Previous Volume Research Articles

Association between Endoscopist Volume and Interval Cancers after Colonoscopy: Results from the National Colorectal Cancer Screening Program in Korea.

The rate of interval colorectal cancer (iCRC) is now accepted as a key performance indicator of organized colorectal cancer (CRC) screening programs. We aimed to examine the association between endoscopist volumes and the rate of iCRC among individuals with a positive fecal immunochemical test (FIT) within a nationwide population-based CRC screening program. Individuals aged ≥ 50 years who underwent colonoscopy after a positive FIT from January 1, 2019 until December 31, 2020 in the Korean National Cancer Screening Program (KNCSP) were enrolled. We converted the data into per-endoscopist screening results, calculated the iCRC rates per endoscopist, and compared them to the previous year's annual volume that was divided into five groups (V1, 1-9; V2, 10-29; V3, 30-59; V4, 60-119; V5, ≥ 120). A total of 10,412 endoscopists performed 216,907 colonoscopies. Overall, the average rate of iCRC per endoscopist was 8.46 per 1,000 examinations. Compared with the group with the highest volume (V5 group), the rate of iCRC was 2.21 times higher in the V1 group. Similar trends were observed in the other groups (V2: relative risks [RR], 2.15; 95% confidence interval [CI], 1.57 to 2.94; V3: RR, 1.56; 95% CI, 1.15 to 2.13; V4: RR, 1.18; 95% CI, 0.83 to 1.67). The findings emphasize that endoscopists with lower procedure volumes have higher risks of interval cancer being missed or undetected. To maximize the preventative impact of colonoscopy for CRC, this issue should be addressed by monitoring endoscopist volumes and variations in performances.

Soggetti che si amano. La vita della coppia dal miele dell’amore romantico all’acido del calo del desiderio e oltre

Soggetti che si amano. La vita della coppia dal miele dell’amore romantico all’acido del calo del desiderio e oltre is the latest book publishedby Giuseppe D'Amore (Psychologist, Psychotherapist and Psychoanalyst, MemberOrdinary of the Italian Society of Relationship Psychoanalysis). Released at the beginning of 2023, it represents at least in part the ideal continuation of the previous volume by the same author, 'Subjects that meet.From the relationship with others to the relationship with oneself... and vice versa',printed in 2021 also with the same publisher and whose review was published in No. 3, Year XXXIII, 2022 of Ricerca Psicoanalitica(pp. 637-641). [...]

The contraction of freshwater lenses in barrier island: A combined geophysical and numerical analysis

Coastal aquifers, vital for supplying freshwater to over one billion people worldwide, often face saltwater intrusion, with barrier island aquifers playing a crucial role in this coastal system. Despite the proliferation of studies exploring the impacts of sea-level rise, storm surges, and over-pumping, the effect of droughts on barrier island aquifers salinization remains largely under-investigated. This lack of attention is particularly concerning given the heightened vulnerability of barrier island aquifers; most ultimately rely solely on aerial recharge compared to continental coastal aquifers. An in-depth understanding of recharge and salinization processes is important for sustainably managing these islands' marginal freshwater resources, especially considering climate change impacts. This study presents an evaluation approach for the response of a freshwater lens (FWL) to drought conditions, incorporating in-situ observations, geophysical measurements, and numerical modeling. The study examines the response of a shallow unconfined aquifer on an Atlantic coast barrier island to the 2020 Northeast extreme hydrological drought. It encompasses a density-driven flow model informed by time-lapse electrical resistivity imaging and in-situ measurements, including groundwater head and salinity collected from monitoring wells. Results from our approach indicate that FWL volume is reduced by 11% during the drought, but it returns to its previous volume over the following spring season, indicating that the net volume of the FWL remains unchanged on an annual scale. The mean groundwater residence time on the island is approximately a year, indicating that the barrier island aquifer is a hydrodynamically active coastal zone. These findings highlight the vulnerability and resilience of shallow unconfined barrier island aquifers to droughts and climate change.

Prostate cancer detection and complications of MRI-targeted prostate biopsy using cognitive registration, software-assisted image fusion or in-bore guidance: a systematic review and meta-analysis of comparative studies.

