Academic literature on the topic 'End of Blockade'

The Na+/H+ exchanger (NHE) and/or the Na+/HCO3− cotransporter (NBC) were blocked during ischemia in isolated rat hearts. Intracellular Na+ concentration ([Na+]i), intracellular pH (pHi), and energy-related phosphates were measured by using simultaneous 23Na and 31P NMR spectroscopy. Hearts were subjected to 30 min of global ischemia and 30 min of reperfusion. Cariporide (3 μM) or HCO3−-free HEPES buffer was used, respectively, to block NHE, NBC, or both. End-ischemic [Na+]i was 320 ± 18% of baseline in HCO3−-perfused, untreated hearts, 184 ± 6% of baseline when NHE was blocked, 253 ± 19% of baseline when NBC was blocked, and 154 ± 6% of baseline when both NHE and NBC were blocked. End-ischemic pHi was 6.09 ± 0.06 in HCO3−-perfused, untreated hearts, 5.85 ± 0.02 when NHE was blocked, 5.81 ± 0.05 when NBC was blocked, and 5.70 ± 0.01 when both NHE and NBC were blocked. NHE blockade was cardioprotective, but NBC blockade and combined blockade were not, the latter likely due to a reduction in coronary flow, because omission of HCO3− under conditions of NHE blockade severely impaired coronary flow. Combined blockade of NHE and NBC conserved intracellular H+ load during reperfusion and led to massive Na+ influx when blockades were lifted. Without blockade, both NHE and NBC mediate acid-equivalent efflux in exchange for Na+ influx during ischemia, NHE much more than NBC. Blockade of either one does not affect the other.

Background Bariatric surgery patients are at risk of perioperative airway collapse. Neuromuscular blockade should be fully reversed before tracheal extubation. The optimal dosage of the reversal agent sugammadex in the morbidly obese is still unknown. This study explored the sugammadex dose adjusted according to train-of-four ratio (TOFR). Methods Prospective observational study of consecutive patients scheduled for laparoscopic bariatric surgery. To reverse a deep blockade (2 or fewer posttetanic twitches), a dose of sugammadex of 4 mg/kg ideal body weight (IBW) was followed by a second dose of 2 mg/kg IBW if the TOFR was less than 0.9 after 3 min. To reverse a moderate blockade (reappearance of the second twitch in the TOF), a 2 mg/kg IBW dose of sugammadex was followed by a second dose of 2 mg/kg IBW if the TOFR was less than 0.9 after 2 min. Sugammadex effectiveness was reflected by the time required to obtain a TOFr of 0.9 or more. Results A total of 120 patients were included. The blockade was deep at the end of surgery in 43 and moderate in 77. The median times (range) to TOFR of 0.9 or more were 167 (20-460) seconds and 113 (28-300) seconds in deep and moderate blockades, respectively (P < 0.05). The percentage of patients requiring a second dose of sugammadex were larger after deep blockades (39.5% [n = 17] vs. 23.4% [n = 18] after moderate blockades); the difference was not significant. Conclusion A sugammadex dose calculated according to IBW is insufficient for reversing both deep and moderate blockades in morbidly obese patients.

Traditionally, experts considered several blockades, including sea and land, with the development of aircraft transportation - air, and with the advent of space technology and special satellites - space. Also, information blockades have been introduced with the rapid development of computer technology and communication tools. Each type of blockade had its historical characteristics; they differed in costs and, of course, efficiency. In the second half and at the end of the 20th century, scientists operated the term cyber blockade and restrictions in cyberspace. The paper sequentially considers physical environments (domains): air, land, sea, outer space, information space, and cyberspace. Multiple definitions of cyberspace have emerged as this concept evolves and becomes more nuanced in response to rapid developments in the technical, technological, economic, and social dimensions of modern life. Due to their potential, cyber-attacks and cyber warfare have garnered significant attention considering the ongoing development of society and business. Cyber-attacks are carried out regularly - against government agencies, military and civilian departments, and private businesses. The growing dependence of countries on cyberspace can play a negative role in the process of confrontation. The enemy can attack those areas where cyberspace is a decisive element. The authors discussed the questions of cyber-blockade efficiency.

Postoperative period in cross-linking is often known to be complicated by presence of pain syndrome of varying intensity due to corneal deepithelization during surgery which negatively affects postoperative rehabilitation. Pterygopalatine blockade by infrazygomatic access refers to minimally invasive interventions and has a sufficiently high analgesic profile, which serves as a justification for its use for the purpose of anesthesia. A therapeutic blockade with levobupivacaine at the end of surgery can create a long-term analgesic effect by a single injection. Purpose. To evaluate the efficacy of pterygopalatine blockade for corneal cross-linking postoperative anesthesia. Methods. A retrospective study: group 1–15 patients who underwent pterygopalatine blockade at the end of the operation, group 2 – 13 patients who took NSAIDs for postoperative anesthesia. The level of pain, the number of prescribed analgesics and the level of the patient's comfort were taken into account. Results. After the surgery, 69.2 % of patients in the second group complained of pain 6 hours later, average pain score on the Verbal Rating Scale (VRS) was 1.1±0.92, in group 1 there was no pain syndrome which led to a decrease in postoperative administration of analgesics in group 1. The level of comfort of patients in the early postoperative period was higher in group 1 and was 6.6 %. Conclusion. The use of pterygopalatine blockade at the end of corneal cross-linking operation allows to create a long-term analgesic effect, reduce lacrimation, thereby improving the patient's comfort level on the 1st day after surgery. Key words: pterygopalatine blockade; pain; levobupivacaine.

This thesis explores the repopulation of Leningrad following the blockade of the city during the Second World War. In the years after the lifting of the siege blockade survivors remaining in Leningrad were joined annually by hundreds of thousands of incomers. However, while the siege has recently been the subject of a number of scholarly and literary treatments, much less attention has been paid to what happened next in terms of the mass resettlement of the city. Accounts of the consequences of the blockade that touch upon the postwar population have deployed the term ‘Leningraders’ as shorthand for a cohesive community of blockade survivors, embedded in the culture and landscape of the city. Even pieces of work that have portrayed post-siege Leningrad as a ‘city of migrants’ have concentrated on the impact of the loss of the prewar population rather than on the multifarious experiences of its itinerant populations. The thesis addresses the role of widespread experiences of displacement and resettlement in structuring relationships among individuals and between citizens and the authorities in the post-siege civic environment. It examines the repopulation in the context of evolving Soviet practices of population management after the war and in terms of the intersection of population movements with the re-affirmation of a civic community in a city which had lost a vast proportion of its population, just as it gained the basis for a powerful new narrative of belonging. It demonstrates how competing visions of the desired postwar order on a national and local scale were constructed and contested in relation to displaced people who were often targeted as a potentially transgressive presence in the postwar landscape.

