Search Results (51)

Cryotherapy could stimulate immune responses and induce abscopal effects. A novel technique was developed for treating spinal bone tumors involving the use of frozen tumor-containing autologous bone grafts for anterior spinal reconstruction following total en-bloc spondylectomy, with the aim of activating cryoimmunity. This study focused on analyzing changes in the T-cell receptor (TCR) repertoire after surgery to evaluate T-cell diversity. Blood samples were collected pre- and post-operatively, with subsequent RNA extraction and immunosequencing. Compared to pre-surgery samples, the diversity and abundance of the Complementarity-Determining Region 3, regions of the TCR α and β chains decreased, suggesting that more selective clones may have emerged and influenced immune responses. Through TCR repertoire analysis, this study demonstrated that transplantation of frozen tumor-containing autologous bone impacted the immune system. This study is expected to provide a foundation for developing treatments that may enhance immune activation. Full article

The Pacific Alliance (PA), established in 2011, aims to foster economic integration among its member states—Peru, Chile, Colombia, and Mexico—by promoting trade liberalization and economic cooperation. However, recent political shifts within these countries have influenced trade policies, affecting intra-bloc commerce and relations with external markets, particularly China and the United States. This study explores how the political environment within the PA has shaped sustainable trade, considering economic policies, trade agreements, and shifts in regional priorities. Using a qualitative and descriptive approach, this research is based on a documentary review of academic literature, official reports, and international trade data. Content analysis was applied to assess the impact of political decisions on PA trade sustainability, including the examination of tariff structures, trade flows, and capital movements. The findings indicate that intra-regional trade within the PA remains limited, with an intraregional trade index below 4%. Mexico continues to prioritize exports to the U.S., while Peru and Chile strengthen ties with China. Although PA member states have maintained liberal economic policies, disparities in trade liberalization levels hinder integration. Furthermore, despite the reduction of tariffs and the implementation of digital trade facilitation measures, political instability and differences in economic strategies among member states challenge the PA’s long-term sustainability. Strengthening institutional frameworks and increasing investments in research and development are crucial for enhancing economic integration and ensuring trade resilience within the bloc. Full article

The Export-Led Growth Hypothesis (ELGH) posits that expanding exports drive long-run economic growth. While this has held true for several Asian economies, its effectiveness across African regional blocs remains underexplored. This study investigates the validity of ELGH in the East African Community (EAC) and Southern African Development Community (SADC), assessing whether exports significantly contribute to economic growth in these regions. The analysis covers 22 EAC and SADC economies from 1990 to 2022—regions marked by structural transformation efforts, trade liberalisation, and participation in the AfCFTA. A dynamic panel data model based on an augmented Cobb-Douglas production function is estimated using the System Generalised Method of Moments (System GMM) to address endogeneity and reverse causality. Granger causality tests supplement the analysis. Exports and technology significantly enhance GDP growth, while labour and FDI are statistically insignificant. Trade openness negatively affects growth, suggesting vulnerability to external shocks. A bidirectional Granger causality exists between exports and GDP. This study offers the first dynamic, bloc-level empirical evaluation of ELGH across EAC and SADC, incorporating trade-related interactions. Findings affirm ELGH’s relevance and stress the need for export diversification, technological upgrading, and institutional reform for sustained growth in Africa. Full article