Three primary strategies for MRI-targeted biopsies (TB) are available: Cognitive TB (COG-TB), MRI-US Fusion TB (FUS-TB), and In Bore TB (IB-TB). Despite nearly a decade of practice, a consensus on the preferred approach is lacking, with previous studies showing comparable PCa detection rates among the three methods. We conducted a search of PubMed, EMBASE, PubMed, Web of Science, and Scopus databases from 2014 to 2023, to identify studies comparing at least two of the three methods and reporting clinically significant PCa (csPCa) detection rates. The primary and secondary outcomes were to compare the csPCa and insignificant prostate cancer (iPCa, ISUP GG 1) detection rates between TB techniques. The tertiary outcome was to compare the complication rate between TB techniques. Detection rates were pooled using random-effect models. Planned sensitivity analyses included subgroup analysis according to the definition of csPCa and positive MRI, previous biopsy status, biopsy route, prostate volume, and lesion characteristics. A total of twenty studies, involving 4928 patients, were included in the quantitative synthesis. The meta-analysis unveiled comparable csPCa detection rates among COG-TB (0.37), FUS-TB (0.39), and IB-TB (0.47). iPCa detection rate was also similar between TB techniques (COG-TB: 0.12, FUS-TB: 0.17, IB-TB: 0.18). All preplanned sensitivity analyses were conducted and did not show any statistically significant difference in the detection of csPCa between TB methods. Complication rates, however, were infrequently reported, and when available, no statistically significant differences were observed among the techniques. This unique study, exclusively focusing on comparative research, indicates no significant differences in csPCa and iPCa detection rates between COG-TB, FUS-TB, and IB-TB. Decisions between these techniques may extend beyond diagnostic accuracy, considering factors such as resource availability and operator preferences. Well-designed prospective studies are warranted to refine our understanding of the optimal approach for TB in diverse clinical scenarios.

The Posthyaluronidase Syndrome: Dosing Strategies for Hyaluronidase in the Dissolving of Facial Filler and Independent Predictors of Poor Outcomes.

Hyaluronic acid dermal fillers are used extensively in periocular aesthetic medicine, and the incidence of filler-related complications is increasing. This study aimed to investigate the optimal dosing strategy for hyaluronidase and to identify predictors of poor outcomes. We performed a retrospective review of 157 orbits of 90 patients treated with hyaluronidase over a 4-year period. Demographic data, indication, and details of hyaluronidase treatment and outcomes were recorded. The primary indication for dissolving filler was swelling in 52%, lumpiness in 20%, and before surgical blepharoplasty in 17%. The most frequently used hyaluronidase concentration was 150 U per mL in 66%, followed by 75 U per mL in 31%, 37.5 U per mL in 3%, and 100 U per mL in 1%. Outcomes were characterized as follows: 59% with a satisfactory result; 24% as insufficient treatment requiring further hyaluronidase; and 18% complaining of facial changes such as hollowing, indicating a post hyaluronidase syndrome. There was no statistical difference in outcomes between the 75 and 150 U per mL dosage groups (P = 0.625). A significant correlation was identified between posthyaluronidase syndrome and duration of filler in situ (P = 0.00019) and volume of filler (P = 0.000017). The posthyaluronidase syndrome may be related to previous filler volume and duration, rather than the concentration or dose of hyaluronidase used. All patients should be informed about the risks of adverse effects after hyaluronidase treatment; patients with longer histories of filler use and higher total volumes should be advised of the increased risk.

Border Zone Maybe Correlated with Radiation Necrosis After Radiosurgery in Metastatic Brain Tumor

BackgroundRadiation necrosis (RN) after stereotactic radiosurgery (SRS) in brain metastases has been extensively evaluated, and RN is correlated with various risk factors. However, no study comprehensively analyzed the correlation between RN and the border zones of the brain that are vulnerable to ischemia. We hypothesized that patients with tumors in the border zone are at high risk of RN. Hence, the current study aimed to assess the correlation between border zone lesions and RN, with consideration of other predetermined factors. MethodsThis retrospective study included 117 patients with 290 lesions who underwent Gamma Knife® stereotactic radiosurgery (SRS). Radiological and clinical analyses were performed to identify factors possibly correlated with RN. Notably, the lesion location was classified into two groups (border zone and non-border zone) based on the blood supply. ResultsIn total, 22 (18.8%) patients with 22 (7.5%) lesions developed RN. Univariate analysis revealed a significant correlation between RN and external border zone lesions, second course of SRS administered at the same site of the previous SRS, prescribed dose, and tumor volume. Multivariate analysis showed that border zone lesions, second course of SRS at the same site of the previous SRS, and tumor volume were significantly correlated with RN. ConclusionsPatients with tumors in the border zone are at high risk of RN. The potential risks of RN can be attributed hypothetically to hypoperfusion. Hence, the association between RN and border zone lesions seems reasonable.