A robust mathematical model of one-dimensional flow for sloping, blocked-end border irrigation was developed using the four-point implicit method to solve the Saint-Venant equations, the volume-balance solution method, and the implementation of new algorithms to avoid numerical instability and solution divergence. The model has the capability of successfully simulating all surface irrigation phases in blocked-end borders for a range of inflow rates (0.01 - 0.05 m3/s per m), longitudinal slopes (up to 1.00%), and border lengths (100 - 500 m). To achieve numerical stability over the specified parameter ranges, the model was divided into three parts: (1) advance-phase simulation which uses the four-point implicit solution method of the Saint-Venant equations, with an algorithm that changes the spatial and temporal weighting, in addition to an algorithm that handles the water depth profile at the blocked-end downstream boundary upon completion of the advance phase; (2) simultaneous advance-recession-phase calculations using a hybrid algorithm to solve the governing equations; and (3) recession-phase simulation using the four-point implicit method until (and if) divergence occurs, then the volume-method is applied to complete the simulation. The three parts also involve the use of computational grid management algorithms and a parabolic equation which defines the Chezy coefficient as a function of water depth. The model incorporates the downhill simplex optimization method to determine the recommended inflow rate and irrigation cutoff time, maximizing a composite irrigation efficiency (water requirement efficiency and application efficiency). Different optimum values of inflow rate and irrigation cutoff time for a range of longitudinal slopes, border lengths, and soil types were generated. Most of the optimum values are for relatively high inflow rate and rapid cutoff time. In addition, exponential relations were developed, based on the simulation results, to determine the best irrigation time for maximization of the composite irrigation efficiency for specified, non-optimal inflow rates. The exponential relations are particularly useful in practice when it is not feasible to use the optimum inflow rate due to constraints at the water source, or because of irrigation scheduling issues.

The use of hyperkalaemic cardioplegia in cardiac surgery induces depolarised arrest and it is currently the gold standard for myocardial protection. Although hyperkalaemia is by far the most commonly used clinically, it has been established that depolarised arrest has detrimental effects due to sodium and calcium loading. This triggered interest in establishing alternative means of cardioplegia. Esmolol, an ultra-short acting β-blocker, was found to induce cardioplegic arrest at high (millimolar) concentrations and offers improved protection to hyperkalaemic arrest. Unlike other alternative cardioplegic agents, esmolol has been used, safely, clinically in high doses, which make it clinically relevant. However the arrest by esmolol in Langendorff perfused hearts isolated from any catecholamine background cannot be explained by its β-blocking mode of action. The aim is to establish the arresting mode of action of esmolol. Pilot data suggested that esmolol has a myofilament desensitising as well as an inhibitory effect on the calcium transient (Catr) in the isolated ventricular myocyte. Esmolol reduced the Catr at high concentration (IC50=~250μm). This was independent from the β-blocking effect. The effect on the sarcoplasmic reticulum (SR) was excluded by blocking the SR effect using thapsigargin and the negative inotropic effect of esmolol was maintained. Using skinned rat myocytes, esmolol did not induce myofibril desensitisation. The effect of esmolol on the L-type calcium channels was studied using patch clamp techniques. Esmolol was found to inhibit the L-type calcium channels (IC50=~450μm). Esmolol also inhibited the fast Na channels (IC50=~150 μm). The arrest by esmolol was caused by direct inhibition of the myocardium and not by inhibiting the conductive system only using paced Langendorff perfused hearts. It was concluded that esmolol induces arrest by blocking sodium and Calcium channels. It was last established that, in the Langendorff perfused rat heart, adding a K+ channel opener,adenosine 0.25mM, to esmolol 0.6 mM offers better protection to St. Thomas’ Hospital cardioplegia (STH) with 1 hour recovery LVDP of 69±3.7 and 51±4.6 (% of control, p < 0.01) in 4-hour ischaemia with room temperature multiple infusion cardioplegia.

Acute Respiratory Distress Syndrome (ARDS), an age-old clinical problem facing the Emergency Department and Intensive Care Units of all health systems, is a common debilitating lung condition consequent upon severe systemic inflammation. Although several studies have gone into understanding the epidemiology and pathogenesis of the disease thus making way for new advances in treatment strategies, there seems to be no known study tailored to its prevention. Neutrophil extravasation within the tissues during inflammation is the hallmark of this syndrome. Our study sought to block excessive neutrophil infiltration by inhibiting the biosynthesis of some essential proteins necessary for the process. In this initial study, neutrophil transmigration was successfully reduced by 66% using protein synthesis inhibitors, a combination of puromycin and anisomycin. Our strategy, if fine-tuned, could form the basis of a new clinical strategy for the prevention of ARDS.

John Burgoyne, a British general during the American Revolution, is best known for his defeat by the Continental Army at Saratoga. In addition to serving as a general,Burgoyne was a playwright. While in Boston during the blockade following the Battle ofBunker Hill Burgoyne combined his interests, writing a satire of the war. The Blockade of Boston, Burgoyne's play, was first presented as an afterpiece to a production of The Busybody on January 8, 1776 (Silverman 292).Accounts of the performance differ in detail, but the central event is consistent: during the performance a soldier walked out on stage and announced that the rebels were attacking a British position. The audience of British military personnel, believing the statement to be a part of the performance, stayed in their seats to enjoy the show, only to then realize their mistake a moment later and rush off in great confusion. Most of the surviving records of this event are from the view of the delighted revolutionaries, who published accounts of it in their newspapers and pamphlets, to the lasting humiliation of the men involved with the production.I first encountered the story of Burgoyne's Blockade of Boston while working as a teaching assistant in an undergraduate theatre history class. The professor, Noreen Barnes, was lecturing on American theatre in the eighteenth century when she told the story of the interrupted first performance. I was intrigued by the story, and so when I wrote a paper on a disrupted performance for a historiography class, I chose to research the topic. I discovered that The Blockade of Boston, in addition to being a great story in its own right, could serve as a lens to examine the history of the period, opening questions of race, gender, and just what it means to be an American.

