Perspectives of NATO’s Partnership Policy

Since its foundation in 1949, the Alliance continually is evolving politics of partnership and cooperation with all non-NATO countries. This policy has a special place in the overall policy of the Alliance. Dating back to the last decade of XX century, the Alliance has tried to establish closer formal partnerships relations with states and regional organizations around the world. The purpose of this cooperation has emphasized the importance of closer cooperation with regional actors and international organizations to face with traditional and new coming challenges and treats in the changing world. NATO is strongly convinced that “the promotion of Euro-Atlantic security is best assured through a wide network of partnerships with countries and organizations across the globe that share NATO’s interest in a peaceful world.” Now, NATO faced with rapidly changing world and should be able to strengthen its partnerships with non-NATO partners and other international organizations around the world

Uterine Fibroid Embolization via Transradial versus Transfemoral Arterial Access: Technical Results

AIM: This study was designed to compare the safety and feasibility of uterine fibroid embolisation (UFE) via transradial access (TRA) and transfemoral access (TFA). MATERIAL AND METHODS: A retrospective analysis was conducted for 2 cohorts: 13 cases with already established TFA (from February 2016 to September 2018) and the first 11 procedures performed via TRA (from October 2017 to October 2018). Indications for embolization included: heavy menstrual bleedings (n = 18), lower urinary tract symptoms (n = 2), pelvic pain (n = 3) and abdominal pain (n = 1). One interventional radiologist and one fellow performed all procedures at one institution. Technical success, procedural time, access site complications as well as feedback from patients were assessed for analysis. RESULTS: Technical success was achieved in 24/24 cases (100%). Unilateral uterine artery embolisation was performed in 7 cases (29.1%) and bilateral in 17 cases (70.8%). Mean procedure time was 72.4 minutes in TFA group, and 60.3 minutes in the TRA group. Mean fluoroscopy time was 25.3 minutes in the TFA group and 21.1 minutes in the TRA group. Access site-related and overall adverse events did not vary significantly among the study cohorts. CONCLUSIONS: TRA represents a safe and feasible approach for UFE with a comparable safety profile to TFA

Analysis and views on the report of the reflection group on NATO 2030: United for a new era

During London Summit held in 2019, allied leaders had a substantive discussion, among other political and security issues, to initiate a “reflection process in order to further strengthen the political dimension of NATO. In that regard Secretary General Stoltenberg in 2019 stressed that “as the world changes, NATO will continue to change”. Going back in the past, we can notice that since its foundation in 1949, NATO has faced numerous challenges related to its own survival. All those adaptations have helped NATO to build appropriate tools and mechanisms and gain political and military strength. Today, NATO is strong, but it has to continue to adapt and respond to a changing security environment. Looking up to 2030, the need for collective defence of the Alliance to protect Europe and North America against threats to their physical security and democratic way of life is as strong as ever. Today, and in the future NATO has to strengthen its political and military adaptation by developing a capability for dealing with emerging challenging threats. To continue adapting the Alliance to this unpredictability, Allied leaders launched the NATO 2030 initiative. Today, the world does not just face one clear challenge, but multiple, complex challenges, from pandemics to infodemics, from climate change to disruptive technologies. So far, well-known threats like terrorism, in all its forms and manifestations will persist, even as new risks loom from pandemics and climate change, to the emerging and disruptive technologies (EDTs) that present both dangers and opportunities for the Alliance. Fulfilling this role will require even greater cohesion and ability to act collectively against shared threats. This is a way for NATO to be in a stronger position than the others, both in the fight to protect the freedom and security of its members and in acting as an essential pillar of an open and stable international order. The initiation of the reflection process is a serious step towards the preparation of a new Alliance`s Strategic Concept that will replace the existing one from 2010 and pave the way for the development of the Alliance until 2030 and beyond

Successful Endovascular Treatment of a Giant Hepatic Artery Aneurysm with Dual Layer Stents Placement as Flow-Diverting Option: Case Report

BACKGROUND: Visceral artery aneurysms are rare conditions. The incidence of hepatic artery aneurysm (HAA) accounts for approximately 20% of all splanchnic aneurysms. HAA can become a life-threatening situation because there is a great risk of rupture when it grows more than 2 cm in diameter. CASE PRESENTATION: In this article, we describe a case of a 54-year-old female patient with large hepatic artery aneurysm which was incidentally founded. From symptoms, she had abdominal discomfort slightly worsening after meals, frequent pain in mesogastrium and reported some unexplained weight loss in the last few months. The lesion was detected by CT examination of the abdomen and pelvis. CONCLUSION: The aneurysm was successfully treated at our department with the endovascular approach, by covering the aneurysmal sac with two stents, one closed cell and one double-layer micromesh new generation stent as a flow diverting option

