Medium Term Research Articles

Medium Term Climate Change Effects on Millet Yields in Gulu District, Northern Uganda

Climate change is expected to adversely affect crop yields and livelihoods of agro-dependent societies, especially in Sub-Saharan Africa. However, there remain gaps on the effects of expected regional climatic changes on key food security crops. This study assessed the projected climatic conditions and expected changes in millet yields for Paicho Sub County (S/C) in Gulu District up to the year 2033 using a cross sectional study design. To determine future climatic conditions, PRECIS (Providing Regional Climates for Impact Studies) model was used based on projected conditions at a 50 km spatial resolution while millet yields were modelled using Penman Grindley soil moisture balance model. PRECIS projected changes for 2033 reveal a strong and significant decrease in rainfall (p< 0.05). This is likely to decrease millet yields by 2.6% below the average current yields of 1.8 tons per hectare per year under business-as-usual scenario. The finding indicates a need for improved millet varieties that can survive under changed climatic conditions

European Integration, Opportunities and Risks of Business and Agriculture in Albania

The Integration Process of Albania in the European Union started in 1993 and is considered a long road with many challenges. The signing of the Stabilization-Association Agreement in 2006 is the most important moment of this process, including the harmonization of legislation, to prepare the final EU membership process. This article analyses business opportunities and risks, mainly those of the agri-food sector on its way to the EU. In this framework, trade agreements with the EU and Free Trade Agreements (CEFTA) have influenced the liberalization of trade for agri-food products, intensifying and increasing the level of trade with Europe and the countries of the region. This article also deals with the identification of comparative advantages for the agri-industry sector, where facing the regulated European market, not only challenges are analyzed, but also serious limitations, increasing the need for a structural change in trade relations. In the focus of this paper, are the economic and regional strategies, as well as the progress of the business and agri-food processes, also addressing the trade flows of Albania with the countries of the region and the EU. The analysis of this paper consists of three main premises: 1) in the framework of European integration, costs and benefits in terms of economy and business are more visible in the medium and long term; 2) the integration in the medium term brings a higher economic growth for the countries that aspire to join the EU; and 3) the European integration makes the economy more efficient, bringing about an increase in the ratio of investments, in relation to income, through the reduction of risk with a tendency to increase capital and income per capita (European Commission Report, 2023). The analysis of empirical data shows that the results are not as convincing as expected, thus confirming other previous studies by experts in the field. The main conclusion of this paper is that the integration process has influenced reforms and economic policies in terms of formal and content, both in terms of costs and benefits. In substantive terms, the data analysis shows that the process of European integration has served as a strong impetus for the development of institutions in the country, inter-institutional coordination, the establishment of new institutions, the improvement of human resources, local markets, and the increase of absorptive capacities of funds from the EU. On the other hand, it is concluded that in specific areas of domestic business, such as agri-industry, the effects of EU integration are either not felt yet or are minimal.

Evaluation of metabolic changes in clinic attendees with therapeutic carbohydrate restriction

Background: Obesity and related metabolic health disorders are major clinical problems that have become increasingly prevalent worldwide.Aim: This before-after study examined the impact of therapeutic carbohydrate restriction (TCR) in managing metabolic health and promoting weight loss in a clinical setting using indirect calorimetry (IC).Setting: Data were collected from medical records obtained from a specialised allied health clinic focusing on metabolic health.Methods: The study analysed retrospective data from 202 overweight or obese participants (77% female, mean age 47.3) who received TCR as part of a behavioural modification programme involving multiple visits where their lifestyle, body composition and respiratory quotient (RQ), a key indicator of fat oxidation were recorded.Results: The study found that TCR improved fat oxidation in 84% of participants at short term visit (around 2 weeks), with an average weight loss of 1.8 kg. At medium term visit (around 12 weeks), 82% of participants maintained an increase in fat oxidation rate, with an average weight loss of 3.9 kg. In addition, among those with recorded body composition and waist circumference, 71% of weight lost was from fat, with an average reduction of 4.9 cm in waist measurements.Conclusion: This real-world study suggests that personalised TCR guided by IC can be an effective strategy for improving metabolic flexibility to help manage excess weight and related co-morbidities in a free-living population. Further research is needed to examine the long-term effects of TCR using this approach.Contribution: The utilisation of IC allows for the examination of individual shifts and improvements in metabolism among patients undergoing TCR.

