Batumi Navigation Teaching University

BackgroundEthical considerations are integral to neurosurgical decision-making, yet emerging technologies, demographic shifts, and global crises continuously introduce new challenges. Key ethical concerns include patient autonomy, prioritization, the value of life, research ethics, and personality-altering procedures. Despite their importance, formal ethics training for neurosurgical residents is often lacking, and guideline application remains inconsistent. This scoping review summarizes current literature on ethical issues in neurosurgery, identifies key topics and assessment methods, and highlights research priorities to enhance ethical awareness.MethodsA systematic literature search was conducted in Medline, Embase, and Web of Science using the search strategy (Ethic∗[Title]) AND (neurosurg∗[Title]). The search, performed on October 8, 2024, yielded 334 records (1985–2024). After removing duplicates and screening, 13 studies met inclusion criteria. Two independent reviewers selected original research in English or German addressing ethical neurosurgical issues, excluding opinion pieces, reviews, and case reports. Extracted data included study characteristics, country, year, topic, design, and key findings.ResultsFrom a neurosurgical perspective, six ethical subcategories emerged: decision-making (31 %), pediatric neurosurgery (23 %), neurosurgery in developing countries (15 %), artificial intelligence (15 %), functional neurosurgery (8 %), and patient care (8 %). From a classical ethical standpoint, seven studies (53.8 %) focused on psychosocial ethical issues, four (30.7 %) examined normative ethical questions, and two (15.4 %) addressed aspects of professional ethics. All studies employed a qualitative research design. Most studies (77 %) used questionnaires or structured interviews for data collection. Findings revealed regional differences in ethical decision-making, increasing reliance on hospital ethics committees, resource-related dilemmas in low-income countries, and emerging AI-related concerns. Despite growing interest, structured assessment methods and standardized ethics education remain limited.ConclusionsEthical challenges in neurosurgery, as explored through the lenses of indirect sources (published literature), are diverse and shaped by technological advancements and sociopolitical factors. AI-related ethics and crisis-driven dilemmas, such as those arising from wars and pandemics, are gaining attention. However, research methodologies remain inconsistent, limiting data comparability. Future studies should focus on enhancing ethics training and developing standardized frameworks for ethical analysis improving neurosurgical ethical decision-making.

ABSTRACT This study mapped the availability, integration, and referral patterns of mental health (MH) and substance use disorder (SUD) services for people living with HIV (PLWH) in Georgia. PLWH face a heightened burden of MH conditions, compounded by systemic and social barriers. In Georgia, these challenges are exacerbated by fragmented healthcare system, centralized HIV care, and limited service integration. Cross-sectional survey was conducted between January-August 2024 using a structured questionnaire distributed to 80 institutions across 11 regions of Georgia, including MH centers, HIV-focused NGOs, PLWH treatment and support organizations, and primary healthcare (PHC) centers. Data analysis included descriptive statistics and social network-informed methods. Findings revealed geographic disparities, with services concentrated in urban centers, particularly Tbilisi. Specialized MH institutions provided most clinical MH and SUD services, while HIV-focused organizations delivered treatment and support services. However, formal service protocols for HIV-related MH care were rare. Referral pathways were siloed, showing strong internal linkages among HIV service providers but weak or absent connections with MH and PHC sectors. These findings highlight the urgent need to integrate MH services into HIV platforms and strengthen inter-organizational referrals ensuring comprehensive, person-centered care for PLWH.

IntroductionA visual digital tool called SEXual Dysfunction Evaluation Tool (SEX-DET) was created for assessing the causes of sexual dysfunction, based on a biopsychosocialsexual and relational schema, to assist patients in understanding the relative influence of the various factors contributing to their sexual dysfunction. The aim of this study was to evaluate satisfaction of this tool in sexual dysfunction patients and practitioners. MethodsA satisfaction study of the SEX-DET was performed in 50 patients (20 F, 30 M) consulting for a sexual trouble and 3 practitioners. The main reasons for consultation were erectile dysfunction (36%) and desire disorder (30%). ResultsAll the participants agreed that the SEX-DET helped them to understand the origin their trouble (46% strongly, 42% moderately, 12% somewhat), the various factors involved (56% strongly, 22% moderately and 18% somewhat) and the management of their trouble (6% strongly, 47% moderately, 33% somewhat). Overall, 94% of participants found that the SEX-DET was easy to use (58% strongly, 16% moderately and 20% somewhat). Practitioners acknowledged the user-friendly interface, its critical role in improving patients’ understanding and providing a comprehensive visualization of the dimensions associated with sexual dysfunction, even if one practitioner threatened the tool's intrinsic inclination to oversimplify complex data. ConclusionSEX-DET enabled to improve patients’ understanding of their trouble and helped practitioners in structuring better communication during consultations communication regarding sexual dysfunction. The shortcomings of this study was its focus on short-term outcomes, self-reported data, and the absence of control group. Level of evidence3.