Orientador: Valéria Nobre Leal de Souza Oliva<br>Banca: Celina Tie Nishimori Duque<br>Banca: Paulo Sérgio Patto dos Santos<br>Resumo: Objetivou-se comparar as técnicas de punções única e dupla e estabelecer uma dose (mL/kg) de ropivacaína 0,75% para realização do bloqueio peribulbar em cães. Vinte e dois cães com indicação para cirurgia de catarata, machos ou fêmeas, de diferentes raças, idades e pesos foram utilizados no experimento. Os pacientes foram alocados em três grupos: punção única inferior (PUI), superior (PUS) ou dupla (PD). Em todos os grupos foram realizadas no máximo três punções em intervalo de 20 minutos tendo-se como critério para repetição a não centralização bulbar. Os volumes administrados foram de 0,2 mL/kg (primeira punção) e, caso necessário, de 0,1 mL/kg nas segunda e terceira punções. Avaliou-se a duração dos bloqueios motor e sensitivo (estesiometria) em intervalos de 15 minutos, número de punções e complicações. As variáveis foram submetidas à análise de variância com medidas repetidas e análise de resíduos. Aquelas com distribuição normal foram analisadas pelo teste de Tukey enquanto as não normais foram analisadas pelo teste de Kruskal-Wallis e teste de Friedman com pós-teste de Dunn. As análises foram efetuadas empregando-se o programa SAS e foram consideradas significativas quando P < 0,05. Não houve diferença significativa (P>0,05) entre os grupos PUI, PUS e PD com relação ao número de punções, duração dos bloqueios motor e sensitivo. As complicações foram significativamente menos frequentes no grupo PUI, diferindo dos grupos PUS e PD. O bloqueio peribulbar realizado pela PUI é melhor e mais seguro comparado a PUS e PD sendo o volume ideal de 0,3 mL/kg de ropivacaína a 0,75%<br>Abstract: The objective of this study was to compare the techniques of single and double puncture and to establish the dosage (mL/kg) of ropivacaine 0.75% for peribulbar blockade. Twenty two dogs with indication for extracapsular facectomy, of both genders and various breeds and ages were used. The dogs were allocated into three groups: inferior single puncture (PUI), superior single puncture (PUS) and double puncture (PD). In all groups up to three punctures were made at 20 minute intervals, being non centralization of the bulb the criteria for each next puncture. The volumes administered were 0.2 mL/kg (first puncture) and 0.1 mL/kg (second and third punctures). The duration of motor and sensitive (estesiometry) blockades was evaluated at 15 minutes intervals, as well as number of punctures and complications. Variables were submitted to ANOVA. Variables with normal distribution were analyzed using a Tukey's test, and the ones that didn't pass normality test were analyzed by using the Kruskal-Wallis and Friedman tests with post-test of Dunn. Such analyses were made by the SAS software (Statistical Analysis System Institut Inc.; Version 9.2, NC, USA) and were considered significant when P < 0.05. There was no significant difference (P>0.05) between groups PUI, PUS and PD concerning number of punctures, duration of motor and sensitive blockades. Complications were significantly lower in the PUI group, differing from groups PUS and PD. Peribulbar blockade performed by PUI is better and safer when compared to PUS and PD, being the ideal volume for it 0.3 mL/kg of ropivacaine 0.75%<br>Mestre

The purpose of this study was to determine how early seizure blockade with ethosuximide (ESX) would influence ion channel expression and long-term spike-wave discharge (SWD) activity in epileptic WAG/Rij rats. The goal was to elucidate the question Do seizures beget seizures? in a genetically prone model and if so, to attempt to interrupt this cycle by early intervention. In our first experiment, we used immunocytochemistry to determine the effect of ESX on cortical expression of ion channels in treated and untreated WAG/Rij rats and age-matched Wistar controls. This experiment revealed that treatment with ESX blocked the upregulation of Nav1.1 and Nav1.6 as well as the downregulation of HCN1 that is associated with epileptic activity in rats (p < .05). In a second experiment, WAG/Rij rats were divided into 3 groups: untreated (H2O), temporary early treatment (ESX 4 month), and continuous early treatment (ESX continuous), and SWD activity was measured by electroencephalogram (EEG) at various timepoints. This second experiment revealed that animals in the ESX 4 month group spent less percent time in SWD (0.242 ± .068 SEM) than animals in the H2O group (0.769 ± .060 SEM, p < .001), although they spent slightly more percent time in SWD than animals in the ESX continuous group (0.020 ± .065 SEM, p = .003). This effect was predominantly due to seizure number, and average seizure duration did not vary among the three groups. Additionally, power spectrum analysis revealed a significant correlation when the difference between power spectra for H2O and ESX 4 month rats was compared to the power spectrum of a seizure (Pearson correlation equals 0.955, 2-tailed significance < .000000001), suggesting quantitatively that seizures were reduced by temporary early treatment. This suggests that early prevention of SWD may reduce the burden of seizures later in life, and that possibilities for prevention of genetic absence epilepsy should be further investigated.

The primary purpose of this research was to improve the accuracy and robustness of pipeline transient modeling. An algorithm was developed to model the transient flow in closed tubes for thin walled pipelines. Emphasis was given to the application of this type of flow to pipelines with small radius 90° elbows. An additional loss term was developed to account for the presence of 90° elbows in a pipeline. The algorithm was integrated into an optimization routine to fit results from the improved model to experimental data. A web based interface was developed to facilitate the pre- and post- processing operations. Results showed that including a loss term that represents the effects of 90° elbows in the Method of Characteristics (MOC) [1] improves the accuracy of the predicted transients by an order of magnitude. Secondary objectives of pump optimization, blockage detection and removal were investigated with promising results.

Over the past 70 years since the introduction of d-tubocurarine, the search for an ideal neuromuscular blocking agent has led to the development of the depolarizing drug, succinylcholine (suxamethonium), with its rapid onset of action and plasma metabolism, and a series of non-depolarizing agents of which there are two groups: benzylisoquinoliniums (e.g. atracurium, cisatracurium and mivacurium) and aminosteroidal agents (e.g. pancuronium, vecuronium and rocuronium). The need to monitor neuromuscular block perioperatively to ensure the appropriate dose of any neuromuscular blocking drug is given has led to the development of several nerve stimulation techniques. Particularly useful clinically are the train-of-four twitch response, double-burst stimulation, and the post-tetanic count. Their benefits and limitations are considered in this chapter. The most suitable equipment to monitor neuromuscular block and the appropriate anatomical sites for stimulation are discussed. To prevent residual block with its pathophysiological consequences such as upper airway and pharyngeal dysfunction and potential respiratory failure at the end of surgery, antagonizing agents are used. These are of two types: anticholinesterases such as neostigmine and edrophonium, and the γ‎-cyclodextrin, sugammadex. The pharmacodynamics and pharmacokinetics of neuromuscular blocking drugs and their antagonists are altered by the extremes of age, obesity, and several disease states including renal and hepatic failure, neuromuscular disorders, and critical illness. The altered response to all these drugs in these pathologies, which is related to their metabolism and excretion, is considered in detail, together with their other side-effects including the particular disadvantages to the use of succinylcholine.

Acute Respiratory Distress Syndrome reviews the definitions, causes, pathophysiology, and management of this relatively common, life-threatening disorder. This chapter describes how to ensure adequate tissue oxygen delivery while minimizing ventilator-induced lung injury and provides an in-depth review of how to determine the optimum level of positive end-expiratory pressure (PEEP). The first topic addressed is the precipitating factors and pathophysiology of acute respiratory distress syndrome. Next the chapter turns to mechanical ventilation, and covers the subjects of adequate oxygenation, ventilator-induced lung injury, ancillary therapies, ventilatory therapies, and high I:E ventilation. The topics addressed in the area of non-ventilatory therapies include: prone positioning of the patient, neuromuscular blockade, inhaled vasodilators, and extracorporeal membrane oxygenation (ECMO).

While end-stage microvascular complications are now relatively uncommon, the burden of microvascular disease is still heavy. National diabetic retinopathy screening programmes have contributed to reducing advanced retinal disease, as has improved laser technology and vitreoretinal surgery. More recently intravitreal anti-VEGF agents (bevacizumab, ranibizumab, and aflibercept) have been effective in reducing visual loss from macular oedema. Diabetic nephropathy has a variable phenotype, and high rates of natural regression from microalbuminuria to normoalbuminuria mandate careful and regular review with regular urinary albumin-creatinine ratio (ACR) measurements. Up to one-quarter of patients with renal impairment have never had microalbuminuria. Long-term glycaemic control is the most important treatment for early diabetic nephropathy; angiotensin blockade treatment (ACE-inhibitors, angiotensin receptor blockers) are less important. In established diabetic nephropathy, intensive multimodal treatment is needed. Neuropathic complications are usually plantar ulceration, Charcot neuroarthropathy, and autonomic, especially gastroparesis and erectile dysfunction.