Approach to the social determination of self-medication by antibiotics in the city of Medellín 2012-2022

Objective: to describe the configuration of the processes of social determination that have influenced self-medication by antibiotics in the city of Medellín between the years 2012-2022. Methods: Descriptive interpretive study with an ethnographic approach from the perspective of the social determination of health. Results: structural processes such as the commodification of social security, few public health actions, and de-industrialization and subsequent loss of labor rights were identified as the main destructive processes that affect self-medication by antibiotics and that are reproduced in the private and private domains. singular respectively. The main protective process identified was family and community support. Conclusion: Self-medication by antibiotics is a practice that is determined by the social structure and the prevailing development model by maintaining barriers to health services that transcend the health system through different mechanisms. That is why the interventions that are carried out around this practice must be characterized by intersectorality and the articulation of different institutions and social actors so that they can be effective and have efficiency in the short, medium and long term.

Double-orifice tricuspid valve: case series and literature review.

The double-orifice tricuspid valve (DOTV) is a rare lesion. We present a series of three patients encountered at the Stollery Children's Hospital with a diagnosis of DOTV on 2D and/or 3D echocardiography. The patient's medical records are reviewed for presentation history, investigative findings, and clinical course. We discuss the cases in the context of a complete review of all literature documenting cases of DOTV. In the majority of cases, the lesion is relatively benign, with little change in valve function over the short to medium term, and outcomes are determined largely by significant concomitant heart defects.

Historical and Future global warming under different RCP emission scenarios

Understanding the relationship between carbon emissions and climate change has become increasingly urgent amidst the universal endorsement of sustainable development and the establishment of net-zero carbon emission target (The Paris Agreement). In this study, model projections based on Coupled Model Intercomparison Project Phase 5 (CMIP5) are used to examine future climate change under different representative concentration pathway (RCP) emission scenarios till 2300. Besides analysis of future global average temperature change under the emission scenarios of RCP2.6, RCP4.5, RCP6.0, and RCP 8.5, historical data is first collected during the past three decades (1990-2021). The results show that the simulated global warming ranges from 0.9 to 1.3 between 1990 and 2021, consistent with the observations (0.93). Carbon emissions in China arose mostly from manufacturing and construction, electricity and heat and transport. Emissions from electricity, heat and transport increase by a high ratio of 7.7 and 3.5 times due to industry development. Under different RCP scenarios, the global surface temperature anomaly will increase by 0.2-1.0, 1.2-2.0, 3.5-4.3 and 3.0-8.5 , respectively. The surface temperature anomaly values under RCP8.5 are much higher than those under other emission scenarios. Only in the RCP2.6 scenario (sustainability), the surface warming in all simulations stays below a 2 threshold at the end of the 21st century. To attain net zero emissions, it is highly demanded to develop strict emission policies, chart a course toward decarbonization, and institute effective measures aimed at realizing net zero emissions within the short to medium term. Concurrently striving for economic objectives, managing the equilibrium between economic growth and environmental sustainability emerges as a critical imperative.

Restructuring reforms for green growth

AbstractPolicymakers across the world are striving to tackle the century‐defining challenge of climate change without undermining potential growth. This paper examines the impact of structural reforms in the energy sector (electricity and gas) on environmental outcomes and green growth indicators in a panel of 25 advanced economies during the period 1970–2020. We obtain striking results. First, while structural reforms so far failed in reducing greenhouse gas emissions per capita, there is some evidence for greater effectiveness in lowering emissions per unit of GDP. Second, although energy reforms are not associated with higher supply of renewable energy as a share of total energy supply, they appear to stimulate a sustained increase in environmental inventions and patents per capita over the medium term. We also find strong evidence of nonlinear effects, with market‐friendly energy reforms leading to better environmental outcomes and green growth in countries with stronger environmental regulations. Looking forward, therefore, structural reforms should be designed not just for market efficiency but also for green growth.