„Јасмин револуција“ – првата автентична револуција во арапскиот свет - Тунис

In the past period we have seen a lot of story about Tunisia’s revolution, but few people understand what exactly happened in this country. It is the High North country on the African continent with a population which exceeding 10.5 million inhabitants and a GDP of 9,400$ per capita in 2010219. In Tunisia there are 13% unemployment, below the poverty live about 3,8% of the population (2005) 220, GDP growth in 2010 was about 3%.221 This country was one of the most open economies in the region and in the past decade saw strong economic growth, which slowed down because of shocks in the euro area, since the EU was a major economic partner of this country. The growth of the economy was not sufficient to reduce unemployment in the country in recent years. According to research at The Economist in 2010, Tunisia is classified as an authoritarian state and the so-called Democracy index of 2.79 and ended on 92nd place from 167 countries.222 Since its declaration of independence from France 55 years ago, Tunisia had only two presidents who ruled autocratically and until 2011 demonstrations against the regime were very rare. The Government are strove to maintain peace in the country by all available means, and every opposition thought was cat down from her root. Because of Tunisia was a state where with decades people aren’t opposed to the government and appeared to rule a general lethargy, without any collective consciousness and hope that the situation can be improved. Until early 2011 the authoritarian regime and the Western Allies and the United States believed that the people of this country can raise its voice and dignified life for greater freedom. At the end of 2010 began demonstrations against authoritarian regime, and organization of protest in Tunisia, first was performed by means of mass communication - mobile phones and Internet social networks (Facebook, My Space, and Twitter). Here, we can ask about dilemma of what is the impact of the Internet, social networks and mobile phones to organize riots and demonstrations? Are we entitled to say that Tunisia is the first Internet revolution happened in the world? However the genesis of the reasons that led to riots gates regime Zine El Abidine Ben Ali are deep in the past of this country

NATO burden sharing policy and Covid 19 implications on defence expenditures

The aim of the paper is to evaluate the implementation of NATO policies, recommendations and guidelines in the field of defence expenditures in accordance with the Declarations and the accompanying documents from 2014 Wales Summit. The pledge to share 2% of GDP for defence expenditures and at least 20% of them on major new equipment aims to increase the Alliance’s ability to meet the three core tasks arising from the 2010 Strategic Concept. At the same time, research and development (R&D) of new capabilities to respond to the rapidly changing threats and risks in the Euro-Atlantic area is a challenge not only for each Ally, but also for NATO as a whole entity. The paper provides an analysis of the implementation of the “2/20 pledge” policies and recommendations of the Alliance from the 2014 Wales Summit in view of meeting the guidelines to spend a minimum of 2% of GDP on defence by 2024 and 20% of it on major new equipment, including related R&D of new capabilities. A parallel of defence expenditures distribution by main categories has been made for the period 2013-2020. The main categories include operational expenditures (personnel, operations and maintenance) and capital investments in defence (equipment and modernization, and infrastructure). At the same time, the distribution of defence expenditures by main categories for the period 2013-2020 for the Republic of North Macedonia was analyzed in accordance with NATO methodology and data provided by the Ministry of Defence of North Macedonia. In addition, expert analyses related to COVID 19 implications and impact on the economic and GDP growth are presented. This COVID 19 implication is expected to have a certain positive or negative impact on defence expenditures in 2020, as well as in the following years. No matter which scenario prevails, experts agree that defence expenditure needs to maintain an upward trend not only as a percentage of GDP, but also in real terms. This is necessary not only for dealing with modern, rapidly growing and unpredictable threats to citizens’ security and safety, but also for the economic recovery of the Allies from the COVID 19 effects