Pregnancy-related heart disease is increasing worldwide and peripartum cardiomyopathy (PPCM) is an important contributor to early (&lt;42 days postpartum) and late (up to 1 year postpartum) maternal death. PPCM is an idiopathic form of cardiomyopathy, presenting with heart failure secondary to left ventricular dysfunction towards the end of pregnancy, or in the months following delivery, where no other cause of heart failure is identified. It is a diagnosis of exclusion. Incidence and prognosis varies according to geography and is likely due to multiple factors. The recent specific pathophysiological hypothesis which states that the oxidative stress–cathepsin D-16 kDa prolactin cascade plays a key role in the development of PPCM in experimental models and in humans suggests that a therapeutic approach involving blockade of this pathway with bromocriptine may be a novel disease-specific approach. Despite ongoing research, numerous uncertainties regarding the incidence, pathophysiology, treatment, and prognosis of PPCM patients remain, indicating the need for further investigation. The establishment of the international registry on PPCM, under the umbrella of the EuroObservational research programme, will provide novel information and address many uncertainties.

This detailed two-volume set tells the story of the Cold War, the dominant international event of the second half of the 20th century, through a diverse selection of primary source documents. One of the most extensive to date, this set of primary source documents studies the Cold War comprehensively from its beginning, with the emergence of the world's first communist government in Russia in late 1917, to its end, in 1991. All of the key events, including the Berlin Blockade, the Korean War, the Cuban Missile Crisis, the Vietnam War, and the nuclear arms race, are discussed in detail. The primary sources provide insight into the thinking of all participants, drawing on Western, Soviet, Asian, and Latin American perspectives. InThe Cold War: Interpreting Conflict through Primary Documentsprimary documents are organized chronologically, allowing readers to appreciate the ramifications of the Cold War within a clear time frame. Extensive interpretive commentary provides in-depth background and context for each document. This work is an indispensable reference for all readers seeking to become deeply knowledgeable about the Cold War.

AbstractThis chapter elaborates on the links between the blockade of Qatar and its relationship with Qatari nationals’ psychological well-being and their sense of national identity. To this end, the chapter reviews the research on various psychological and attitudinal effects of the blockade on Qatari people. Moreover, it presents the research on how the development of a sense of national identity influenced Qataris’ well-being during the blockade. Finally, the chapter presents the results of research on the use of social media before and after the blockade and how social media were used to show national identity and support for the government after the blockade.

Diabetic nephropathy is a common and serious complication of diabetes mellitus (DM), characterized by progressive kidney damage that can lead to end-stage renal disease (ESRD). It primarily affects individuals with both type 1 and type 2 diabetes, and its pathogenesis involves complex interplay of metabolic, hemodynamic, and inflammatory factors. Key mechanisms include hyperglycemia-induced oxidative stress, activation of the renin-angiotensin-aldosterone system (RAAS), and inflammatory pathways. Current therapeutic approaches aim to delay or prevent the progression of diabetic nephropathy. Tight glycemic control through lifestyle modifications and pharmacotherapy remains fundamental, as it helps reduce the incidence and progression of kidney disease. Additionally, renin-angiotensin system blockade with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) is crucial in managing diabetic nephropathy due to their renoprotective effects, including reducing proteinuria and preserving kidney function. Beyond glucose and blood pressure control, newer therapeutic strategies involve the use of sodium-glucose co-transporter 2 (SGLT2) inhibitors, which have shown promising results in reducing renal events and slowing the decline in kidney function in patients with diabetic nephropathy. These agents exert their effects by inhibiting glucose reabsorption in the proximal tubule of the kidney, leading to glycosuria and natriuresis, and thereby reducing intraglomerular pressure and albuminuria. Furthermore, comprehensive management includes lifestyle modifications (such as dietary sodium restriction and smoking cessation), treatment of dyslipidemia, and regular monitoring of kidney function through urine albumin-to-creatinine ratio and estimated glomerular filtration rate (eGFR). Multidisciplinary care involving nephrologists, endocrinologists, and primary care providers is essential to optimize therapeutic strategies and improve outcomes in patients with diabetic nephropathy.

AbstractThis chapter presents the introductory remarks about the book and its content. In so doing, the chapter describes the blockade of Qatar and the ways in which Qatari government reacted to it. The authors describe different analytical perspectives and arguments put forward to understand Qatari policies in order to respond to the blockade. The chapter ends with an overview of the content of different chapters and the organization of the study.

AbstractA 1:15 small-scale model was built based on a blocked tunnel at one end of Chongqing rail transit, the reliability of FDS numerical simulation was verified by experiments. Adopts the FDS18.0 software for the shaft seal at the end of the tunnel, and discusses the fire location, fire heat release rate on the effects of the shaft of natural smoke extraction mode when fire between seal and shaft, shaft smoke exhaust volume significantly greater than other fire source position, the critical length of shaft is bigger, when fire heat release rate between 2.5 MW to 7.5 MW. The critical shaft length decreases with the increase of shaft height, but has nothing to do with the heat release rate of fire source. A critical shaft length prediction model for tunnel closure at one end is proposed.

AbstractChemotherapy has been the backbone for the treatment of recurrent or metastatic nasopharyngeal carcinoma (RMNPC), which remains an incurable disease. Currently the most active area of therapeutic investigations in RMNPC is in immunotherapy, especially after the results of five anti-programmed death-1 (anti-PD-1) antibodies, i.e. pembrolizumab, nivolumab, camrelizumab, toripalimab and tislelizumab, have demonstrated monotherapy objective response rates of 21%–43%. Combinations using anti-PD1/L1 antibodies as backbone to evaluate their additivity or synergy with cytotoxic chemotherapy, molecularly targeted agents, or other immuno-oncology compounds are actively being developed. Besides immune checkpoint blockade, additional ways to modulate the host immune system, such as Epstein-Barr virus (EBV)-directed vaccination against viral antigens (such as EBNA1, LMP1, LMP2) with dendritic cells or peptides, adoptive cell transfer of autologous or HLA-matched allogeneic EBV-specific cytotoxic T lymphocytes, CAR or TCR T-cell therapy, personalized cancer vaccines and oncolytic viruses are being explored. Finally, novel molecularly targeted agents that have entered human testing in RMNPC include apatinib and anlotinib (antiangiogenic agents), MAK683 (an embryonic ectoderm development or EED protein inhibitor), among others. This review provides an update of ongoing clinical trials evaluating these new compounds in RMNPC.