Lipomatous Interatrial Septum Detected During Cardioversion Evaluation for Atrial Fibrillation

Primary cardiac tumors are rare, with an estimated prevalence in autopsy series ranging from 0,001 to 0,28%. Benign tumors are the most common type, with lipoma being the second most frequent among these, following myxoma. Lipoma can pose a differential diagnostic problem with lipomatous hypertrophy of the interatrial septum (IAS). This entity is rare and often asymptomatic, requiring no surgical treatment unless it causes obstruction of surrounding anatomical structures. In practice, cardiac CT and MRI are frequently used to confirm echocardiographic suspicions, both transthoracic and transesophageal. We present the case of a 72-year-old patient referred for management of recent atrial fibrillation, with heart rate control proving difficult despite maximum dose medical treatment. We opted for electrical cardioversion to improve the patient's hemodynamic state in the short term and to prevent progression to atrial cardiomyopathy in the medium and long term. In the transesophageal echocardiogram (TEE), the patient exhibited significant thickening of the interatrial septum, measuring 22 mm, without compression of the superior vena cava, and with the fossa ovalis remaining intact. Through this case, we discuss the diagnostic and therapeutic approaches to lipomatous hypertrophy of the IAS.

Analysis of The Feasibility of Hydrogen Injection in Pipeline Gas Distribution Networks

Analysis of The Feasibility of Hydrogen Injection in Pipeline Gas Distribution Networks

Medium-Term Comparative Effects of Prescribed Burning and Mechanical Shredding on Soil Characteristics in Heathland and Shrubland Habitats: Insights from a Protected Natural Area

Parts of the Cantabrian Mountains (N Spain) have been colonized by woody species in the past six or seven decades as a result of a decline in livestock activity and changes in the fire regime. Various management strategies have been used to prevent the expansion of shrubs and recover grassland ecosystems for grazing activities. However, it is not clear how different vegetation treatments affect soils, which are crucial in supporting life and providing nutrients in these ecosystems. The aim of the present study was to compare the dynamics of the physicochemical and biological soil properties after two vegetation treatments: prescribed burning and shredding. Samples were obtained from plots representing alkaline and acidic soils dominated by gorse shrub (Genista hispanica subsp. occidentalis) and heath (Calluna vulgaris) plant communities, respectively. The soil samples were collected immediately before and after the treatments and one and two years later. The level of available P varied depending on the soil pH, and it only increased after the treatments in the acidic soils in the heathland community. The total N and available P concentrations were higher after the prescribed burning, and the enzymatic activity tended to be higher after the shredding treatment. Despite the significant effects on some soil variables, prescribed burning and shredding did not have important short- and medium-term effects on the chemical and soil enzymatic properties. These treatments can therefore be considered sustainable vegetation management tools, at least in the medium term.

The effect of 2020 lockdown on bank internal ratings

AbstractWe investigate how banks’ internal ratings were affected by the first lockdown shock in Italy (March-June 2020). Using monthly proprietary data from a regional bank between October 2019 and January 2022, and adding credit registry data and balance sheet data of client firms, we estimate the lockdown effect on the change in six different ratings assigned by the bank to client firms in June 2020 and December 2020. We obtain three main results. First, controlling for both supply and demand factors, the lockdown is associated with a decline in four of the six ratings. Second, the lockdown effect also depends on specific firm characteristics, i.e. the lockdown effect appears to be mitigated in the presence of high turnover or for firms belonging to essential sectors. However, these interaction effects do not hold for all ratings, suggesting that each type of rating is influenced by different firm characteristics. Third, once we consider a full interaction model, the lockdown effect disappears in the medium term.

Experimental and numerical approach for the evaluation of PV-system performance on energy and environmental behavior of nearly zero energy buildings: Case study in Mediterranean climate

Nowadays, the performance of photovoltaic (PV) systems has strategic role for satisfying the standard of net or nearly zero energy building with in-situ production. In this frame, the novelty of the paper is the proposal of a combined experimental and numerical approach for evaluating the mismatch between PV production and consumptions during design, operational and future performance under expected emissions scenarios. First of all, it proposes a comparison of production estimation by means of several tools for the evaluation of the energy balance in the design phase; then the expected and real behavior is compared with also the evaluation of the performance ratio (PR) evolution as function of cell temperature. Finally, a sensitivity analysis is proposed in the short and medium scenarios by varying the size of installed system and considering the degradation rate under future weather conditions. The approach is applied to a case study in a typical Mediterranean climate, starting from the monitoring data available for the building energy request and the renewable production (2016–2022). The results of the case study indicate that the PR greatly influences the performance, mainly under expected climate changes, since the operational emissions could increase of more than 15 % compared to actual performance also if the zero energy balance is satisfied. Furthermore, through a sensitivity analysis on the PV-system size, the study demonstrates that with a maximum linear degradation rate of 1.51 %/year, the building could be configured as nearly zero energy in the medium term (20 years) also with lower peak power. The analysis also suggests that the maximization of installed power is a prerequisite to follow the implementation of positive energy goal because, under all considered climatic evolutions it can balance the penalties both due to technical aspects that to modification of consumption and production profiles.

