decade has, however, also potentially increased the financial vulnerability and the external sources of contagion for a number of countries, particularly those in Central and Eastern Europe that have seen a significant increase in their foreign borrowing, and also those with still relatively underdeveloped financial systems. We thus analyze the risks of financial instability and asset bubbles in the emerging economies of the two regions, taking into account the degree of development of their domestic financial systems. We conclude by discussing possible policy responses to these challenges by the monetary authorities of the concerned countries.Asian economies, Central and Eastern European economies, capital markets, international financial integration

Comparative Advantage Patterns and Domestic Determinants in Emerging Countries: An Analysis with a Focus on Technology

During the last two decades a number of emerging economies have become deeply engaged in technology-intensive production. This has been reflected in their international trade specialization shifting from labour-intensive goods towards capital-intensive ones, and in rapid productivity gains across all manufacturing activities. The paper investigates for a sample of sixteen emerging countries, the linkages between the pattern of revealed comparative advantages (RCAs), captured by a modified version of the Lafay index of international trade specialization, and the competitiveness structure of the domestic manufacturing sector, measured by a set of industry and country-specific variables. Positive and large RCAs are found to be associated with low unit labour costs in both low-technology (high labour-intensive) and medium- or high tech sectors. On the other hand, domestic accumulation of physical capital is associated with positive and large RCAs in medium- or high technology sectors. The international disadvantage (negative RCAs) in technology-intensive production tends to deepen for countries with low human capital, whereas it diminishes for countries with large domestic markets importing technology through foreign capital goods.revealed comparative advantages, technological up-grading

Foreign direct investment and trade: complements or substitutes?

This paper examines the relationship between international production and exports for a number of countries. In the theoretical literature the relationship between direct investment and trade is not certain apriori: some works emphasize their complementarity, others their reciprocal substitutability, depending on the aim of the investment (e.g. to serve the local market, to transfer production phases to low-wage countries, to circumvent trade barriers, to acquire natural or technological resources). The empirical investigation performed finds that the hypothesis of complementarity is more robust than that of substitutability, albeit with pronounced differences between areas. A panel econometric analysis of an “enlarged” gravitational model, performed on the markets of five industrial countries for the period 1985-94, shows that the imports of market i from country j are positively correlated with the sales of the foreign affiliates of country j that are present in market i, after controlling for the effect of the ordinary variables of scale, economic similarity and relative distance. However, an alternative analysis, using appropriate “indices of relative geographical orientation” constructed for the exports and direct investment flows of the leading investor countries towards the main areas of the world in 1982-94, shows that the complementarity hypothesis is not confirmed in equal measure for all the flows examined. In particular, complementarity is greater for flows between the United States and the European Union than for those between European countries and those between North America and Japan, where a possible substitution of direct investment for exports is found.direct investment, trade

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Comparative advantage patterns and domestic determinants in emerging countries: an analysis with a focus on technology”. World Institute for Development Economic Research (UNU-WIDER) Working Paper RP2008/81

Abstract During the last two decades a number of emerging economies have become deeply engaged in technology-intensive production. This has been reflected in their international trade specialization shifting from labour-intensive goods towards capital-intensive ones, and in rapid productivity gains across all manufacturing activities. The paper investigates for a sample of sixteen emerging countries, the linkages between the pattern of revealed comparative advantages (RCAs), captured by a modified version of the Lafay index of international trade specialization, and the competitiveness structure of the domestic manufacturing sector, measured by a set of industry and country-specific variables. Positive and large RCAs are found to be associated with low unit labour costs in both low-technology (high labour-intensive) and medium-or high-tech sectors. On the other hand, domestic accumulation of physical capital is associated with positive and large RCAs in medium-or high technology sectors. The international disadvantage (negative RCAs) in technology-intensive production tends to deepen for countries with low human capital, whereas it diminishes for countries with large domestic markets importing technology through foreign capital goods

Industrial countries' protectionism with respect to Eastern Europe: the impact of the Association Agreement concluded with the EC on the exports of Poland, Czechoslovakia and Hungary

SIGLEITItal

EVOLUZIONE ATIPICA DI UN CASO DI LEIOMIOMA METASTATIZZANTE BENIGNO POLMONARE

Scopo del lavoro: descrivere un caso eccezionalmente raro di trasformazione maligna di un leiomioma metastatizzante benigno polmonare (LMB). Materiali e Metodi: una donna di 62 anni, ex-fumatrice, nel marzo 2011 si presenta alla nostra attenzione per il riscontro radiologico (TAC torace) di multipli noduli polmonari bilaterali. Nove anni prima, la paziente era stata sottoposta ad isterectomia per un leiomioma uterino. Una biopsia polmonare permette di porre diagnosi di LMB. Successivamente, si procede all’asportazione chirurgica dei noduli del polmone destro con diagnosi di LMB (Ki67: 1%; positività immunoistochimica per ER e PGR; Fig.1C-D-E). Da settembre 2011 a febbraio 2012, la paziente esegue una terapia con anastrazolo, assistendo tuttavia ad un incremento dei noduli del polmone sinistro. Viene pertanto posta indicazione ad asportazione chirurgica dei noduli polmonari a sinistra, il cui esame sitologico conferma la diagnosi di LMB. In seguito all’ulteriore ricomparsa di noduli polmonari bilaterali, da novembre 2013 a giugno 2014 viene intrapresa una terapia con tamoxifene, risultata anch’essa inefficace. Per questo motivo, nel gennaio 2015 viene nuovamente posta indicazione ad asportazione chirurgica dei noduli del polmone destro. Il decorso post-operatorio risulta regolare e la paziente viene dimessa in V giornata post-operatoria. Risultati: macroscopicamente, i noduli polmonari si presentano a margini lisci, giallo-biancastri e di consistenza teso-elastica (Fig.1A-B). Microscopicamente, si osservano fasci intersecati di cellule fusate, con moderate atipie nucleari, organizzate in un pattern fascicolare (Fig.1F). L’attività mitotica risulta incrementata rispetto alle precedenti lesioni polmonari asportate chirurgicamente tre anni prima (>10 mitosi/10 HPF). Dal punto di vista immunoistochimico, le cellule fusate risultano positive per actina muscolare liscia, desmina e negative per HMB-45, CD34, TTF-1. L’indice di proliferazione Ki67 risuta pari al 20% (Fig.1G). I recettori estrogenici e progestinici risultano debolmente positivi (Fig. 1H). In considerazione dell’attuale quadro istopatologico-immunoistochimico, viene posta diagnosi di leiomiosarcoma a basso grado. A distanza di un anno, la paziente presenta un riscontro TAC torace di noduli polmonari bilaterali. Attualmente risulta in terapia con megestrolo acetato. Conclusioni: il LMB polmonare è una condizione patologica rara riscontrata solitamente in donne con una pregressa storia di leiomioma uterino. La patogenesi non è ancora ben definita. Sebbene le caratteristiche istopatologiche depongono per una natura benigna, il suo comportamento biologico suggerisce un certo grado di malignità. Il decorso è tipicamente indolente e la terapia medica o chirurgica risulta spesso risolutiva. Una regressione parziale o totale può avvenire in età menopausale. Sebbene eccezionale, l’evoluzione verso un leiomiosarcoma a basso grado dovrebbe essere considerata nella storia naturale della malattia