Academic literature on the topic 'Long-term side effects'

Background Long-term side effects associated with the treatment of Hodgkin’s lymphoma (HL) have frequently been reported during the last decades. Studies have shown increased mortality in HL survivors. Following Hodgkin’s lymphoma, second malignancies (SM) and cardiovascular disease (CVD) are the most common causes of death in individuals treated for HL. This study investigates the incidence of side effects such as SM, CVD and infections in a cohort diagnosed with HL in Sweden between 1965 and 1995. In addition, this study identifies covariate risk factors for late side effects in order to develop strategies that prevent morbidity and mortality in HL survivors. Methods Using the Swedish Cancer Registry (SCR) at the National Board of Health and Welfare and the Multi-Generation Registry at Statistics (MGR) Sweden, we identified 6946 individuals diagnosed with HL between the years 1965 and 1995, and their first degree relatives (FDR) (n=17 858). In addition we identified the malignancies and inpatient care for CVD and infections for the HL cohort and their FDR. The standard incidence ratio (SIR) was calculated for the risk of SM, CVD and infections. For SM and CVD the risk also was stratified and calculated for family history of disease. The Swedish Hodgkin Intervention and Prevention study (SHIP), a prospective study, invited 702 individuals treated for HL at the age of 45 years or younger and who were treated in the region of Skåne, Uppsala or Umeå. The participants completed a questionnaire and were invited to an out-patient visit to an oncologist with clinical examination and blood tests. Any pathological findings were referred for further investigation. Results An increased risk for SM in HL long-term survivors was observed and seems to increase with the number of FDRs with cancer. There was also an increased risk for inpatient care due to congestive heart failure (CHF) and coronary artery disease (CAD). A family history of CHF and CAD further increased the risk for these diseases. The risk for inpatient care due to infections was increased and remained increased after 20 years or longer. The risk for infections was associated with splenectomy and hypothyroidism. Radiotherapy was an independent risk factor for cardiovascular disease in the cohort of the prospective study. ConclusionLong-term survivors from HL have an increased risk for developing late side effects such as SM, CVD and infections. Since many HL patients are young and the cure rate from the disease is high, it is of great importance to offer focused surveillance programs to selected individuals who are at high risk, e.g. individuals who received radiotherapy as part of their treatment and who have other known risk factors for cardiovascular disease such as hypertension, hypercholesterolemia, family history and smoking.

Magister Scientiae - MSc
Despite recent advances in radiotherapy, some tumours have shown to be resistant to treatment and patients still experience long term side effects. Gold nanoparticles (AuNPs) have been identified as effective radiosensitizers when employed concurrently with kilovoltage X-rays, which could selectively increase the dose delivered to a patient's tumour. The clinical application of proton radiation has gained renewed attention due to the lower integral body dose of protons compared to traditional X-ray based therapy. While extensive research has been formed on the behaviour of AuNPs in photon beams, limited information is available on the combination of AuNPs and proton radiation. Several questions remain regarding the interaction of protons with the AuNPs and possible dose enhancement effects at different depths along the Spread Out Bragg Peak (SOBP).

Attention Deficit/Hyperactivity Disorder (ADHD) was originally thought to occur only in children, but is increasingly recognised as causing functional impairment also in adulthood. The overall aim of this thesis was to achieve a comprehensive understanding of ADHD in adulthood. A questionnaire based on the DSM-IV criteria of ADHD, reported childhood symptoms, reading and spelling problems, difficulties and suffering and general assessment of functioning (GAF) was distributed to three samples: the general population (GP), outpatient psychiatry (OPP) and female prison inmates. Symptoms consistent with ADHD were more than three times higher in the OPP sample than in the GP sample (6.6 versus 2.1%). ADHD symptoms and related problems occurred in 50% of the prison inmates. A cohort of 168 patients diagnosed with ADHD in adulthood was interviewed about current ADHD symptoms and psychiatric comorbidity on axis I and II. The lifetime prevalence of psychiatric comorbidity on axis I was 92% and current comorbidity, including autism spectrum disorders and Tourette’s syndrome, was 47%. The sex-specific pattern of the comorbid disor-ders was similar to that in the general population. Forty-six per cent of the patients endorsed the specific criteria for at least one personality disorder. After a mean follow-up of six years, there was remission of adult ADHD in about 30% of the patients, regardless of whether there was ongoing medication or not. There were no differences in function and quality of life, except for global general improvement, which was better in patients currently on medication. The most prevalent long-term side effects of pharmacological treatment with mainly stimulants were decreased appetite, dry mouth, anxiousness/restlessness and an increase in pulse frequency. The discontinuation rate was about 50%: 29% discontinued because of a perceived lack of effect, followed by elevated mood or hypomania (11%). No detectable evidence of tolerance and increased need for dosage over time was observed. To conclude, Symptoms of ADHD is highly overrepresented in OPP and in female inmates compared with the GP. Furthermore, adults diagnosed with ADHD have a high lifetime prevalence of psychiatric comorbidity. Long-term pharmacological treatment with stimulants is safe with relatively mild and tolerable adverse effects. Continued medication, however, is not related to remission.