Open Dislocated Interphalangeal Fracture of the Thumb in a 16-Year-Old Basketball Player

Phalangeal dislocation fractures of the hand are common in the sports world especially contact sports and ball sports. Open ones are less common. In this article we report a case of a 16-year-old young basketball player who injured her right thumb during a practice. Clinical and radiological examinations showed an open phalangeal dislocation fracture of the thumb. Management consisted of immediate reduction, abundant washing and finger splint for 4 weeks after X-rays showed anatomical reduction. Short, medium and long term clinical and radiological examinations showed good evolution. At our last follow up (1.5 years) our patient had regained full use of her hand in both daily and sporting activities. The purpose of this study is to encourage non operative treatment in dislocated fractured fingers when treated early if the initial external reduction is anatomical, and to show the need for further studies in similar cases in the sport world.

Probing the carbon neutrality drive of environmental-related technologies and energy transition in France and Germany: a novel time–frequency technique

AbstractThis study presents a rare comparative analysis of the factors influencing environmental quality through greenhouse gas (GHG) emissions in the European Union member states’ largest economies, i.e., France and Germany. By considering the unique economic, energy, and environmental characteristics of both countries, the finding unveils a novel perspective in the literature. The research utilizes a recently developed wavelet local multiple correlation (WLMC) technique with quarterly dataset spanning from 1990/Q1 to 2020/Q4. The results demonstrate that environmental-related information and communication technologies innovations, energy transition, and financial development play significant roles in limiting the growth of GHGs emission, particularly in the medium and long term. The wavelet-based Granger causality analysis reveals evidence of feedback causality among the variables in both countries in the medium and long term. Moreover, there are slight differences in the short-term relationships given that the observations are generally similar in later period. Overall, the findings offer a deeper understanding and policy insights regarding the time and frequency dynamics of GHG drivers in France and Germany. Graphical abstract

INTERNATIONAL TRADE: CHALLENGES OF MODERN GEOPOLITICAL CONFLICTS

This article is devoted to the study of the relationships between modern geopolitical conflicts and structural and dynamic changes in modern international trade. The author notes the ambiguous impact of conflicts on international exchange, as a result of which trade models undergo significant changes. Geopolitical conflicts, which have changed the conditions for further participation of countries in international trade, have become a serious challenge to the current openness of markets. It is the superposition of several successive shocks (the Chinese- American trade conflict, the pandemic and the risks of deglobalization) that make the scenarios for the development of international trade uncertain even in the foreseeable future, since the very impact of conflicts on trade has become wave and cumulative. Conflicts will ultimately not lead to a reduction in trade relations between countries, but will only reformat them and modify them, which will likely have a negative impact on trade costs that will be associated with the restructuring of global supply chains. International trade in the future will become more fragmented and regionalized, but in the medium term it will restore its pre-pandemic dynamics. Trade policy will gradually adapt to increasingly frequent geopolitical conflicts, gradually moving away from the main established principle of international trade – liberalization, but without abandoning it completely.

“Fundamentals of Global Competition: Logistics, Technology and Polar Alliances in Past, Present and Future. Part 1”

The formation and functioning of various models of the world order has a deep and complex history that does not fit into the traditional chronologically consistent scheme, and these models themselves did not inherit each other, but were combined in varying degrees of harmony. The dynamics of international relations, at least in the medium term, will be determined by the trends observed over the past decades — such as inequality in the levels of economic development, the redistribution of shares of world wealth, the rivalry for global dominance between the United States, gradually losing its position as sole leader, China, Russia and other global players, and finally, the search for new tools balancing the global status quo. Expansion geopolitics will also remain the dominant trend in the short- to medium-term perspective. One of its striking manifestations is the Belt — Road Initiative, implemented by the PRC. Expansion geopolitics seems to get start most intensively in West Africa. The region, on the one hand, needs large infrastructure investments, on the other hand, — has a number of advantages that could create a production and logistics hub in it, the starting point of a project similar to the Chinese Belt — Road initiative.