The aerodynamic interaction between rotor wake and surrounding obstacles is complex, and generates high compensatory workload for pilots, degradation of the vehicle handling qualities and performance, and unsteady forces on the structure of the obstacles. The interaction also affects the minimum distance between rotorcraft and obstacles to operate safely. A vortex-based approach is here employed to investigate the complex aerodynamic interaction between rotors and ground obstacles and identify the distance where the interaction ends. This is also one of the objectives of the GARTEUR AG22 effort. In this approach, the aerodynamic loads of the rotor blades are described through a panel method, and the unsteady behavior of the rotor wake is modelled using a vortex particle method. The effects of the ground plane and obstacle are accounted for via a viscous boundary model. The method is then applied to "Large" and "Wee" rotor near the ground and obstacle and compared with earlier experiments carried out at the University of Glasgow. The results show that the predicted rotor induced inflow, and flow-field compare reasonably well with the experiments in terms of magnitude and phase, for the peaks of the radial outwash and vertical downwash. Furthermore, at certain conditions the tip vortices are pushed upwards and are re-ingested into the rotor wake due to the effect of the obstacle resulting in a recirculation. Moreover, contrary to cases without the obstacle, the peak and thickness of the radial outwash near the obstacle is lower due to blockage effects, and an up-wash is observed. Additionally, as the rotor closes to the obstacle, the rotor slipstreams impinge directly on the obstacle, and the up-wash near the obstacle is faster, indicating a stronger interaction between the rotor wake and the obstacle. Also, contrary to the case without the obstacle, the fluctuations of the rotor thrust, roll and pitch moments are obviously strengthened. When the distance between the rotor and the obstacle is larger than 3R, the effect of the obstacle is small.

Traditionally, experts considered several types of blockades, including sea, land, with the development of aircraft construction - air, with the advent of space technology and special satellites - space. With the rapid development of computer technology and communication tools, the information blockades have been introduced. Each type of blockade had its own historical characteristics; they differed in costs and, of course, efficiency. In the second half and at the end of the 20th century, scientists operated the term cyber blockade and restrictions in the field of cyberspace. A number of definitions of cyberspace are provided, since this category changes and is refined depending on the rapidly developing technical, technological, economic and social aspects of our life. Because of the threat they pose, cyber-attacks and cyber warfare receive significant attention once society and business is developing. The growing dependence of countries on the cyberspace can play a negative role in the process of confrontation; the enemy can attack those areas where cyberspace is a decisive element.

Surgery with extracorporeal circulation (ECC) is associated with platelet activation, which greatly contribute to prolonged postoperative bleeding and increased blood loss after surgery. Antiplatelet ccnpounds which induce rapid and reversible inhibition of platelet function, without affecting platelet adhesiveness would be potentially useful in the management of the platelet-dependent hemostatic disorder observed in ECC. Ajoene, an organosulfur originally obtained from garlic, inhibits platelet release and aggregation induced ex vivo by all know agonists. It does not affect shape change or adhesion to collagen nor interfere with metabolic pathways relevant to the platelet reaction. Ajoene action is related to its direct interaction with the fibrinogen receptor on the platelet surface which irrpairs fibrinogen binding to stimulated or chymotrypsin treated platelets. IV administration of ajoene (15 mg/Kg) to mongrel dogs, inhibits platelet aggregation induced ex vivo by collagen (2-5 g/ml) or ADP (10 M). Ccnplete inhibition is attained after 20-35min and recuperation of platelet reactivity is obtained after 2.5-3.5 hours. To study the potential benefit of ajoene for the prevention of platelet activation during cardio-pulnonary bypass, ajoene was administered to anesthesized (heparin-anticoagulated) dogs, as described above, 40min before establishing the ECC. Circulation was mantained at 1.5L/min for a period of lOOmin Platelet count, and aggregation induced esc vivo by ADP or collagen were meassured immediately before ajoene administration, lOmin after the end of ECC and thereafter, hourly. Platelet count lOmin after end of ECC, in ncn-treated dogs fell to about 57% of prepump values, while in ajoene-treated animals circulating platelets represented 80% of pre-ECC values. Recovery of platelet function in ajoene-treated dogs started 2 hr after end of ECC (about 4 hr. after ajoene administration) reaching 70% 4 hr after end of ECC. Surgical bleeding in treated-dogs was not different frrm controls. Moderate bradicardia and hypotension, which in atrqpi-nized dogs returned to normal values within 3 min was observed. Although detailed pharmacological studies are still needed, our results suggest that ajoene is a potentially useful drug for the prevention of platelet activation induced by ECC.

A CFD study has been carried out on fluid flow and heat transfer in the HLM-cooled Fuel Pin Bundle of the ALFRED LFR DEMO. In the context of GEN-IV Heavy Liquid Metal-cooled reactors safety studies, the flow blockage in a Fuel sub-assembly is considered one of the main issues to be addressed and the most important and realistic accident for LFR Fuel Assembly. The present paper is a first step towards a detailed analysis of such phenomena, and a CFD model and approach is presented to have a detailed thermo-fluid dynamic picture in the case of blockage. The closed hexagonal, grid-spaced fuel assembly of the LFR ALFRED has been modeled and computed. At this stage, the details of the spacer grids have not been included, but a conservative analysis has been carried out based on the current main geometrical and physical features. Reactivity feedback, as well as axial power profile, have not been included in this analysis. Results indicate that critical conditions, with clad temperatures around ∼900°C, are reached with blockage larger than 30% in terms of area fraction. Two main effects can be distinguished: a local effect in the wake/recirculation region downstream the blockage and a global effect due to the lower mass flow rate in the blocked subchannels; the former effect gives rise to a temperature peak behind the blockage and it is dominant for large blockages (&gt;20%), while the latter effect determines a temperature peak at the end of the active region and it is dominant for small blockages (&lt;10%). The blockage area has been placed at the beginning of the active region, so that both over-mentioned phenomena can fully take place. The mass flow rate at the different degree of blockage has been imposed from preliminary system code simulations. Transient analyses with fully resolved SST-ω turbulence model have been carried out and results indicate that a blockage of ∼15% (in terms of blocked area) leads to a maximum clad temperature around 800 °C, and this condition is reached in a characteristic time of 3–4 s without overshoot. Local clad temperatures around 1000 °C can be reached for blockages of 30% or more. CFD simulations indicate that Blockages &gt;15% could be detected by putting some thermocouples in the plenum region of the FA.

This report discusses a collection of songs and poems written by partisans behind enemy lines. The book contains 58 works. The compiler divided it into six parts. The first two parts are devoted to major events and phenomena as such: namely the Thirteen Special Partisan Regiment and the Bovkin blockade. The remaining four parts are more personalized: the partisan routine and way of life are described, some of the poems are written in memory of the dead, as well as various local events. In addition to poems and songs, a number of personalities (authors and those mentioned), events and locations will be considered. At the end of the report is a list of all mentioned names and places in alphabetical order. The main actions and battles are tied to the Smolensk and Mogilev regions. The poetic creativity of the partisans, shown in the collection from the funds of the Bykhov Museum of Local History, is a curious phenomenon for researchers, museologists, and historians. By studying and analyzing the information obtained from these sources, researchers can draw up a picture of front-line life, relationships, and the emotional state of the fighters.