Lors de la liaison d’un glucocorticoïde (GC) naturel ou synthétique (par exemple, la Dexaméthasone) au récepteur des glucocorticoïdes (GR), les GCs régulent l’expression de gènes cibles soit par (i) transactivation par liaison ‘’directe’’ à un élément de liaison à l’ADN de type ‘’(+)GRE’’, (ii) transrépression ‘’directe’’ par liaison à un élément de type ‘’nGRE’’ ou (iii) transrépression ‘’indirecte’’ par interaction physique directe avec des facteurs de transcription pro-inflammatoires tels que AP-1 et NF-κB. Les effets anti-inflammatoires bénéfiques des GCs sont généralement attribués à la transrépression indirecte, alors que nombre de leurs effets secondaires pathologiques indésirables paraissent liés à la transactivation et/ou à la transrépression directe. Notre laboratoire a récemment découvert qu’un composé non-stéroïdien dénommé CpdX ainsi que ses dérivés deutérés, ne présentent ni la fonction de transactivation, ni celle de transrépression directe du GR, tout en stimulant son activité bénéfique de transrépression indirecte. Notre projet a consisté à caractériser un composé non-stéroïdien dit CpdX, ainsi que ses dérivés, quant à leurs activités thérapeutiques et à démontrer qu’elles sont semblables à celles des glucocorticoïdes anti-inflammatoires, couramment utilisés, tout en étant débarrassés de leurs effets pathologiques secondaires, tels que l’ostéoporose, l’atrophie cutanée et le syndrome métabolique. Pour atteindre nos objectifs, nous avons utilisés des modèles de souris présentant soit les affections cutanées (dermatites de contact ou atopique, psoriasis), l'asthme, l’arthrite rhumatismale, la colite ulcérative ou la conjonctivite allergique, associés à des études d’immunologie et de biologie moléculaire et cellulaire. Mon travail de thèse a démontré que CpdX, et certains de ses dérivés deutérés, présentent une activité anti-inflammatoire dans le traitement de ces modèles ‘’souris’’ (Partie I). Nous avons aussi montré que le traitement par CpdX et ses dérivés n’induit pas les effets secondaires pathologiques des glucocorticoïdes (Partie II), ouvrait ainsi la vue à une nouvelle ère dans le traitement à long-terme de maladies inflammatoires, sans provoquer les effets pathologiques indésirables des traitements actuels aux glucocorticoïdes
Upon binding of natural or synthetic glucocorticoids (GCs) (e.g. Dexamethasone) to their glucocorticoid receptor (GR), GCs regulate the expression of target genes either by (i) direct transactivation through direct binding to “(+)GRE” DNA binding sites (DBS), (ii) direct transrepression through binding to “IR nGRE” DBSs or (iii) tethered indirect transrepression mediated through interaction with transactivators, such as NFkB, AP1, or STAT3 bound to their cognate DBSs. The beneficial anti-inflammatory effects of GCs have been generally ascribed to tethered transrepression, whereas many of their long-term undesirable side-effects could be due to transactivation and/or direct transrepression. Our laboratory recently reported that a non-steroidal compound, named CpdX, selectively lacks both direct transactivation and direct transrepression functions, while still exerting an indirect transrepression activity. The goal of our project was to characterize CpdX and some of its derivatives as effective anti-inflammatory drugs similar to glucocorticoids, but lacking their main deleterious side-effects, e.g. osteoporosis, skin atrophy and metabolic disorders. To this end, we have used experimental mouse model for skin disorders (atopic dermatitis, contact dermatitis, and psoriasis), asthma, rheumatoid arthritis, ulcerative colitis and allergic conjunctivitis, combined with immunology, molecular and cellular biology. My thesis studies have demonstrated that in mouse models, CpdX and its derivatives exhibit anti-inflammatory activities, which are similar to those of glucocorticoids (Part I). Importantly, we further show that CpdX and its derivatives do not exhibit the long-term debilitating side-effects of glucocorticoids (Part II). Thereby paving the way to a new era in the long-term therapy of major inflammatory diseases