Closure of the Peritoneum in Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair (TAPP) With Cyanoacrylate Glue in a Microdroplet Device: A Single Surgeon Prospective Comparison vs. Barbed Suture

Purpose:To describe and compare a peritoneal closure technique using cyanoacrylate glue (Glubran 2®, GEM, Cardiolink SL) with a microdroplet device (Glutack®, GEM, Cardiolink SL) in laparoscopic transabdominal preperitoneal repair (TAPP) of inguinal hernia with the routinely used barbed suture peritoneal closure (V-Lock 3.0, Covidien France).Materials and methods:From January to August 2022, 60 patients undergoing TAPP repair for uni- or bilateral inguinal hernia were randomized into one of two groups. One using as mesh fixation and peritoneal closure the Glutack® device with Glubran 2® cyanoacrylate glue (Glu-close group) and the other using mesh fixation with cyanoacrylate and peritoneal closure with V-lock 3.0 (Sut-close group), with a follow-up of 12 months. Demographic variables, operative time, peritoneal closure time, main surgical findings and main intra- and postoperative complications were analyzed prospectively.Results:63 patients were included with no losses to follow-up. The mean operative time was 34 min (range 58.25) for the glu-close group and 40 (range 64.25) for the sut-close group, with no conversion (0%) for either group. The mean flap closure time was 1.18 min (SD 24 0.19) for the glu-close group and 3.24 min (SD 0.78) for the sut-close group, with statistically significant differences (p < 0.001). The intraoperative complication rate was 0 for the glu-close group and 0 for the sut-close group, with no significant difference. The median hospital stay was 0.8 days (range, 0–1) for both groups. The median duration of follow-up was 12 months and none had hernia recurrence. The postoperative VAS score at the first and second check-up at 1 month and 3 months was 2.83 (SD 1.341) and 0.60 (SD 0.621) in the sut-close group and 1.03 (0.984) and 0.24 (SD 0.435) in the glue-close group, with significant differences (p < 0.001 and p < 0.012).Conclusion:The data demonstrated by the study are that the glue can be used safely to close the peritoneum and that the method provides a small, statistically significant but not clinically relevant reduction in the time to close the peritoneal flap, as well as in postoperative pain after surgery in short and medium term.

Exploring the correlation between rising temperature and household Electricity Consumption: an empirical analysis in China

This study investigates the nexus between rising temperatures and household energy consumption using data from respondents' electricity bills in the "China Residential Energy Consumption Survey." Our analysis reveals a significant correlation, with an 8.9% increase in yearly energy consumption observed when the average temperature exceeds 32°C. Additionally, we explore potential shifts in power usage due to global warming by integrating baseline estimates with daily temperature forecasts from eight contemporary climate models. Our findings project alarming trends: without interventions to curb greenhouse gas emissions, home electricity consumption could surge by 9.59–30.09% in the medium term and by 9.77–47.70% in the long run. By shedding light on these critical connections, our research underscores the urgent need for policy actions to mitigate the adverse impacts of climate change on energy consumption patterns.