In early 2020, a global outbreak of Corona Disease Virus 2019 (Covid-19) emerged as an acute respiratory infectious Disease with high infectivity and incidence. China imposed a blockade on the worst affected city of Wuhan at the end of January 2020, and over time, covid19 spread rapidly around the world and was designated pandemic by the World Health Organization on March 11. As the epidemic spread, the number of confirmed cases and the number of deaths in countries around the world are changing day by day. Correspondingly, the price of face masks, as important epidemic prevention materials, is also changing with each passing day in international trade. In this project, we used machine learning to solve this problem. The project used python to find algorithms to fit daily confirmed cases in China, daily deaths, daily confirmed cases in the world, and daily deaths in the world, the recorded mask price was used to predict the effect of the number of cases on the mask price. Under such circumstances, the demand for face masks in the international trade market is enormous, and because the epidemic changes from day to day, the prices of face masks fluctuate from day to day and are very unstable. We would like to provide guidance to traders and the general public on the purchase of face masks by forecasting face mask prices.

Abstract This work presents strategies adopted to solve what at the time was the largest production loss related to flow assurance in the company: the recurrent formation of hydrate blockages in flowlines of multiple wells of a FPSO in the Marlim oil field in Brazil. These blockages, which reoccurred frequently for various reasons, required a comprehensive plan for resolution. The main hydrate blockage cases were related to operational mistakes, problems in topside equipment, problems in subsea equipment and inaccurate procedures. In response to this challenge, a systematic approach was employed to identify and implement viable solutions. The key point of this work revolves around the same strategy - prevention - which was divided into three different courses of action: equipment, procedures and people. After implementing these processes, the results were exceedingly positive. That which was a recurrent problem became a steady state of zero production loss due to preventable hydrate blockages for 1.5 years, until the end of the FPSO unit’s production life.

The article provides an assessment of the Ukrainian agricultural market and determines that the total amount of losses caused to the agricultural industry as a result of the Russian invasion of Ukraine amounted to more than 8 billion USD at the end of 2022. At the same time, indirect losses of Ukrainian agriculture due to reduced production, blockade of ports, and growth in production costs are estimated at 34.25 billion USD. Due to a significant deterioration in the financial performance of agricultural enterprises in Ukraine, the article presents the authors’ algorithm for diagnosing the competitive potential of an agricultural enterprise based on the results of a study of internal factors influencing the competitiveness of agricultural enterprises, grouped into the following groups: - “technical level of production and sales of equipment”; - “state of production”; - “personnel and the extent of its use”; - “financial condition of society”; - “marketing resources”; - “economic efficiency of activity”; - “investment and innovation resources”. It has been proven that the use of elasticity models allows to take into account the influence of a significant number of factors, and elasticity can be defined as a measure of susceptibility to changes in one or more independent variables. It has been proven that the level of competitiveness of an agricultural enterprise at any given time is determined by the overall influence of interrelated factors, acting simultaneously and in different directions, enhancing or weakening the overall effective impact. It is substantiated that an agricultural enterprise must constantly respond to the demands of an unstable environment, reconfiguring and updating its resources and competencies; move through systematic problem solving, identify opportunities and threats, make quick decisions, implement productive strategies, etc.

Based on the proposal by the European Council, more than 25 heads of state and the World Health Organization (WHO) support development of an international treaty on pandemics, that planned to be negotiated under the auspices of WHO, will be presented to the World Health Assembly in May 2021. Given that the treaty alone is not enough to ensure compliance, triggers for a high-level political response is required. To this end, to inform the design of a support system, we explored institutional mechanismsi with a mandate to review compliance with key international agreements in their signatory countries and conduct independent country investigations in a manner that manages sovereign considerations. Based on our review, there is no single global mechanism that could serve as a model in its own right. There is, however, potential to combine aspects of existing mechanisms to support a strong, enforceable treaty. These aspects include: • Periodic review - based on the model of human rights treaties, with independent experts as the authorized monitoring body to ensure the independence. If made obligatory, the review could support compliance with the treaty. • On-site investigations - based on the model by the Committee on Prevention of Torture according to which visits cannot be blocked by state parties. • Non-negotiable design principles - including accountability; independence; transparency and data sharing; speed; emphasis on capabilities; and incentives. • Technical support - WHO can provide countries with technical assistance, tools, monitoring, and assessment to enhance emergency preparedness and response.

This one year exploratory project investigated hydraulic architecture of apple dwarfing rootstocks. The hypothesis was that hydraulic conductance is correlated with rootstock vigor. A previous study of trees on three rootstocks in Israel showed that dwarfed trees used less water than un-dwarfed trees. Analysis showed that if the tree maintains leaf water potentials above minimum values, then this implies that the dwarfed trees have lower leaf conductance, which may also be the cause of dwarfing. The current project studied small 2-year old unworked rootstock trees, and full sized trees bearing commercial yields. In both cases hydraulic conductance was determined with two methods - the non-destructive evaporative flux (EF)-leaf water potential (L WP) method, and a destructive method in which water was forced through the plant at known pressure using the "high pressure flow meter" (HPFM). Detailed work allowed measurement of conductance of the rootstock-scion union. This was achieved both with the HPFM and with the EF-LWP methods, the former in the US and the latter in Israel. Direct measurements of leaf conductance were made, and carbon isotope ratios ( d ¹³ C) were determined for leaves sampled at the end of the season. The latter can indicate sustained differences in leaf conductance behavior. HPFM and EF-LWP methods did not give the same results. In the small plants results were similar in magnitude, but not significantly correlated. In large trees, EF- L WP measurements were a fraction of those obtained with the HPFM. The latter indicates that some of the xylem is not normally functional but transports water when pressurized. Additional experimental work targeted this result. Xylem was stained before and after perfusion with water at high pressure. This showed that at least for one rootstock a significant amount of xylem was blocked before perfusion. The "air method" for determining xylem vessel properties was improved and employed. Length, radius and density of xylem vessels of different rootstocks were found to be similar, and significant differences found were not clearly related to rootstock vigor. Measurements in the commercial orchard in Israel showed that the graft union in a dwarfing rootstock was a large obstacle for water transport (i.e. had a high resistance). This apparently led to low leaf conductance to water vapor, as indicated by lower d ¹³ C, which implies low internal CO ₂ concentrations. In the US orchard, d ¹³ C in 2001 was correlated with rootstock vigor, and significant differences were found in leaf conductance. However, the d ¹³ C differences were not observed in 2002, were opposite to those found in the Israeli orchard, and measurements of the graft union with the HPFM did not find large resistances. We speculate that the graft union is not necessarily a large impediment to water transport unless the scion starts to separate from the rootstock. It was concluded that significant differences in hydraulic conductance exist between different dwarfing rootstocks. These differences may be caused by differences in xylem properties and in the degree of cavitation, as well as resistance in the graft union. However, no general relationship to rootstock vigor was found. Therefore, hydraulic conductance alone cannot explain dwarfing, but may be one of two or more factors that lead to dwarfing. Future work should integrate more factors with hydraulic relations, e.g. nutrient and solute transport and production of hormones.