Short term studies have suggested that ground based timber harvesting on wet sites can alter soil properties and inhibit early survival and growth of seedlings. Persistence of such negative effects may translate to losses in forest productivity over a rotation. During the fall and winter of 1989, numerous salvage logging operations were conducted during high soil moisture conditions on wet pine flats in the lower coastal plain of South Carolina following Hurricane Hugo. A long-term experiment (split-plot within an unbalanced randomized complete block design) allowed assessment of long term effects of rutted and compacted primary skid trails and subsequent site preparation on soil properties and loblolly pine (Pinus taeda L.) productivity. The experiment had 12 blocks, four levels of site preparation as the whole plot factor (bedding, disking with bedding, disking, and no site preparation), and two levels of traffic as the subplot factor (primary skid trail, no obvious traffic). After 23 years, bedding and disking with bedding treatments effectively enhanced soil physical properties and stand productivity via promoting greater survival and stocking, but had little effect on the size of individual trees relative to disking and no site preparation treatments. Primary skid trails significantly reduced the size of individual trees, but had no appreciable long term effects on soil properties or stand productivity after 23 years. The study suggests that bedding is the most efficient practice to enhance soil properties, seedling survival, and stand productivity on wet sites. However, site preparation is not necessary for these soils and sites, if strictly intended to restore soil properties and stand productivity in primary skid trails. Reduction in individual tree sizes on primary skid trails emphasizes benefits in minimizing the spatial extent of disturbance.
Master of Science

The objective was to determine the effects of immunocastration (Improvest) on reproductive characteristics in boars. Seventy-two boars were used in a randomized design with three treatments: single injection (SI) or double injection (DI) of Improvest, and intact controls (no Improvest; CNT) (n = 24/group). At wk 10, 15, 20, 25, and 40, blood was collected and serum harvested to evaluate testosterone concentrations via RIA. At wk 25, 18 pigs (n = 6/ group) were sacrificed and testes were removed, weighed, and measured. Libido was assessed at 32, 36, 47, 60, and 63+ wk of age (1 to 5; 1 = no libido; 5 = high libido) and semen collected beyond 60 wk of age. Testosterone concentrations were less for DI boars compared to CNT boars and SI boars at 20 and 25 wk of age (P < 0.001), but not different at 40 wk of age. All testicular measurements and weight were less for DI boars compared to SI and CNT boars (P < 0.001). There was no treatment effect on libido between 32 to 63+ wk of age. Semen volume, gel weight and total number of sperm cells were not different among treatments. Sperm concentration was greater for DI than SI (P = 0.011), and tended to be greater for DI compared to CNT (P = 0.102). Sperm motility tended to be greater for DI boars compared to CNT boars (P = 0.066). The results show that there are no permanent effects of immunocastration on reproductive characteristics in boars.
Master of Science

Two hundred and sixtyeight (268) consecutive out-patients with clinical features compatible with deep venous thrombosis (DVT) were referred to our Department for contrast venography, which was carried out according to standard methods, employing 120-160 ml of a non-ionic contrast medium (Iohexol). All side effects probably related to venography were recorded during the test, immediately after its execution, at one day and during long-term follow-up (1 week, 1 month and 6 months), including impedance plethysmography (IPG) evaluation in patients with normal venograms. Eighteen patients (7%) did not undergo venography because of severe edema of the dorsum of the foot (3), impossibility to find a vein (7), patient refusal (1), known hypersensibility to radiopaque dye (4) and allergic reactions after injection of contrast medium (3). Our analysis therefore included 250 patients. Hypersensitivity reaction to the contrast medium following the venography were encountered in 3 patients (1%) of whom two had severe reactions. Pain and tenderness of the foot and calf after the test was observed in 15 patients (6%). No clinical signs and symptoms of pulmonary embolism were observed during and after the procedure and all serum creatine levels, assessed before venography, at day 1 and day 7, remained unchanged. There were 7 instances of contrast extravasation (3%) which did not result in local skin or tissue damage. In none of the patients was there any evidence to suggest the presence of post-venographic phlebitis and no patients with negative venograms developed a positive IPG during the period of follow-up.