Dziesmu virknes kāzu apdziedāšanās tradīcijas kontekstā: īpatnības un problemātika

Singing of mutual mocking songs in Latvian traditional culture is an ancient and highly cultivated custom. It can be found at clean-up days, traditional annual celebrations and family-related festivities. Of all the festivities, this tradition is most vividly manifested in weddings and has been preserved in some places until today. Singing usually takes place between two groups – boys and girls, unmarried girls and married women, guests and housemates, etc. During the wedding, the singing takes place mainly between the relatives of the groom and the bride. This custom, which permeates the entire wedding ritual, symbolically features a clash between the groom’s family and the bride’s family, which allows psychological tension to be discharged by reaching the catharsis. In particular, singing mocking songs effectively discharges the accumulated negative feelings in a socially permitted manner. The 12th volume of the academic edition “Latvian Folk Songs” (Latviešu tautasdziesmas) was published in the summer of this year. This volume continues, which was started in the previous volume by publishing wedding songs. This edition covers the wedding theme more completely than all the ones published so far, so the texts included in the 12th volume and those not included were selected as the sources for this study. A folk song is usually understood as a content-autonomous and structurally closed quatrain, but when working with song manuscripts, it turns out that they are not always complete texts in content and form or aesthetically perfect texts. Additionally, a fairly large number of songs consist of much more than four lines. If we look at the tradition of Latvian folk songs as a whole, it can be seen that, for various reasons, long songs and strings of songs have been significantly less studied; therefore, the article focuses on one of these phenomena – strings of songs. The article also focuses on the importance and development of the wedding mutual mocking song singing tradition over time and the variability and improvisational nature of the mocking songs. At the end of the article, attention is paid to the following problems of publishing strings of songs: lack of classification principles, volume limitations, including whether and how the mentioned reasons have influenced the inclusion of a string of songs in the 12th volume of “Latviešu tautasdziesmas”.

Single Versus Fractionated Gamma Knife Radiosurgery for Nonfunctioning Pituitary Adenomas Close to the Optic Pathway: A Multicenter Propensity Score Matched Study.

Gamma Knife radiosurgery (GKRS), typically administered in a single session (S-GKRS), is an effective treatment for nonfunctioning pituitary adenoma (NFPA). For lesions close to the optic pathway, the use of hypofractionated radiosurgery is growing. This study seeks to compare the results of S-GKRS vs fractionated-GKRS (F-GKRS) for NFPAs adjacent to the optic pathway. Two cohorts of patients with residual or recurrent NFPAs in contact to the optic pathway were retrospectively included in this study: (1) a group of patients who underwent a 3-day course of F-GKRS in Europe and (2) a group of patients treated with S-GKRS in the United States. A propensity score matching (ratio 1:1) was carried out to obtain and compare 2 homogeneous groups of patients with NFPA. A total of 84 patients were included for analysis (42 in the S-GKRS cohort and 42 in the F-GKRS group). The 2 cohorts did not differ for age, sex, number of previous surgical procedure, tumor volume, and follow-up. The mean follow-up was 60.2 ± 37.0 months and 62.4 ± 37.4 months for F-GKRS and S-GKRS cohort, respectively ( P = .38). The overall tumor control at last follow-up was achieved in 95.2% and 92.9% of patients in F-GKRS and S-GKRS, respectively ( P = .64). The 1-year, 3-year, 5-year, and 7-year progression-free survival rate after F-GKRS was 100%, 97.1%, 97.1%, and 91%, respectively. In the S-GKRS sample, progression-free survival rates were 100%, 100%, 92.5%, and 92.5% at 1, 3, 5, and 7 years after treatment, respectively. Two patients (4.7%) from the F-GKRS cohort and 2 (4.7%) from the S-GKRS cohort sustained visual worsening after radiosurgery ( P = 1.0). In the management of NFPAs adjacent to the optic pathway both F-GKRS and S-GKRS had comparable outcomes and risks at 7 years. Future prospective studies including larger cohorts with longer follow-up are needed to confirm our results.