Banco de la República is celebrating its 100th anniversary in 2023. This is a very significant anniversary and one that provides an opportunity to highlight the contribution the Bank has made to the country’s development. Its track record as guarantor of monetary stability has established it as the one independent state institution that generates the greatest confidence among Colombians due to its transparency, management capabilities, and effective compliance with the central banking and cultural responsibilities entrusted to it by the Constitution and the Law. On a date as important as this, the Board of Directors of Banco de la República (BDBR) pays tribute to the generations of governors and officers whose commitment and dedication have contributed to the growth of this institution.1 Banco de la República’s mandate was confirmed in the National Constitutional Assembly of 1991 where the citizens had the opportunity to elect the seventy people who would have the task of drafting a new constitution. The leaders of the three political movements with the most votes were elected as chairs to the Assembly, and this tripartite presidency reflected the plurality and the need for consensus among the different political groups to move the reform forward. Among the issues considered, the National Constitutional Assembly gave special importance to monetary stability. That is why they decided to include central banking and to provide Banco de la República with the necessary autonomy to use the instruments for which they are responsible without interference from other authorities. The constituent members understood that ensuring price stability is a state duty and that the entity responsible for this task must be enshrined in the Constitution and have the technical capability and institutional autonomy necessary to adopt the decisions they deem appropriate to achieve this fundamental objective in coordination with the general economic policy. In particular, Article 373 established that “the State, through Banco de la República, shall ensure the maintenance of the purchasing power of the currency,” a provision that coincided with the central banking system adopted by countries that have been successful in controlling inflation. In 1999, in Ruling 481, the Constitutional Court stated that “the duty to maintain the purchasing power of the currency applies to not only the monetary, credit, and exchange authority, i.e., the Board of Banco de la República, but also those who have responsibilities in the formulation and implementation of the general economic policy of the country” and that “the basic constitutional purpose of Banco de la República is the protection of a sound currency. However, this authority must take the other economic objectives of state intervention such as full employment into consideration in their decisions since these functions must be coordinated with the general economic policy.” The reforms to Banco de la República agreed upon in the Constitutional Assembly of 1991 and in Act 31/1992 can be summarized in the following aspects: i) the Bank was assigned a specific mandate: to maintain the purchasing power of the currency in coordination with the general economic policy; ii) the BDBR was designatedas the monetary, foreign exchange, and credit authority; iii) the Bank and its Board of Directors were granted a significant degree of independence from the government; iv) the Bank was prohibited from granting credit to the private sector except in the case of the financial sector; v) established that in order to grant credit to the government, the unanimous vote of its Board of Directors was required except in the case of open market transactions; vi) determined that the legislature may, in no case, order credit quotas in favor of the State or individuals; vii) Congress was appointed, on behalf of society, as the main addressee of the Bank’s reporting exercise; and viii) the responsibility for inspection, surveillance, and control over Banco de la República was delegated to the President of the Republic. The members of the National Constitutional Assembly clearly understood that the benefits of low and stable inflation extend to the whole of society and contribute mto the smooth functioning of the economic system. Among the most important of these is that low inflation promotes the efficient use of productive resources by allowing relative prices to better guide the allocation of resources since this promotes economic growth and increases the welfare of the population. Likewise, low inflation reduces uncertainty about the expected return on investment and future asset prices. This increases the confidence of economic agents, facilitates long-term financing, and stimulates investment. Since the low-income population is unable to protect itself from inflation by diversifying its assets, and a high proportion of its income is concentrated in the purchase of food and other basic goods that are generally the most affected by inflationary shocks, low inflation avoids arbitrary redistribution of income and wealth.2 Moreover, low inflation facilitates wage negotiations, creates a good labor climate, and reduces the volatility of employment levels. Finally, low inflation helps to make the tax system more transparent and equitable by avoiding the distortions that inflation introduces into the value of assets and income that make up the tax base. From the monetary authority’s point of view, one of the most relevant benefits of low inflation is the credibility that economic agents acquire in inflation targeting, which turns it into an effective nominal anchor on price levels. Upon receiving its mandate, and using its autonomy, Banco de la República began to announce specific annual inflation targets as of 1992. Although the proposed inflation targets were not met precisely during this first stage, a downward trend in inflation was achieved that took it from 32.4% in 1990 to 16.7% in 1998. At that time, the exchange rate was kept within a band. This limited the effectiveness of monetary policy, which simultaneously sought to meet an inflation target and an exchange rate target. The Asian crisis spread to emerging economies and significantly affected the Colombian economy. The exchange rate came under strong pressure to depreciate as access to foreign financing was cut off under conditions of a high foreign imbalance. This, together with the lack of exchange rate flexibility, prevented a countercyclical monetary policy and led to a 4.2% contraction in GDP that year. In this context of economic slowdown, annual inflation fell to 9.2% at the end of 1999, thus falling below the 15% target set for that year. This episode fully revealed how costly it could be, in terms of economic activity, to have inflation and exchange rate targets simultaneously. Towards the end of 1999, Banco de la República announced the adoption of a new monetary policy regime called the Inflation Targeting Plan. This regime, known internationally as ‘Inflation Targeting,’ has been gaining increasing acceptance in developed countries, having been adopted in 1991 by New Zealand, Canada, and England, among others, and has achieved significant advances in the management of inflation without incurring costs in terms of economic activity. In Latin America, Brazil and Chile also adopted it in 1999. In the case of Colombia, the last remaining requirement to be fulfilled in order to adopt said policy was exchange rate flexibility. This was realized around September 1999, when the BDBR decided to abandon the exchange-rate bands to allow the exchange rate to be freely determined in the market.Consistent with the constitutional mandate, the fundamental objective of this new policy approach was “the achievement of an inflation target that contributes to maintaining output growth around its potential.”3 This potential capacity was understood as the GDP growth that the economy can obtain if it fully utilizes its productive resources. To meet this objective, monetary policy must of necessity play a countercyclical role in the economy. This is because when economic activity is below its potential and there are idle resources, the monetary authority can reduce the interest rate in the absence of inflationary pressure to stimulate the economy and, when output exceeds its potential capacity, raise it. This policy principle, which is immersed in the models for guiding the monetary policy stance, makes the following two objectives fully compatible in the medium term: meeting the inflation target and achieving a level of economic activity that is consistent with its productive capacity. To achieve this purpose, the inflation targeting system uses the money market interest rate (at which the central bank supplies primary liquidity to commercial banks) as the primary policy instrument. This replaced the quantity of money as an intermediate monetary policy target that Banco de la República, like several other central banks, had used for a long time. In the case of Colombia, the objective of the new monetary policy approach implied, in practical terms, that the recovery of the economy after the 1999 contraction should be achieved while complying with the decreasing inflation targets established by the BDBR. The accomplishment of this purpose was