Achieving the appropriate primary stability for immediate or early loading in areas with low-density bone, such as the posterior maxilla, is challenging. A three-dimensional (3D) stabilization implant design featuring a tapered body with continuous cutting flutes along the length of the external thread form, with a combination of curved and linear geometric surfaces on the thread’s crest, has the capacity to enhance early biomechanical and osseointegration outcomes compared to implants with traditional buttressed thread profiles. Commercially available implants with a buttress thread design (TP), and an experimental implant that incorporated the 3D stabilization trimmed-thread design (TP 3DS) were used in this study. Six osteotomies were surgically created in the ilium of adult sheep (N = 14). Osteotomy sites were randomized to receive either the TP or TP 3DS implant to reduce site bias. Subjects were allowed to heal for either 3 or 12 weeks (N = 7 sheep/time point), after which samples were collected en bloc (including the implants and surrounding bone) and implants were either subjected to bench-top biomechanical testing (e.g., lateral loading), histological/histomorphometric analysis, or nanoindentation testing. Both implant designs yielded high insertion torque (ITV ≥ 30 N⋅cm) and implant stability quotient (ISQ ≥ 70) values, indicative of high primary stability. Qualitative histomorphological analysis revealed that the TP 3DS group exhibited a continuous bone–implant interface along the threaded region, in contrast to the TP group at the early, 3-week, healing time point. Furthermore, TP 3DS’s cutting flutes along the entire length of the implant permitted the distribution of autologous bone chips within the healing chambers. Histological evaluation at 12 weeks revealed an increase in woven bone containing a greater presence of lacunae within the healing chambers in both groups, consistent with an intramembranous-like healing pattern and absence of bone dieback. The TP 3DS macrogeometry yielded a ~66% increase in average lateral load during pushout testing at baseline (T = 0 weeks, p = 0.036) and significantly higher bone-to-implant contact (BIC) values at 3 weeks post-implantation (p = 0.006), relative to the traditional TP implant. In a low-density (Type IV) bone model, the TP 3DS implant demonstrated improved performance compared to the conventional TP, as evidenced by an increase in baseline lateral loading capacity and increased BIC during the early stages of osseointegration. These findings indicate that the modified implant configuration of the TP 3DS facilitates more favorable biomechanical integration and may promote more rapid and stable bone anchorage under compromised bone quality conditions. Therefore, such improvements could have important clinical implications for the success and longevity of dental implants placed in regions with low bone density. Full article

Purpose—This study examines the interaction of economic openness, governance, and money laundering. The paper’s main objective is to analyze how trade openness, foreign direct investment, and anti-corruption measures influence the risk of money laundering in specific economic blocs. Design/methodology/approach—This study analyzes these economic blocs (EU, G20, BRICS, and CIVETS) using annual data from the Basel Institute on Governance and World Bank statistics for 2012–2021. A panel-corrected standard errors (PCSE) estimator is employed to examine the relationships among the variables, accounting for cross-sectional dependence and ensuring robust parameter estimation. The corruption control index is a proxy for governance effectiveness, though it does not directly measure regulatory strength. Future research should incorporate more specific variables to evaluate the regulatory impact. Findings—This study reveals significant variations in money laundering risks by a country’s income category and economic bloc influenced by economic openness and governance structures. Economic growth and foreign direct investment (FDI) inflows exhibit contrasting effects on money-laundering risks; they tend to exacerbate risks in middle-income countries, while high-income nations demonstrated a lower risk of money laundering, likely due to more robust governance structures. Trade openness and anti-corruption measures generally reduced risks in wealthier countries, highlighting the importance of strong governance frameworks. These insights suggest that anti-money-laundering policies should be tailored to fit different regions’ unique economic and institutional contexts for enhanced effectiveness. Originality—This study employs a structured approach to analyzing a decade of panel data from key economic blocs, providing insights into the intricate relationships between governance, economic openness, and money laundering risks. Bridging the gap between theoretical research and practical, actionable strategies serves as a valuable resource for improving the effectiveness of anti-money-laundering (AML) measures on a global scale. Full article

Southeast Asian countries have come together to form the Association of Southeast Asian Nations (ASEAN), especially the formation of the ASEAN Economic Community (AEC) in 2015, which has united countries into an AEC economic bloc. The aims of the study are to assess the impact of integration policies and the role of the AEC on economic growth during the period 1970–2022. Using quantitative analysis methods through OLS, FEM, REM and long-term impact analysis through the ARDL panel, the research results show that a higher level in economic integration is consistent with a higher level of economic growth. Specifically, FDI has a positive impact on economic growth in the short term and the positive impact is stronger in the long term. At the same time, trade openness has a negative impact on growth in the short term, but this effect is no longer in the long term. The result affirms the very positive nature of the AEC for international integration and contribution to economic growth in the Southeast Asian region. Finally, this study has some policy implications for Southeast Asian countries in the context of implementing economic integration policies and setting growth targets. Full article