HYALURONIC ACID LIP AUGMENTATION AND ITS EFFECT ON HUMAN IDENTIFICATION BY CHEILOSCOPY: A CASE REPORT

Cheiloscopy is a human identification technique that consists of studying the lips and their characteristics, such as their thickness, the arrangement of the labial commissure, the position of the grooves and their classifications, as well as recording the impressions produced by them on various supports. Lip augmentation with hyaluronic acid (HA) fillers has become very popular in recent years, especially since facial harmonization was included as a dental specialty. The aim of this study was to verify whether lip fillers with HA have implications for cheiloscopic studies, by means of a clinical case report. A 37-year-old female patient with leukoderma took part in the study. Photographs were taken and measurements of lip thickness, lip commissure layout and lipstick impressions were taken before the lip filler, 15 days after the application of 1 ml of HA and 15 days after the full 2 ml of HA filler. The results of the study suggest that lip filling with HA can interfere with the cheiloscopic method, as there was a change in the architecture of the lips, the layout of the labial commissure, improved contour, cupid's bow and filter, with a significant change in the thickness of the upper and lower lips of approximately 42% in relation to the previous volume. As for the pattern of the lip furrows, there was no change in the designs, however, the quality of the lip impression was affected due to the effect produced by the HA

Histological and immunohistochemical analysis of autografts and xenografts synergy in rectifying attached keratinized gingiva deficiency

Relevance. The complex, multi-stage surgical procedure aimed for replacing missing teeth often results in a deficiency of attached keratinized gingiva (AKG) in the intervened area. Despite numerous methods available for soft tissue volume and esthetics reconstruction, only a few demonstrate considerable long-term stability post-surgery. The quest to address this intricate issue has led to the combined utilization of autografts and xenografts Consequently, there is a need to evaluate the tissue structure obtained through this synergy via histological and immunohistochemical examination of the oral mucosa in the reconstructed region.Materials and methods. This study involved analyzing 87 biopsies of oral mucosa obtained from 57 patients aged 28 to 59 years who had undergone previous soft tissue volume and esthetics reconstruction in the AKG zone. Histological and immunohistochemical examinations were conducted on these biopsies, collected six weeks post soft tissue operation. A section of oral mucosa from the hard palate served as the reference sample.Results. The epithelial structure in the examined groups exhibited a well-defined basal layer with a continuous structure comprising two layers of cells without notable atypia, indicating a high cell proliferation capability. Immunohistochemical analysis targeting protein molecules revealed an absence of inflammation. The expression results of the Ki-67 antigen suggested the preservation of cell proliferation capacity and, consequently, the maintenance of tissue regenerative potential at a high level during the remote postoperative period, up to six weeks.Conclusion. This research showcases the efficacy of employing a combination of autografts and xenografts, a conclusion drawn from comprehensive histological and immunohistochemical analyses. Consequently, this approach presents a promising and innovative alternative to conventional methods for soft tissue volume and esthetics reconstruction.

Allele Frequency Net Database.

The allele frequency net database (AFND, http://www.allelefrequencies.net ) is an online web-based repository that contains information on the frequencies of immune-related genes and their corresponding alleles in worldwide human populations. At present, the website contains data from 1784 population samples in more than 14 million individuals from 129 countries on the frequency of genes from different polymorphic regions including data for the human leukocyte antigen (HLA) system. In addition, over the last four years, AFND has also incorporated genotype raw data from 85,000 individuals comprising 215 population samples from 39 countries. Moreover, more population data sets containing next generation sequencing data spanning >3 million individuals have been added. This resource has been widely used in a variety of contexts such as histocompatibility, immunology, epidemiology, pharmacogenetics, epitope prediction algorithms for population coverage in vaccine development, population genetics, among many others. In this chapter, we present an update of the most used searching mechanisms as described in a previous volume and some of the latest developments included in AFND.

Prediction of Reproductive Outcomes of Intracytoplasmic Sperm Injection Cycles Using a Multivariate Scoring System.