remarkable. In the first half of the first decade of the 2000s, economic activity recovered significantly and reached a growth rate of 6.8% in 2006. Meanwhile, inflation gradually declined in line with inflation targets. That was how the inflation rate went from 9.2% in 1999 to 4.5% in 2006, thus meeting the inflation target established for that year while GDP reached its potential level. After this balance was achieved in 2006, inflation rebounded to 5.7% in 2007, above the 4.0% target for that year due to the fact that the 7.5% GDP growth exceeded the potential capacity of the economy.4 After proving the effectiveness of the inflation targeting system in its first years of operation, this policy regime continued to consolidate as the BDBR and the technical staff gained experience in its management and state-of-the-art economic models were incorporated to diagnose the present and future state of the economy and to assess the persistence of inflation deviations and expectations with respect to the inflation target. Beginning in 2010, the BDBR established the long-term 3.0% annual inflation target, which remains in effect today. Lower inflation has contributed to making the macroeconomic environment more stable, and this has favored sustained economic growth, financial stability, capital market development, and the functioning of payment systems. As a result, reductions in the inflationary risk premia and lower TES and credit interest rates were achieved. At the same time, the duration of public domestic debt increased significantly going from 2.27 years in December 2002 to 5.86 years in December 2022, and financial deepening, measured as the level of the portfolio as a percentage of GDP, went from around 20% in the mid-1990s to values above 45% in recent years in a healthy context for credit institutions.Having been granted autonomy by the Constitution to fulfill the mandate of preserving the purchasing power of the currency, the tangible achievements made by Banco de la República in managing inflation together with the significant benefits derived from the process of bringing inflation to its long-term target, make the BDBR’s current challenge to return inflation to the 3.0% target even more demanding and pressing. As is well known, starting in 2021, and especially in 2022, inflation in Colombia once again became a serious economic problem with high welfare costs. The inflationary phenomenon has not been exclusive to Colombia and many other developed and emerging countries have seen their inflation rates move away from the targets proposed by their central banks.5 The reasons for this phenomenon have been analyzed in recent Reports to Congress, and this new edition delves deeper into the subject with updated information. The solid institutional and technical base that supports the inflation targeting approach under which the monetary policy strategy operates gives the BDBR the necessary elements to face this difficult challenge with confidence. In this regard, the BDBR reiterated its commitment to the 3.0% inflation target in its November 25 communiqué and expects it to be reached by the end of 2024.6 Monetary policy will continue to focus on meeting this objective while ensuring the sustainability of economic activity, as mandated by the Constitution. Analyst surveys done in March showed a significant increase (from 32.3% in January to 48.5% in March) in the percentage of responses placing inflation expectations two years or more ahead in a range between 3.0% and 4.0%. This is a clear indication of the recovery of credibility in the medium-term inflation target and is consistent with the BDBR’s announcement made in November 2022. The moderation of the upward trend in inflation seen in January, and especially in February, will help to reinforce this revision of inflation expectations and will help to meet the proposed targets. After reaching 5.6% at the end of 2021, inflation maintained an upward trend throughout 2022 due to inflationary pressures from both external sources, associated with the aftermath of the pandemic and the consequences of the war in Ukraine, and domestic sources, resulting from: strengthening of local demand; price indexation processes stimulated by the increase in inflation expectations; the impact on food production caused by the mid-2021 strike; and the pass-through of depreciation to prices. The 10% increase in the minimum wage in 2021 and the 16% increase in 2022, both of which exceeded the actual inflation and the increase in productivity, accentuated the indexation processes by establishing a high nominal adjustment benchmark. Thus, total inflation went to 13.1% by the end of 2022. The annual change in food prices, which went from 17.2% to 27.8% between those two years, was the most influential factor in the surge in the Consumer Price Index (CPI). Another segment that contributed significantly to price increases was regulated products, which saw the annual change go from 7.1% in December 2021 to 11.8% by the end of 2022. The measure of core inflation excluding food and regulated items, in turn, went from 2.5% to 9.5% between the end of 2021 and the end of 2022. The substantial increase in core inflation shows that inflationary pressure has spread to most of the items in the household basket, which is characteristic of inflationary processes with generalized price indexation as is the case in Colombia. Monetary policy began to react early to this inflationary pressure. Thus, starting with its September 2021 session, the BDBR began a progressive change in the monetary policy stance moving away from the historical low of a 1.75% policy rate that had intended to stimulate the recovery of the economy. This adjustment process continued without interruption throughout 2022 and into the beginning of 2023 when the monetary policy rate reached 12.75% last January, thus accumulating an increase of 11 percentage points (pp). The public and the markets have been surprised that inflation continued to rise despite significant interest rate increases. However, as the BDBR has explained in its various communiqués, monetary policy works with a lag. Just as in 2022 economic activity recovered to a level above the pre-pandemic level, driven, along with other factors, by the monetary stimulus granted during the pandemic period and subsequent months, so too the effects of the current restrictive monetary policy will gradually take effect. This will allow us to expect the inflation rate to converge to 3.0% by the end of 2024 as is the BDBR’s purpose.Inflation results for January and February of this year showed declining marginal increases (13 bp and 3 bp respectively) compared to the change seen in December (59 bp). This suggests that a turning point in the inflation trend is approaching. In other Latin American countries such as Chile, Brazil, Perú, and Mexico, inflation has peaked and has begun to decline slowly, albeit with some ups and downs. It is to be expected that a similar process will take place in Colombia in the coming months. The expected decline in inflation in 2023 will be due, along with other factors, to lower cost pressure from abroad as a result of the gradual normalization of supply chains, the overcoming of supply shocks caused by the weather, and road blockades in previous years. This will be reflected in lower adjustments in food prices, as has already been seen in the first two months of the year and, of course, the lagged effect of monetary policy. The process of inflation convergence to the target will be gradual and will extend beyond 2023. This process will be facilitated if devaluation pressure is reversed. To this end, it is essential to continue consolidating fiscal sustainability and avoid messages on different public policy fronts that generate uncertainty and distrust. 1 This Report to Congress includes Box 1, which summarizes the trajectory of Banco de la República over the past 100 years. In addition, under the Bank’s auspices, several books that delve into various aspects of the history of this institution have been published in recent years. See, for example: Historia del Banco de la República 1923-2015; Tres banqueros centrales; Junta Directiva del Banco de la República: grandes episodios en 30 años de historia; Banco de la República: 90 años de la banca central en Colombia. 2 This is why lower inflation has been reflected in a reduction of income inequality as measured by the Gini coefficient that went from 58.7 in 1998 to 51.3 in the year prior to the pandemic. 3 See Gómez Javier, Uribe José Darío, Vargas Hernando (2002). “The Implementation of Inflation Targeting in Colombia”. Borradores de Economía, No. 202, March, available at: https://repositorio.banrep.gov.co/handle/20.500.12134/5220 4 See López-Enciso Enrique A.; Vargas-Herrera Hernando and Rodríguez-Niño Norberto (2016). “The inflation targeting strategy in Colombia. An historical view.” Borradores de Economía, No. 952. https://repositorio.banrep.gov.co/handle/20.500.12134/6263 5 According to the IMF, the percentage change in consumer prices between 2021 and 2022 went from 3.1% to 7.3% for advanced economies, and from 5.9% to 9.9% for emerging market and developing economies. 6 https://www.banrep.gov.co/es/noticias/junta-directiva-banco-republica-reitera-meta-inflacion-3