Introduction: Hemangioblastomas (HBs) are benign, highly vascular tumors that can be found intracranially or in the spinal region, representing around 2–15% of primary intramedullary tumors. They can occur sporadically or in association with Von Hipple–Lindau (VHL) disease. Despite recent of advancement of nonsurgical treatments, complete surgical resection remains the gold standard of care for the spinal HBs. Materials and Methods: We conducted an international multicenter retrospective analysis of adult patients surgically treated for spinal HBs in four European referral centers between January 2000 and September 2024, with a minimum post-operative follow-up duration of 6 months. Patients’ sex and age at surgical intervention, clinical presentation, and duration symptoms prior to clinical diagnosis were identified. The pre- and post-operative neurological status at 1 and 6 months and at the last visit was assessed using the modified McCormick score (MCS). The extent of surgical resection was divided into gross total resection (GTR) and subtotal resection (STR). Finally, post-operative complications were inspected as well, namely cerebrospinal fluid leaks, infections, hemorrhages and post-operative spinal stability. Results: A total of 35 patients were included in the cohort, with an age median of 52 years (34.5–60) and a slight male predominance (21/35, i.e., 60%). The median follow-up period was 37.5 months (12–75). More than half were located in the cervical region, making it the most common (54.3%). Syrinxes were observed in 23 cases (72%), and HBs were more commonly intramedullary (80%). GTR was achievable in around 88% of cases. Post-operative complications were observed in nine patients (25.7%). Nearly half of patients were discharged into rehabilitations centers (48.5%). Tumor recurrence was seen in 10.3% only. At the last follow-up, an excellent overall post-operative neurological status (positive ∆ McCormick) was observed in most of patients (88%) and was found to be associated with a relatively younger age group. Tumor location and presence of syrinxes did not show any statistical significance regarding clinical outcome. In patients having benefited from intra-operative monitoring, only D-wave changes showed statistical significance regarding post-operative outcome (p < 0.05). Conclusions: A large majority of patients operated for a spinal HB demonstrated favorable outcome after surgery, with unchanged or improved neurological status. Advanced age could have an impact on the post-operative neurological outcome. Other factors such as tumor size, location, and the presence of syrinx did not seem to significantly impact the neurological outcome. Finally, the surgery of these vascular lesions with no possibility of debulking or piece-meal removal and requiring “en bloc” resection is technically demanding and should be performed by experienced teams in spine and spinal cord surgery only. Full article

According to data from the Food and Agricultural Organization of the United Nations (FAO), Ukraine was the fifth and ninth global producer and exporter of corn and wheat, respectively, before Russia’s invasion. The disruption of the supply chain in Ukraine in these food sectors due to the Russian–Ukrainian conflict can hamper global food security. Very little is known about how the war has impacted these important food sectors globally. This paper examines the global impact of the war on the corn and wheat sectors in the first year of the war and investigates the relationship between market vulnerability and trade ties with the conflicting regions. Analysis of FAO data shows that Ukraine suffered a 12.87% and 17.45% production decline in the corn and wheat sectors, respectively, compared to the 2012–2021 base years. Using the Acclimate economic network model, these shocks are applied to Ukraine’s corn and wheat network nodes to analyze their global impact. The production value and total losses are calculated and compared to the base year, both regionally and in some major global economic blocs. The results show that the corn sectors in Germany, Ukraine, Poland, and Belgium suffered the largest production value losses, while Ukraine, China, Venezuela, and Korea suffered the largest overall losses. In the wheat sector, Russia, Germany, Ukraine, and Canada suffered the largest production value losses, while Ukraine, Kazakhstan, Uzbekistan, and China suffered the largest overall losses. Overall, the corn sector was the hardest hit globally compared to the wheat sector, with the EU, the US, China, South America, and Africa being the hardest hit in the corn sector, while BRICS and Oceania were the hardest hit in the wheat sector. The study equally finds a strong correlation between increased regional food market vulnerability and Ukraine’s trade relations. These findings can contribute to better investment decisions, regional and sectoral emergency management planning, and the development of regulatory frameworks. Full article