V. A. Sukhomlinsky’s pedagogical heritage: innovation and foresight

Introduction. Modern education does not always meet the challenges associated with the rapid changes brought by the new millennium. The spiritual and moral crisis is becoming more and more pronounced. Relying only on “rationality” and practical expediency leads to human degradation and civilizational crisis. This underlies the unprecedented value of pedagogical systems containing certain constructive solutions to the identified problem put forward by practice. According to the general opinion of the world pedagogical community, among such systems is one created by the outstanding humanist V.A. Sukhomlinsky (1918 – 1970). Purpose: To identify and reveal the essence of the ideas and provisions of the Pavlysh innovator that have already played an invaluable role in the enrichment of the national education and will be the driving force of its development in the third millennium. Materials and Methods. The basis of the study is V.A. Sukhomlinsky’s works and the products of his rich educational practice, as well as materials from those who studied the innovator’s creative heritage. The research methodology was based on the conceptual provisions of humanistic pedagogy. The specific methodological tools included the principles of integrity and consistency, objectivity, universal connection of phenomena, combination of retrospective and prospective development, along with sociocultural and system-functional principles. In addition to general scientific methods, such as system-structural analysis and synthesis, the research process also involved formal logical research methods. Results. The study expands and concretizes the existing knowledge about the development of pedagogical theory and school practice in the second half of the 20th century. Identified and characterized are the key ideas and scientific positions of V.A. Sukhomlinsky, the prominent representative of the studied period. They were the foundation of his pedagogical system and played an important role in enriching the theoretical and methodological foundations of pedagogy, the content and support (methodological and technological) of modern educational practice and will certainly become the driving force of its development in the medium and long term. Even though V.A. Sukhomlinsky lived and worked in an ideologized epoch, difficult for creative work, he managed to develop his own pedagogical system, in which the poetic and popular idea merged with its scientific foundations. V.A. Sukhomlinsky’s pedagogy is in many respects the pedagogy of the present and the future. It is entirely aimed at the realization of the humanistic ideal. The concepts of goodness and humanity, preached by the educator, nowadays win more and more supporters. As many other provisions of the innovator concerning the construction of the educational process, they can undoubtedly become one of the cornerstones of developing the educational practice in the third millennium. Conclusion. V.A. Sukhomlinsky’s multifaceted activity not only enriched pedagogical science with new ideas and provisions, but also can rightfully be regarded as an important stage in its development. Nowadays, when the world has entered the third millennium and the pedagogical community solves the problems associated with the renewal of the content essence of all parts of education, we believe that the ideas and practical experience of the outstanding teacher will play a productive role in this process. Keywords: upbringing of a comprehensively developed personality, humanization of the pedagogical process, regental function of upbringing, system-forming factor of upbringing, unity of teaching and upbringing

Outcomes following interval delayed first rib resection for acute axillosubclavian deep venous thrombosis

BackgroundCurrent management of axillosubclavian deep venous thrombosis (DVT) often uses thrombolysis for the DVT, prompt first rib removal, and occasional venoplasty or stenting. Our institution has increasingly used anticoagulation alone followed by interval first rib resection. We sought to analyze the effectiveness of this simplified technique. MethodsBetween September 2012 and April 2021, 27 patients were identified within the institution's electronic medical record as having undergone first rib resection for upper extremity DVT. Seven of these patients had undergone preoperative thrombolysis before referral and were excluded. Among the remaining 20 patients, preoperative clinic charts were evaluated for age, venous segment involvement, contralateral limb involvement, presence of documented hypercoagulable state, duration of preoperative and postoperative anticoagulation, and postoperative outcomes. ResultsOf the 20 patients (mean age, 26.2 years; 13 males) presenting with acute axillosubclavian DVT, all patients had right (n = 8) or left (n = 12) arm swelling. Five patients had extremity pain and four had extremity discoloration. Ten had axillosubclavian vein involvement, 9 had subclavian vein involvement, and 1 had axillary vein involvement. Two patients were on oral contraceptives and no patients had any other diagnosed hypercoagulable conditions. The mean duration of preoperative and postoperative anticoagulation was 3.2 ± 2.6 months and 2.1 ± 2.1 months, respectively. Nineteen patients underwent supraclavicular first rib resection and 1 patient underwent transaxillary resection. Twelve patients (60%) demonstrated complete DVT resolution by venous duplex examination during the postoperative period and 8 patients (40%) demonstrated partial recanalization/chronic DVT. Complications included one hemothorax and one thoracic duct injury. All 20 patients remain asymptomatic without arm swelling, with a mean follow-up of 55.1 ± 34.7 months. ConclusionsAmong patients presenting with acute axillosubclavian DVT, anticoagulation alone followed by interval first rib resection proved to be successful in providing symptomatic relief in the short to medium term. By eliminating the need for preoperative thrombolysis and postoperative venograms, this potentially cost-saving algorithm simplifies our management for acute venous thoracic outlet syndrome while maintaining good clinical outcomes. Because this study only analyzed our management algorithm's effectiveness in the short to medium term, the long-term effectiveness of this treatment will need to be demonstrated.