Prediction of in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) success is crucial in counselling patients about their real chance of getting a live birth before commencing treatment. A multivariate scoring system proposed by Younis et al., 2010, was amongst the predictive models used to evaluate IVF/ICSI success. The score entitles basal endocrine, clinical and sonographic parameters. The objective of this study is to assess the predictability of the Younis multivariate score for pregnancy outcomes in ICSI cycles. This prospective observational cohort study (NCT03846388) included patients who pursued IVF or ICSI in a tertiary infertility unit between February 2019 and December 2021. The score variables were age, body mass index, antral follicle count, basal follicle-stimulating hormone (FSH), basal FSH/luteinising hormone ratio, infertility duration, number of previous cancellations and mean ovarian volume. For each woman included in the study, Younis multivariate score was calculated. Then, we correlate the different reproductive outcomes with score levels to validate the score predictability. A score of ≤14 was defined as a low score based on the previous study's results. The student's t-test and Mann-Whitney test were used to compare numerical variables, whereas categorical variables were analysed using the Chi-square test. A receiver operating curve (ROC) and a multivariate logistic regression model were used to investigate the predictability of the Younis scoring model for cycle outcomes. Two hundred ninety-two ICSI-ET cycles were analysed. Of the total cohort, 143 (48.97%) women included showed a low score (≤14), whereas 149 (51.03%) women showed a high score (>14). Women with low scores had significantly higher pregnancy and live birth rates compared to women with high scores (60.1% vs. 7.4%, respectively, P < 0.001; 44.7% vs. 6.7%, respectively, P < 0.001). The area under the curve (AUC) in the ROC curve analysis showed a higher predictability for the scoring system for live birth rate with an AUC of 0.796, with a sensitivity of 86.5% and specificity of 63.8% when using a cut-off level of ≤14. For pregnancy prediction, the AUC was 0.829, with a sensitivity of 88.66% and a specificity of 70.77% when using the same cut-off. Women who have a low score have a high chance of having frozen embryos. Likewise, women who have a high score have a very high chance of cycle cancellation. The Younis multivariate score can be used for the prediction of ICSI cycle outcomes and to calculate the chance of cycle cancellation, pregnancy and take-home baby before ICSI.

Óvodai és iskolai szociális segítő tevékenység gyakorlati tapasztalatai csoportos és közösségi szinten

This study aims to investigate social work in nurseries and schools – as a legally mandatory activity in Hungarian primary and secondary education since 2018 – on group and community intervention levels. Based on mixed methodology, practices and experiences of professionals were uncovered using a 26 item questionnaire and interviews in 2023. While detailed presentation of the individual intervention level in 174 regional micro units has already been published in a previous volume of this journal (Herczeg 2023), this article focuses on institution types, typology of professionals regarding community events, group sessions and their management. Results show that the inclusion of a fellow professional leads to a more complex vision during group session management, creating an opportunity for interprofessional cooperation.

HPB P37 Sustaining and rebuilding a laparoscopic cholecystectomy service in the COVID and post-COVID era

Abstract Background In the Belfast Trust (BHSCT), general surgery provision is complex- segregated into emergency and elective care, across multiple sites. The Emergency Surgical Unit (EmSU) provides ‘hot’ laparoscopic cholecystectomy (LC), and aside from a brief pause, continued throughout COVID. Elective LC was offered on another site in conjunction with the HPB service. This site became a COVID centre and surgical wards closed. Few cholecystectomies were performed during 2020/1. In an effort to restore provision, two ambulatory lists were established on the emergency site in December 2021. Subsequently, a regional ‘over-night stay’ unit opened on the original elective site in April 2023. Methods Previous BHSCT data demonstrated 300-350 elective LCs are undertaken annually with 66% as day cases. Since COVID, anecdotally significantly less LCs have been performed, and the length of stay (LOS) appeared greater. We performed a retrospective study looking at three time periods for comparison. “Pre-pandemic era” January 2019 to February 2020, “pandemic era” March 2020 to December 2021, and “pandemic recovery” from January 2022 to present. Patients were identified using the local HPB database and the electronic care record was reviewed for each patient. Information was gathered on demographics, day-case rate and LOS, as well as conversion and complication rates. Results In all, 827 patients have undergone cholecystectomy since the beginning of 2019. This is significantly less than the projected 1575, based on previous unit volume. Patient demographics are unchanged with mean age of 51.2 years, BMI of 30.27 and M:F ratio of 1:2.3. With the onset of the pandemic, we observed an increase in the average length of stay from 1.22 to 1.77 days with an associated fall in the day-case rate from 63.1% to 35.1%(figure 1). As demonstrated in figure 2, complication rates increased across the board and have been slow to fall in the recovery phase. Conclusions COVID decimated elective surgery globally. Locally, LC provision is an obvious example, with only urgent cases undertaken (76 in 2021 vs 363 in 2019). Unsurprisingly, conversion and complication rates increased. Despite attempts to reinstate the service, previous volume and outcomes have not been matched for multiple reasons. Increased time to surgery (waiting list &amp;gt;1600pts) means patients present with more severe disease. Ambulatory patients are nursed in EmSU where the environment is not orientated to rapid turnaround surgery. In addition, major losses of experienced nursing staff further impact theatre turnover and added to the challenge of setting up new elective facilities.