The European Green Deal (EGD), a complex policy program meant to address climate change and ensure a “just, fair and inclusive” transition into a more sustainable and greener Europe, was launched by the EU in 2019. It was clear from the very beginning that the opportunities and costs of the ambitious green transition would be very uneven geographically, not only within the EU but also among its regions and locations. Regions with higher environmental stress and/or less technological and economic capacities will inevitably be disadvantaged. The EGD requires large-scale public acceptance, which comes with democratic innovations and participative practices, which are less embedded in many regions. The former socialist bloc still struggles today with establishing decent levels of public participation, as well as with adopting and implementing democratic community principles in practice. The main aim of this paper is twofold. On the one hand, we intend to give an assessment of where Central and Eastern European (CEE) countries stand in the process of the green transition and what the major focus areas affecting them are, based on the existing academic literature. On the other hand, we intend to give a clear overview of the causes for and aspects of the weakness of civil society in the post-communist bloc and reasons why the adaptation of democratic innovations is lagging in this region. For this purpose, a systematic literature search and bibliometric analysis was performed based on articles indexed in the Scopus and Web of Science databases. Altogether, 172 articles published in the region were filtered and systematically analyzed according to the main themes of the papers related to the EGD. Research findings show that the interests of researchers in CEE countries largely differ from those in the mainstream academic discourse. Research topics, high on the agenda in Western countries, are hardly present in the academic discourse in CEE countries. On the other hand, issues like energy efficiency, urbanization’s impacts on green growth and renewable energy development, and innovations towards a circular economy dominate the research agenda. This region started the green transition process with major handicaps compared to the West, connected to path dependency and the legacy of socialist structures. The paper analyses the bibliometric aspects of articles published on these topics and highlights the highly sectoral and country-focused approaches taken with regard to the EGD. In our paper, we highlight the importance of the region on a geographic scale, which goes beyond the initial framework and offers a different approach to addressing the issue. The paper proves that the presence of EGD-related participation processes is significantly lacking in academic literature in the CEE region. However, the most important finding of our paper is the identification of an academic gap regarding democratic innovations and deliberation, as well as regarding active involvement and participation of people in EGD-related programs. This gives an even more important base for the assessment of the region in terms of the EGD, which faces growing populism and advancing authoritarian regimes, such that public participation and citizen control have become vitally important for the implementation of the green transition. Full article

Mucosal melanomas (MMs) are under-researched tumors with a poor prognosis that arise from melanocytes found in the mucous membranes at different anatomical locations throughout the body. MMs are an uncommon yet highly aggressive tumor that typically develops on mucosal surfaces, predominantly in the head and neck region. MM of the head and neck occurs in 8–10% of all head and neck melanomas. It most commonly affects the mucosa of the nasal cavity and paranasal sinuses (75%), followed by the oral cavity mucosa (25%). A family history and the presence of mucosal nevi are associated with the occurrence of MM. Inhaled and dietary carcinogens are also linked to the development of sinonasal melanoma, much like other malignancies of the nasal cavity. Overexpression of the C-KIT gene is found in more than 80% of all primary mucosal melanomas, with somatic mutations in 10–30% of cases. The presence of these genetic alterations is also reflected in recent clinical studies of specific gene inhibitors that have proven efficiency in the systemic therapy of melanoma. There are various treatment modalities for MM. Surgical therapy involves en bloc surgical resection with a macroscopically visible and palpable mucosal margin of 1.5–2 cm. Partial resection of the maxilla may be considered if it ensures adequate tumor-free margine. Because of its rarity, outcome data for locally advanced head and neck MM is limited and primarily derived from retrospective studies with small case numbers. This review aims to update and summarize findings from clinical trials, prospective observational studies, and retrospective studies, while also exploring future directions for multimodal treatment approaches in this area. Full article

Background/Objectives: Although lateral mass screws lower the risk of vertebral artery injury, they are shorter and have a weaker purchase than a pedicle screw, thereby posing the risk of mechanical failure following a ≥3-level posterior cervical fusion (PCF). Therefore, the purpose of this study is to demonstrate that the posterior en bloc fusion of C2-7 is mechanically stronger than shorter, regionally confined posterior fusions of the cervical spine. Methods: We included 178 patients who underwent PCF with ≥3 levels. Patients who underwent PCF that included both C2 and C7 were classified as the en bloc fusion group (EBF group, n = 116), while PCF cases not including these levels were assigned to a regional fusion group (RF group, n = 62). The fusion rate, incidences of mechanical failure, and clinical outcomes were evaluated using univariate analysis between the two groups. Results: The fusion rate was significantly higher in the EBF group than in the RF group (p = 0.038). In contrast, the mechanical failure rate was significantly lower in the EBF group (8/116 [6.9%] vs. 16/62 [25.8%], p = 0.047). Although the ROM was significantly higher in the RF group (p < 0.001), the functional scores did not significantly differ between the two groups. Conclusions: EBF seems to lower the rate of mechanical failure, as well as similar clinical outcomes, compared to RF. When the possibility of mechanical failure is high after PCF, extending the fusion level to C2 and C7 could be considered to minimize mechanical failure, rather than stopping at C3 or C6. Full article