Thermoelectric (TE) modules used in a heat pumping mode are increasingly being used for various applications involving heating and cooling. As their use becomes more prevalent and extends to lower cost applications using inexpensive commodity power supplies, it is important to characterize the long-term effects of power cycling and power quality on their performance. Two power supplies were evaluated with different levels of periodic and random deviations (PARD) from ideal DC power. This paper presents the results of an accelerated aging experimental study on intermittent power cycling of TE modules over the span of 5 actual months with each power supply. TE performance metrics that were monitored at specific time intervals are the AC resistance and figure of merit. The applied voltage, power consumption, TE hot and cold side temperatures and air temperatures were continuously measured. The experimental results indicate that the low-quality power supply quality had only a minor influence on properties and integrity of the TE modules, and is suitable for applications requiring intermittent use without a substantial reduction in performance.

This technical report presents two applications of the GenCade model to simulate long-term shoreline evolution along the Delaware Coast driven by waves, inlet sediment transport, and longshore sediment transport. The simulations also include coastal protection practices such as periodic beach fills, post-storm nourishment, and sand bypassing. Two site-specific GenCade models were developed: one is for the coasts adjacent to the Indian River Inlet (IRI) and another is for Fenwick Island. In the first model, the sediment exchanges among the shoals and bars of the inlet were simulated by the Inlet Reservoir Model (IRM) in the GenCade. An inlet sediment transfer factor (γ) was derived from the IRM to quantify the capability of inlet sediment bypassing, measured by a rate of longshore sediments transferred across an inlet from the updrift side to the downdrift side. The second model for the Fenwick Island coast was validated by simulating an 11-y ear-long shoreline evolution driven by longshore sediment transport and periodic beach fills. Validation of the two models was achieved through evaluating statistical errors of simulations. The effects of the sand bypassing operation across the IRI and the beach fills in Fenwick Island were examined by comparing simulation results with and without those protection practices. Results of the study will benefit planning and management of coastal sediments at the sites.

Fish communities are an important component of aquatic systems and are good bioindicators of ecosystem health. Land use changes in the Midwest have caused sedimentation, erosion, and nutrient loading that degrades and fragments habitat and impairs water quality. Because most small wadeable streams in the Heartland Inventory and Monitoring Network (HTLN) have a relatively small area of their watersheds located within park boundaries, these streams are at risk of degradation due to adjacent land use practices and other anthropogenic disturbances. Shifts in the physical and chemical properties of aquatic systems have a dramatic effect on the biotic community. The federally endangered Topeka shiner (Notropis topeka) and other native fishes have declined in population size due to habitat degradation and fragmentation in Midwest streams. By protecting portions of streams on publicly owned lands, national parks may offer refuges for threatened or endangered species and species of conservation concern, as well as other native species. This protocol describes the background, history, justification, methodology, data analysis and data management for long-term fish community monitoring of wadeable streams within nine HTLN parks: Effigy Mounds National Monument (EFMO), George Washington Carver National Monument (GWCA), Herbert Hoover National Historic Site (HEHO), Homestead National Monument of America (HOME), Hot Springs National Park (HOSP), Pea Ridge National Military Park (PERI), Pipestone National Monument (PIPE), Tallgrass Prairie National Preserve (TAPR), and Wilson's Creek national Battlefield (WICR). The objectives of this protocol are to determine the status and long-term trends in fish richness, diversity, abundance, and community composition in small wadeable streams within these nine parks and correlate the long-term community data to overall water quality and habitat condition (DeBacker et al. 2005).