P11.16.B THE MAYO CLINIC MULTIDISCIPLINARY NF2 CLINIC EXPERIENCE OF BEVACIZUMAB IN NEUROFIBROMATOSIS TYPE 2-RELATED SCHWANNOMATOSIS PATIENTS WITH VESTIBULAR SCHWANNOMAS

Abstract BACKGROUND Neurofibromatosis type 2-related schwannomatosis (NF2) is an autosomal dominant tumor-predisposition syndrome characterized by bilateral vestibular schwannomas (VS) as well as other nervous system tumors. Management decisions for NF2-related VS are typically predicated on tumor size, associated symptoms, patient age, and comorbidities. Observation, surgical resection, and stereotactic radiosurgery can be viable options. In patients with VS associated with NF2, vascular endothelial growth factor A (VEGF-A) inhibitor, bevacizumab, is a systemic treatment option. In this single institution study, we review our clinical experience in patients with NF2 who received bevacizumab for VS and evaluate the effect of bevacizumab treatment on VS growth and symptom progression. MATERIAL AND METHODS This is a retrospective analysis of patients seen at the Mayo Clinic Rochester Multidisciplinary NF2 Clinic. Three-dimensional volumetric data for VS were measured using manual segmentation with Visage PACS software under the direct supervision of a board-certified neuroradiologist. RESULTS Out of 76 patients with NF2 evaluated in the past 3 years, we identified 19 that received treatment with bevacizumab. Median age of NF2 diagnosis was 19 years (range 0.5-61) with a median NF2 phenotype severity score of 2 (range 1-3). Thirteen of these patients have discontinued bevacizumab, accounting for a median duration of 12.2 months (range 3.3-88 months) of bevacizumab treatment. Bevacizumab was discontinued due to hypertension (n=5), proteinuria and renal dysfunction (n=3), tumor progression (n=2), fatigue or other intolerance (n=2), or non-compliance (n=1). The remaining 6 patients are currently receiving bevacizumab treatment for a median duration of 9.4 months as of March 2023 (range 3.7-48.3 months). Fifteen patients had brain MRI data available to evaluate VS change during bevacizumab treatment, with partial response observed in 5 patients, stable disease in 8, and progression in 2. Ten of the 13 patients who stopped bevacizumab had MRI data to evaluate VS change following treatment termination. Within 6 months of bevacizumab discontinuation, 6 patients had rebound growth of their VS between 21-95% from their previous tumor volume, while 4 did not. Three patients with rebound growth went on to have surgery or irradiation for VS management. CONCLUSION Our single institution experience confirms that bevacizumab can slow progression of VS and symptoms associated with VS growth. However, we note that there is the potential for rapid VS growth following bevacizumab discontinuation, for which we propose heightened surveillance imaging and symptom monitoring for at least 6 months upon stopping anti-VEGF therapy.

The Poetry and Music of Science: Comparing Creativity in Science and Art

The Poetry and Music of Science: Comparing Creativity in Science and Art

ЗЕРНОВИЙ ЕКСПОРТ УКРАЇНИ В УМОВАХ ВІЙНИ

Досліджено шляхи і проблеми зернового експорту України в умовах війни. Основними шляхами відновлення експорту зерна є «смуги солідарності» Україна – ЄС і Чорноморська зернова ініціатива. Проте ці заходи лише частково вирішили проблему експорту зерна з України у 2022 – на початку 2023 р. У 2022 р. відбулося зменшення обсягів експорту українського зерна на 32,6 % порівняно з обсягами попереднього року. Повномасштабна воєнна агресія РФ проти України спричинила різке зростання світових цін на пшеницю, а започаткування «смуг солідарності» й морського зернового коридору посприяли їх суттєвому зниженню, зокрема на зерно. Проте вітчизняні виробники зерна і експортери не змогли скористатися зростанням світових цін на зерно у 2022 р. через збільшення транспортних видатків при перевезенні до портів, зростання маржі посередників з урахуванням ризиків воєнного часу, підвищення вартості фрахту суден тощо. Відповідні втрати в ціні зерна при експорті з України перекладаються по зерновому ціновому ланцюгу переважно на нижню його ланку – виробника зерна. Частка виробника (на умовах EXW) у експортній ціні пшениці 2-го класу зменшилася з 80 % на початку дії морського зернового коридору до 67 % при експорті морським зерновим коридором у лютому 2023 р. Серйозні ризики для повоєнного відновлення українського експорту зерна становлять процеси релокації торговельних потоків на традиційних ринках експорту зернових з Чорноморського регіону, пов’язані, насамперед, із заміщенням українського зерна російським. Розвитку українського зернового експорту сприяло б максимальне дистанціювання від РФ у торговельній політиці щодо експорту продукції у межах Чорноморського регіону за рахунок залучення до торговельних потоків Середземноморського регіону з використанням конвенції щодо правил походження Пан-Євро-Мед.