Farmers are an important and fundamental professional class on which the food, health and well-being of all citizens depend. Recently, and similar to what has happened in other European countries, in Portugal there were also demonstrations of civic and spontaneous movements of farmers dissatisfied with the current Common Agricultural Policy Strategic Plan (PEPAC), with the excessive bureaucracy and with the increase in the costs of production and unfair competition from agricultural products from other countries, especially from outside the European bloc, which do not meet the same production requirements and which are available to consumers. This work consists of a synthesis and reflection on the reasons, arguments and demands made by civic movements of farmers in the northern region of Portugal (NUT II). Among the most frequent allegations was the need to consider specific aspects of the northern Portuguese region, small family farming and some specific sectors. Although the factor that triggered farmers’ indignation was the reduction in support payable under eco-schemes, the consideration of the common land areas for subsidies and for certification in organic farming (in the mountain region), the installation of anti-hail towers in the fruit growing area and compensation for increases in energy and animal feeding costs are among the most frequently mentioned reasons for which farmers require answers. Full article

Background/Objectives: The increasing complexity of spinal oncology procedures, particularly in en-bloc tumor resections, creates challenges in tissue perfusion assessment due to extended operative times and extensive surgical dissection. Real-time visualization of tissue perfusion can be achieved with ICG using commercially available handheld imaging systems, offering potential advantages in spinal oncology cases. This study assessed the utility of ICG in analyzing soft-tissue viability during complex spine procedures extending beyond 7.5 h, with a particular focus on oncologic resections. Methods: Three cases that required over 7.5 h of operative time were chosen for ICG utilization. These cases included an en-bloc malignant peripheral nerve sheath tumor resection, an en-bloc resection of a malignant epithelioid neoplasm, and a long-segment fusion revision for pseudoarthrosis. At the conclusion of the critical portion of the procedure, a handheld intraoperative fluorescence camera was utilized to visualize the tissue penetration of intravenous ICG. Results: Prior to injecting ICG, devascularized tissue was not clearly visible. Injecting ICG allowed clear separation of vascularized (fluorescing) and devascularized (non-fluorescing) tissues. One region of non-florescent tissue was later confirmed to be devascularized with MRI and experienced postoperative infection. Conclusions: As the complexity of spinal oncology procedures increases, ICG fluorescence imaging offers a novel method for real-time assessment of tissue perfusion. This technique may be particularly valuable in extensive tumor resections, post-radiation cases, and revision surgeries where tissue viability is at risk. Further investigation in the spinal oncology population could help establish whether early identification of poorly perfused tissues impacts wound healing outcomes. Full article

Efficiency is one of the tenets in assessing the financial health of an enterprise. Ultimately, the form of asset management has a major impact on growth but also on the decline of profit. It also reveals how the enterprises are positioned within the competitive market environment. For this reason, the aim of this article is to define the level of business activity in the Visegrad Four in the pre-crisis, during-crisis and post-crisis periods of the COVID-19 pandemic. The investigation included 48,650 enterprises from Slovakia, Czechia, Poland, and Hungary over the period 2017–2023. We determined the median values of eleven business efficiency indicators separately for each country and sector. The Friedman test and Kruskal–Wallis test confirmed significant differences between years and countries. Furthermore, multiple pairwise comparisons revealed analogies between the pre-crisis and post-crisis periods, as well as similarities between the two pandemic years for the tested ratios. One can observe that the results serve as the foundation for regional and international benchmarks, particularly for enterprises from former Eastern Bloc countries. Full article

Background/Objectives: EnBloc resections of bone tumors of the spine are very demanding as the target to achieve a tumor-free margin specimen (sometimes impossible due to the extracompartimental tumor extension) is sometimes conflicting with the integrity of neurological functions and spine stability. Methods: The surgical treatment of a huge multi-level chordoma of the thoracic spine with unusual extension is reported. Anteriorly, the tumor widely invaded the mediastinum and displaced the aorta; on the left side, it expanded in the subpleuric region; posteriorly, it was uncommonly distant 13 mm from the posterior wall. Results: EnBloc resection is largely performed for primary bone tumors of the spine and many reports have been published concerning brilliant solutions to difficult issues of surgical anatomy. One of the major challenges is still the compatibility between oncological and functional requirements. Conclusions: Oncological staging, careful imaging analysis, a multidisciplinary surgical team, and utilization of the most recent technologies like navigation and robotics have made an oncologically appropriate EnBloc resection of a multi-level chordoma of the thoracic spine possible without affecting the continuity of the spinal canal and without any involvement of its content by an original “L”-shaped osteotomy. Full article