1.1 Macroeconomic summary Economic recovery has consistently outperformed the technical staff’s expectations following a steep decline in activity in the second quarter of 2020. At the same time, total and core inflation rates have fallen and remain at low levels, suggesting that a significant element of the reactivation of Colombia’s economy has been related to recovery in potential GDP. This would support the technical staff’s diagnosis of weak aggregate demand and ample excess capacity. The most recently available data on 2020 growth suggests a contraction in economic activity of 6.8%, lower than estimates from January’s Monetary Policy Report (-7.2%). High-frequency indicators suggest that economic performance was significantly more dynamic than expected in January, despite mobility restrictions and quarantine measures. This has also come amid declines in total and core inflation, the latter of which was below January projections if controlling for certain relative price changes. This suggests that the unexpected strength of recent growth contains elements of demand, and that excess capacity, while significant, could be lower than previously estimated. Nevertheless, uncertainty over the measurement of excess capacity continues to be unusually high and marked both by variations in the way different economic sectors and spending components have been affected by the pandemic, and by uneven price behavior. The size of excess capacity, and in particular the evolution of the pandemic in forthcoming quarters, constitute substantial risks to the macroeconomic forecast presented in this report. Despite the unexpected strength of the recovery, the technical staff continues to project ample excess capacity that is expected to remain on the forecast horizon, alongside core inflation that will likely remain below the target. Domestic demand remains below 2019 levels amid unusually significant uncertainty over the size of excess capacity in the economy. High national unemployment (14.6% for February 2021) reflects a loose labor market, while observed total and core inflation continue to be below 2%. Inflationary pressures from the exchange rate are expected to continue to be low, with relatively little pass-through on inflation. This would be compatible with a negative output gap. Excess productive capacity and the expectation of core inflation below the 3% target on the forecast horizon provide a basis for an expansive monetary policy posture. The technical staff’s assessment of certain shocks and their expected effects on the economy, as well as the presence of several sources of uncertainty and related assumptions about their potential macroeconomic impacts, remain a feature of this report. The coronavirus pandemic, in particular, continues to affect the public health environment, and the reopening of Colombia’s economy remains incomplete. The technical staff’s assessment is that the COVID-19 shock has affected both aggregate demand and supply, but that the impact on demand has been deeper and more persistent. Given this persistence, the central forecast accounts for a gradual tightening of the output gap in the absence of new waves of contagion, and as vaccination campaigns progress. The central forecast continues to include an expected increase of total and core inflation rates in the second quarter of 2021, alongside the lapse of the temporary price relief measures put in place in 2020. Additional COVID-19 outbreaks (of uncertain duration and intensity) represent a significant risk factor that could affect these projections. Additionally, the forecast continues to include an upward trend in sovereign risk premiums, reflected by higher levels of public debt that in the wake of the pandemic are likely to persist on the forecast horizon, even in the context of a fiscal adjustment. At the same time, the projection accounts for the shortterm effects on private domestic demand from a fiscal adjustment along the lines of the one currently being proposed by the national government. This would be compatible with a gradual recovery of private domestic demand in 2022. The size and characteristics of the fiscal adjustment that is ultimately implemented, as well as the corresponding market response, represent another source of forecast uncertainty. Newly available information offers evidence of the potential for significant changes to the macroeconomic scenario, though without altering the general diagnosis described above. The most recent data on inflation, growth, fiscal policy, and international financial conditions suggests a more dynamic economy than previously expected. However, a third wave of the pandemic has delayed the re-opening of Colombia’s economy and brought with it a deceleration in economic activity. Detailed descriptions of these considerations and subsequent changes to the macroeconomic forecast are presented below. The expected annual decline in GDP (-0.3%) in the first quarter of 2021 appears to have been less pronounced than projected in January (-4.8%). Partial closures in January to address a second wave of COVID-19 appear to have had a less significant negative impact on the economy than previously estimated. This is reflected in figures related to mobility, energy demand, industry and retail sales, foreign trade, commercial transactions from selected banks, and the national statistics agency’s (DANE) economic tracking indicator (ISE). Output is now expected to have declined annually in the first quarter by 0.3%. Private consumption likely continued to recover, registering levels somewhat above those from the previous year, while public consumption likely increased significantly. While a recovery in investment in both housing and in other buildings and structures is expected, overall investment levels in this case likely continued to be low, and gross fixed capital formation is expected to continue to show significant annual declines. Imports likely recovered to again outpace exports, though both are expected to register significant annual declines. Economic activity that outpaced projections, an increase in oil prices and other export products, and an expected increase in public spending this year account for the upward revision to the 2021 growth forecast (from 4.6% with a range between 2% and 6% in January, to 6.0% with a range between 3% and 7% in April). As a result, the output gap is expected to be smaller and to tighten more rapidly