The Importance of Previous Resistance Training Volume on Muscle Growth in Trained Individuals

ABSTRACT Resistance training volume has been suggested to be one of the most effective variables for developing muscular hypertrophy. Meta-analyses have concluded that there exists a dose-response relationship between weekly resistance training volume (i.e., the number of sets performed over the training week) and muscle mass accrual in nonresistance-trained individuals; however, experimental data in resistance-trained individuals have shown conflicting results. Current literature suggests that the performance of additional sets of resistance exercise within a single training session and training week does not inherently result in greater increases in muscle size compared with groups or conditions that perform lower volumes of resistance training. Notwithstanding these results, it has been suggested that controlling for each individual's previous training volume could improve the precision of the muscle hypertrophic response to resistance training and that failing to do so would disregard the principle of progressive overload. Herein, we explore the evidence for the suggestion that a higher-volume approach to training, in comparison to what an individual has been accustomed to, would improve the precision of the muscle growth response to resistance training and the physiological rationale that may (or may not) underpin this phenomenon.

Answering Our Nation's Call: A Solution for Military Neurosurgery Wartime Readiness Through Civilian Collaboration.

Military-civilian partnerships have built the foundation for US neurosurgery as we see it today. Each conflict throughout history has led to expansion within the field of neurosurgery, benefiting civilian patients and those in uniform. Despite the field's growth during wartime, military neurosurgical case volume declines during peacetime, and as a result, important knowledge gained is at risk of being lost. The current landscape of military neurosurgery reflects the relative peacetime for the US-World relationship. Because of this peacetime, the surgical case volume and experience of the military neurosurgeon are declining rapidly. In addition to providing a history of military-civilian partnerships in neurosurgery, we have analyzed the declining case volume trends at a single military treatment facility with neurosurgical capabilities. We compared the case volume of a military neurosurgeon at a civilian partnered location with their previous volume at a military treatment facility and analyzed current trends in wartime readiness by Neurosurgery Knowledge, Skills and Abilities metrics. We believe that military civilian partnerships hold the key to scaffolding the experience to maintain the wartime readiness in the military neurosurgical community.

Obraz przewodnika górskiego w literaturze romantycznej. Część II

The article is a continuation of the analysis begun in the previous (15th) volume of Góry – Literatura – Kultura and dealing with the image of the mountain guide. In the second part the author discusses the earliest high mountain expeditions in the history of Tatra tourism, which were led by more or less experienced guides. The history of the profession in the Tatras goes back to the 17th century. One of the first people to employ a professional guide was a man named Simplicissimus (1654) — this was for a three-day high mountain trek. Among the subsequent expeditions, one of the biggest was a scientific expedition organised by Robert Townson (1793), who made an ascent of Łomnica, guided by Hans Gross.&#x0D; Attempts to create an ideal image of the mountain guide were made in the first mountain guidebooks by Baltazar Hacquet, Eugeniusz Janota or Walery Eljasz. When the Tatra Society was established in 1873, it concluded that one of the most urgent matters to solve was the question of providing care for guides. It was to be regulated by a newly drafted statute, which created an organisational framework for the guiding profession, as a consequence of which guides were divided into three categories in accordance with their qualifi cations. A breakthrough in mountain tourism came in 1874, when Dr Tytus Chałubiński arrived in Zakopane and began his original “itinerary-less trips”, which lasted a few days. The numerous participants in these trips were led by the best guides. This irreverent way in which an elite group usurped the services of guides particularly experienced in mountain guiding provoked a heated discussion within the tourist community, which raged in the press at the time.