BACKGROUND. Ankylosing Spondylitis is an autoimmune chronic inflammatory disease of the axial/central skeleton of human body that leads to partial or complete fusion and rigidity of spine. As Ankylosing Spondylitis have its onset typically in late adolescents or middle age group, it is quite necessary to have a hold on it. Ankylosing Spondylitis was thought of having a bad prognosis earlier but in recent few years, with help of research advancement techniques a totally new and highly effective treatment known as biological therapy is used. OBJECTIVE. Our aim was to identify the outcome with biological treatment of 29 patients which got biological medication TNF (tumor necrosis factor) inhibitor Simponi (Golimumab). We evaluated the effectiveness of managing Ankylosing Spondylitis with biological therapy in Adjara region. As this is an autoimmunity disorder and it may affect any person especially the young and middle age people, everyone must be educated about getting biologic treatment as soon as possible so that they immediately get control over the disease progression. MATERIALS AND METHODS. We investigated 29 patients of Ankylosing Spondylitis (22 males and 7 females) from 24 yrs. old to 65 yrs. old age-group. We used the biological therapy with TNF-α inhibitor named Simponi (Golimumab). 50 mg of Golimumab was injected once a month subcutaneously in the beginning of therapy. We identified pain intensity, levels of CRP and ESR in all recruited patients since the first day over a period of 3 months, 6 months, and 12 months. Accordingly, doses were decreased from once a month to once in three months. The study was conducted at the clinic “Solo-med” during the period of 2022 October to 2023 December. RESULTS. The effectiveness of biological treatment with Simponi (Golimumab) is appreciated as it has shown a significant reduction in symptoms of Ankylosing Spondylitis such as the pain intensity, levels of CRP and ESR. About Pain intensity – After 3 months, light pain intensity was in about 18% of males with 14% of females and moderate pain intensity was in about 64% of males with 71% of females. It decreased and after 12 months, now moderate pain intensity was in about 22% of males and severe pain intensity was in none of the males. But in contrast, the female patients had neither severe nor moderate pain intensity rather they all had light pain intensity. About CRP – In the beginning all patients including both males and females had an increased level of CRP. It decreased and after 12 months only 9% of males and 8% of females had an increased CRP. About ESR – In the beginning 95% of males and 85% of females had an increased ESR. It decreased quickly with biological therapy and consequently after 12 months of treatment only 1 patient had increased ESR. After receiving Golimumab, 3 patients had episodes of acute rhinitis within 2 months, 2 patients had minor sneezing for 3 months as side effects, 5 patients had general weakness just after getting injection. 3 patients had urinary tract infection for 1 month as complication. And, no one had any serious complications. CONCLUSION. According to these studies, it can be said that biologics have improved the quality of life of these patients by improving body mobility, flexibility and preventing complications from internal organs. To take care of the youth, use of biological therapy is advised so that the disease do not progress any further. Biological therapy is a present-day superlative method to manage Ankylosing Spondylitis as it reaches a stable remission period and alleviates the symptoms of Ankylosing Spondylitis.

Ihor Halytsia
 E-mail: igalica@ukr.net
 Doctor of Economics , Full Professor of National University of Food Technologies 
 Kyiv, Ukraine
 https://orcid.org/0000-0002-1276-5743
 
 Oleksii Oleksiuk 
 E-mail:oleksiuk@kneu.edu.ua 
 Doctor of Economics, Full Professor of Kyiv National Economic University named after Vadym Hetman 
 Kyiv, Ukraine
 https://orcid.org/0000-0002-3407-6201
 
 Olha Prokopenko 
 E-mail: prokopenko.olha.w@gmail.com
 Doctor of Economics, Full Professor Sumy State Makarenko Pedagogical University 
 Sumy, Ukraine
 https://orcid.org/0000-0003-1362-478X
 
 Giorgi Abashidze
 E-mail: g.abashidze@bntu.edu.ge
 Assistant of Batumi Navigation Teaching University
 Batumi, Georgia
 https://orcid.org/0000-0002-3233-6890
 
 Tamara Berezianko 
 E-mail: E-mail: tvb-nuft@i.ua
 Doctor of Economics, Full Professor National University of Food Technologies 
 Kyiv, Ukraine
 https://orcid.org/0000-0001-9228-4239
 
 Abstract: A virtual intellectual economy is being formed due to the Fourth Industrial Revolution. The main characteristics of this economy are the virtualization of the whole social and economic life, an increase in the share of intellectual spheres of economic management in the real economy, intellectualization of mainly non-intellectual spheres of economic management. The development of the virtual-intellectual economy transforms the management of socio-economic systems and, first of all, of economic entities. New regularities of enterprise management emerge acceleration of the impact of the subject of activity on the object of activity, the impact of the subject of management activity on the object of management activity and event-driven management densification.

Журнал зареєстровано у міжнародному каталозі періодичних видань

The actuality of the formation of regional (territorial) transport-logistics systems based on cluster approach is substantiated in the presented work. The importance of clusters in the innovative development process of the region is shown. Based on the analysis of European transport-logistics clusters and the world clustered principles in general, the need for creation of territorial transport-logistics clusters in the region are substantiated and a strategic algorithm for their gradual formation and development are presented.

Once the dam had been built, they used the following tools to implement the agreements:• Single Sector Operational or Implementation Plans (T39): the PWC makes a monthly management plan that includes decisions on the operation of the dam and its facilities, a water usage schedule, cleanliness of the dam reservoir, and fish production in the dam lake.• Periodic Reviews (T48): today, both the Armenian and Turkish sides have technical subcommittees that periodically gauge the other country's water usage.• Site Visits (T33): a joint inspection commission inspects the dam every three to five years.• Negotiations (T66): the PWC is charged with negotiating disputes that arise between the two sides; if it cannot resolve the conflict in question, the governments of both countries are notified. Coordination Framework (Stage 3)• International Treaties (T44): a bilateral agreement that specifies the rules for managing the dam and the dam lake was signed in 1973.• River Basin Organizations, Authorities or Commission (T59): the PWC, a joint entity to manage the rivers as well as dam operations, was established based on the 1973 agreement.• Executive Functions (T51): the PWC established a subcommission to carry out its decisions.• Technical Entities (T36): a joint inspection commission carries out regular Site Visits (T33) and subcommittees on both sides gauge the water usage of the other party.