than projected in the previous report, though it is still expected to remain in negative territory on the forecast horizon. Wide forecast intervals reflect the fact that the future evolution of the COVID-19 pandemic remains a significant source of uncertainty on these projections. The delay in the recovery of economic activity as a result of the resurgence of COVID-19 in the first quarter appears to have been less significant than projected in the January report. The central forecast scenario expects this improved performance to continue in 2021 alongside increased consumer and business confidence. Low real interest rates and an active credit supply would also support this dynamic, and the overall conditions would be expected to spur a recovery in consumption and investment. Increased growth in public spending and public works based on the national government’s spending plan (Plan Financiero del Gobierno) are other factors to consider. Additionally, an expected recovery in global demand and higher projected prices for oil and coffee would further contribute to improved external revenues and would favor investment, in particular in the oil sector. Given the above, the technical staff’s 2021 growth forecast has been revised upward from 4.6% in January (range from 2% to 6%) to 6.0% in April (range from 3% to 7%). These projections account for the potential for the third wave of COVID-19 to have a larger and more persistent effect on the economy than the previous wave, while also supposing that there will not be any additional significant waves of the pandemic and that mobility restrictions will be relaxed as a result. Economic growth in 2022 is expected to be 3%, with a range between 1% and 5%. This figure would be lower than projected in the January report (3.6% with a range between 2% and 6%), due to a higher base of comparison given the upward revision to expected GDP in 2021. This forecast also takes into account the likely effects on private demand of a fiscal adjustment of the size currently being proposed by the national government, and which would come into effect in 2022. Excess in productive capacity is now expected to be lower than estimated in January but continues to be significant and affected by high levels of uncertainty, as reflected in the wide forecast intervals. The possibility of new waves of the virus (of uncertain intensity and duration) represents a significant downward risk to projected GDP growth, and is signaled by the lower limits of the ranges provided in this report. Inflation (1.51%) and inflation excluding food and regulated items (0.94%) declined in March compared to December, continuing below the 3% target. The decline in inflation in this period was below projections, explained in large part by unanticipated increases in the costs of certain foods (3.92%) and regulated items (1.52%). An increase in international food and shipping prices, increased foreign demand for beef, and specific upward pressures on perishable food supplies appear to explain a lower-than-expected deceleration in the consumer price index (CPI) for foods. An unexpected increase in regulated items prices came amid unanticipated increases in international fuel prices, on some utilities rates, and for regulated education prices. The decline in annual inflation excluding food and regulated items between December and March was in line with projections from January, though this included downward pressure from a significant reduction in telecommunications rates due to the imminent entry of a new operator. When controlling for the effects of this relative price change, inflation excluding food and regulated items exceeds levels forecast in the previous report. Within this indicator of core inflation, the CPI for goods (1.05%) accelerated due to a reversion of the effects of the VAT-free day in November, which was largely accounted for in February, and possibly by the transmission of a recent depreciation of the peso on domestic prices for certain items (electric and household appliances). For their part, services prices decelerated and showed the lowest rate of annual growth (0.89%) among the large consumer baskets in the CPI. Within the services basket, the annual change in rental prices continued to decline, while those services that continue to experience the most significant restrictions on returning to normal operations (tourism, cinemas, nightlife, etc.) continued to register significant price declines. As previously mentioned, telephone rates also fell significantly due to increased competition in the market. Total inflation is expected to continue to be affected by ample excesses in productive capacity for the remainder of 2021 and 2022, though less so than projected in January. As a result, convergence to the inflation target is now expected to be somewhat faster than estimated in the previous report, assuming the absence of significant additional outbreaks of COVID-19. The technical staff’s year-end inflation projections for 2021 and 2022 have increased, suggesting figures around 3% due largely to variation in food and regulated items prices. The projection for inflation excluding food and regulated items also increased, but remains below 3%. Price relief measures on indirect taxes implemented in 2020 are expected to lapse in the second quarter of 2021, generating a one-off effect on prices and temporarily affecting inflation excluding food and regulated items. However, indexation to low levels of past inflation, weak demand, and ample excess productive capacity are expected to keep core inflation below the target, near 2.3% at the end of 2021 (previously 2.1%). The reversion in 2021 of the effects of some price relief measures on utility rates from 2020 should lead to an increase in the CPI for regulated items in the second half of this year. Annual price changes are now expected to be higher than estimated in the January report due to an increased expected path for fuel prices and unanticipated increases in regulated education prices. The projection for the CPI for foods has increased compared to the previous report, taking into account certain factors that were not anticipated in January (a less favorable agricultural cycle, increased pressure from international prices, and transport costs). Given the above, year-end annual inflation for 2021 and 2022 is now expected to be 3% and 2.8%, respectively, which would be above projections from January (2.3% and 2,7%). For its part, expected inflation based on analyst surveys suggests year-end inflation in 2021 and 2022 of 2.8% and 3.1%, respectively. There remains significant uncertainty surrounding the inflation forecasts included in this report due to several factors: 1) the evolution of the pandemic; 2) the difficulty in evaluating the size and persistence of excess productive capacity; 3) the timing and manner in which price relief measures will lapse; and 4) the future behavior of food prices. Projected 2021 growth in foreign demand (4.4% to 5.2%) and the supposed average oil price (USD 53 to USD 61 per Brent benchmark barrel) were both revised upward. An increase in long-term international interest rates has been reflected in a depreciation of the peso and could result in relatively tighter external financial conditions for emerging market economies, including Colombia. Average growth among Colombia’s trade partners was greater than expected in the fourth quarter of 2020. This, together with a sizable fiscal stimulus approved in the United States and the onset of a massive global vaccination campaign, largely explains the projected increase in foreign demand growth in 2021. The resilience of the goods market in the face of global crisis and an expected normalization in international trade are additional factors. These considerations and the expected continuation of a gradual reduction of mobility restrictions abroad suggest that Colombia’s trade partners could grow on average by 5.2% in 2021 and around 3.4% in 2022. The improved prospects for global economic growth have led to an increase in current and expected oil prices. Production interruptions due to a heavy winter, reduced inventories, and increased supply restrictions instituted by producing countries have also contributed to the increase. Meanwhile, market forecasts and recent Federal Reserve pronouncements suggest that the benchmark interest rate in the U.S. will remain stable for the next two years. Nevertheless, a significant increase in public spending in the country has fostered expectations for greater growth and inflation, as well as increased uncertainty over the moment in which a normalization of monetary policy might begin. This has been reflected in an increase in long-term interest rates. In this context, emerging market economies in the region, including Colombia, have registered increases in sovereign risk premiums and long-term domestic interest rates, and a depreciation of local currencies against the dollar. Recent outbreaks of COVID-19 in several of these economies; limits on vaccine supply and the slow pace of immunization campaigns in some countries; a significant increase in public debt; and tensions between the United States and China, among other factors, all add to a high level of uncertainty surrounding interest rate spreads, external financing conditions, and the future performance of risk premiums. The impact that this environment could have on the exchange rate and on domestic financing conditions represent risks to the macroeconomic and monetary policy forecasts. Domestic financial conditions continue to favor recovery in economic activity. The transmission of reductions to the policy interest rate on credit rates has been significant. The banking portfolio continues to recover amid circumstances that have affected both the supply and demand for loans, and in which some credit risks have materialized. Preferential and ordinary commercial interest rates have fallen to a similar degree as the benchmark interest rate. As is generally the case, this transmission has come at a slower pace for consumer credit rates, and has been further delayed in the case of mortgage rates. Commercial credit levels stabilized above pre-pandemic levels in March, following an increase resulting from significant liquidity requirements for businesses in the second quarter of 2020. The consumer credit portfolio continued to recover and has now surpassed February 2020 levels, though overall growth in the portfolio remains low. At the same time, portfolio projections and default indicators have increased, and credit establishment earnings have come down. Despite this, credit disbursements continue to recover and solvency indicators remain well above regulatory minimums. 1.2 Monetary policy decision In its meetings in March and April the BDBR left the benchmark interest rate unchanged at 1.75%.

The main recommendations of the panel report can be summarised under five key headings:  Building blocks: The ultimate aim should be to build rich, detailed and testable narratives situated within a European context, and addressing phenomena from the longue durée to the short-term over international to local scales. Chronological control is essential to this and effective dating strategies are required to enable generation-level analysis. The ‘serendipity factor’ of archaeological work must be enhanced by recognising and getting the most out of information-rich sites as they appear. o There is a pressing need to revisit the archives of excavated sites to extract more information from existing resources, notably through dating programmes targeted at regional sequences – the Western Isles Atlantic roundhouse sequence is an obvious target. o Many areas still lack anything beyond the baldest of settlement sequences, with little understanding of the relations between key site types. There is a need to get at least basic sequences from many more areas, either from sustained regional programmes or targeted sampling exercises. o Much of the methodologically innovative work and new insights have come from long-running research excavations. Such large-scale research projects are an important element in developing new approaches to the Iron Age.  Daily life and practice: There remains great potential to improve the understanding of people’s lives in the Iron Age through fresh approaches to, and integration of, existing and newly-excavated data. o House use. Rigorous analysis and innovative approaches, including experimental archaeology, should be employed to get the most out of the understanding of daily life through the strengths of the Scottish record, such as deposits within buildings, organic preservation and waterlogging. o Material culture. Artefact studies have the potential to be far more integral to understandings of Iron Age societies, both from the rich assemblages of the Atlantic area and less-rich lowland finds. Key areas of concern are basic studies of material groups (including the function of everyday items such as stone and bone tools, and the nature of craft processes – iron, copper alloy, bone/antler and shale offer particularly good evidence). Other key topics are: the role of ‘art’ and other forms of decoration and comparative approaches to assemblages to obtain synthetic views of the uses of material culture. o Field to feast. Subsistence practices are a core area of research essential to understanding past society, but different strands of evidence need to be more fully integrated, with a ‘field to feast’ approach, from production to consumption. The working of agricultural systems is poorly understood, from agricultural processes to cooking practices and cuisine: integrated work between different specialisms would assist greatly. There is a need for conceptual as well as practical perspectives – e.g. how were wild resources conceived? o Ritual practice. There has been valuable work in identifying depositional practices, such as deposition of animals or querns, which are thought to relate to house-based ritual practices, but there is great potential for further pattern-spotting, synthesis and interpretation. Iron Age Scotland: ScARF Panel Report v  Landscapes and regions:  Concepts of ‘region’ or ‘province’, and how they changed over time, need to be critically explored, because they are contentious, poorly defined and highly variable. What did Iron Age people see as their geographical horizons, and how did this change?  Attempts to understand the Iron Age landscape require improved, integrated survey methodologies, as existing approaches are inevitably partial.  Aspects of the landscape’s physical form and cover should be investigated more fully, in terms of vegetation (known only in outline over most of the country) and sea level change in key areas such as the firths of Moray and Forth.  Landscapes beyond settlement merit further work, e.g. the use of the landscape for deposition of objects or people, and what this tells us of contemporary perceptions and beliefs.  Concepts of inherited landscapes (how Iron Age communities saw and used this longlived land) and socal resilience to issues such as climate change should be explored more fully.  Reconstructing Iron Age societies. The changing structure of society over space and time in this period remains poorly understood. Researchers should interrogate the data for better and more explicitly-expressed understandings of social structures and relations between people.  The wider context: Researchers need to engage with the big questions of change on a European level (and beyond). Relationships with neighbouring areas (e.g. England, Ireland) and analogies from other areas (e.g. Scandinavia and the Low Countries) can help inform Scottish studies. Key big topics are: o The nature and effect of the introduction of iron. o The social processes lying behind evidence for movement and contact. o Parallels and differences in social processes and developments. o The changing nature of houses and households over this period, including the role of ‘substantial houses’, from crannogs to brochs, the development and role of complex architecture, and the shift away from roundhouses. o The chronology, nature and meaning of hillforts and other enclosed settlements. o Relationships with the Roman world

Training cadets-weightlifters at all stages has a multipurpose orientation, that is why it is important to define and plan a rational combination of the training means use. Distribution of such micro structures in the cycle of training, as the days, months of training, provides effective volume, intensity and other values of physical load distribution. The structure of training cadets-weightlifters is based on taking into account the regularities and principles of sports training as the condition for physical readiness and working capacity increase. Any power oriented sports demands components characteristics in the structure of micro cycles. We consider the methodology of the training lessons organization by the example of the micro cycle of training taking into account bioenergetic profile of cadets-weightlifters. We revealed the necessity to distribute the macro cycle to structural components as the condition for the effectiveness of different variants of the training effects distribution. Materials and methods. We analyzed the range of training lessons among cadets-weightlifters in order to create the variants of gradual training problems solution according to the kinds of training. We analyzed training programs of cadets taking into consideration the level of readiness and their bioenergetic profiles. We created the content of the training work in the micro cycle of the preparatory period for cadets-weightlifters with different bioenergetic profiles. The main material of the research includes the ratio of the training effects volume in one micro cycle taking into account cadets’ bioenergetic profile. Cadets-weightlifters from Tyumen Higher Military-Engineering Command College (military Institute) took part in the research (Tyumen, Russia). Results. We created the content of the training work by the example of one micro cycle for cadets-weightlifters taking into account bioenergetic profile. The created variant of the training loads structure includes the main means of training taking into account the kind of training. Realization orientation in five regimens of work fulfillment with the effectiveness estimation of a total load within one lesson and a week in general is estimated according to a point system. Conclusion. The created variant of a micro cycle considers kinds of training realization taking into account the percentage of the ratio. Taking into account bioenergetic profiles helps to discuss strong and weak sides of muscle activity energy supply mechanisms. We consider the ability to fulfill a long-term aerobic load among the representatives of the 1st and the 2nd bioenergetic profiles. The representatives of the 3rd and the 4th biotype are inclined to fulfill the mixed load. The representatives of the 5th biotype are characterized by higher degree of anaerobic abilities demonstration. The technology of planning the means taking into account the regimens of work realization with point system helps to increase physical working capacity and rehabilitation processes in cadets’ organisms.