COVID 19 impacts on defense capabilities development

COVID 19 severely disrupted our way of life and caused social and economic dysfunction. Many spheres of social life as the geopolitical, economic, security, defense, socio-humanitarian, psychological, communication, health and other has influenced by COVID 19. Many countries, including North Macedonia, were forced to adjust the economy growth. The consequences for the economy growth will be felt not only in 2020 but also in beyond. The adjustments in the GDP have reflected on the defense expenditures of the countries. The reduction of defense expenditures mostly has reflected on the development of defense capabilities. The realization of the equipment projects was postponed. Any further delay in the equipment projects will seriously affect the further development of the state defense capabilities, and may disrupt the readiness of the Armed Forces of Republic of North Macedonia. The pandemic has tested the country’s resilience in dealing with security threats, and contingency plans. The magnitude of the pandemic underscored the importance and utility not only of national capacities and capabilities engagement, but also of the solidarity that the Alliance has demonstrated in action through its civil emergency response mechanisms. Additionally, the utility of the defense capacities and the Armed Forces in support of the civilian authorities in a crisis situation or state of emergency caused by endangering the health of the population comes to the surface. Although no one can say for sure when the pandemic will end, however, we must learn from the past and the experiences gained from dealing with COVID 19. What we need to do in the near future is to establish more precise mechanisms, tools and procedures for the possible use of national capacities and capabilities in dealing with similar situations. Therefore, it is very important for the North Macedonia to adhere to the obligations and guidelines of the Alliance for investment of 2% of GDP in defense, of which at least 20% to be allocated for the development of new military capabilities

Urgent Endovascular Treatment of Iliac Artery Pseudoaneurysm in Patient with Ehlers-Danlos Syndrome: A Case Report

BACKGROUND: Ehlers-Danlos syndrome (EDS) type IV is a heritable disorder of connective tissue that is mainly associated with vascular maladies such as aneurysms, pseudoaneurysms, and dissections with or without spontaneous rupture. Historically, vascular complications in EDS IV have been treated conservatively whenever possible, due to the high morbidity and mortality after vascular interventions, whether open or endovascular. We present a case of a ruptured pseudoaneurysm of the right common iliac artery in a 18-year-old male, who was successfully treated by endovascular approach and later diagnosed with EDS type IV. CASE PRESENTATION: A 18-year-old male patient was admitted in ER with sharp pain in the right hypogastrium, hypotensive and with reduced blood parameters. Multiphasic modern computed tomography (MDCT) scan of abdomen and pelvis revealed massive ride sided pelvic and retroperitoneal hematoma. The presence of pseudoaneurysms on both common iliac arteries (CIA) was detected, with small ulcer on the right side and a focal dissection on the left side. An urgent endovascular repair of the ruptured pseudoaneurysm on the right CIA with covered stent was performed. Patient’s laboratory parameters and clinical status improved significantly within the next few days. CONCLUSIONS: Vascular repair in EDS-IV patients carries significant risk and should be indicated very carefully. Endovascular treatment for these patients is feasible and should be considered as an alternative to open surgery in some challenging cases as this one

The impact of migration on urban security and the quality of urban life

The paper analyzes the impact of migration on urbanization, that is, on urban security in major cities and the quality of urban life. Urbanization itself has its own positive and negative challenges. The positive challenges are most often associated with accelerated modernization of cities and their industrialization, economic development, democratization, im�proved quality of services, cultural development, education, etc. According to some unwritten rule, the quality of services in urban areas increases in proportion to the increase in the popula�tion. On the other hand, the large concentration of population in a small area highlights the dis�advantages that are a side segment of the urbanization and are most often related to security, i.e. to the so-called “urban security”. The shortfalls are associated with the increased occurrence of negative social deviations, poverty, increased crime rate, lack of drinking water, enormous soil, water and air pollution, concentration of large populations in a small area, vulnerability to terrorism, increased noise, scarce green areas, appearance of a specific microclimate, climate change, etc. This also leads to a division of the population living in neighborhoods, which are most often formed based on the economic power of the population and security. There are also poor neighborhoods that may be hotbeds of negative social deviations and are characterized by a lack of security of the population. This, in turn, requires the city authorities and the state to invest additional resources in finding mechanisms that will remove such shortfalls and allow the population greater equity and security. Urbanization is widely accepted by a large proportion of the population, but there is also strong resistance in part of the population that opposes modernization and urbanization and is attached to the traditional way of life in the rural areas. The paper aims to emphasize some of the benefits, but also some of the challenges that are a segment of the urbanization, that is, the migration of the population and urban security and the quality of life of the population

Engagement of the armed forces in support of civilian autorities in crisis situation and state of emergency

For the need ofengagement of theArmed Forces in support of civilian authorities and citizens is a topic on which there is a comprehensive consensus both at the national level and within the NATO member states. Controversy over the mechanisms of engagement, the precise definition of tasks, and the duration of the engagement of the Armed Forces.The Army of the Republic of North Macedonia supports the civilian component of the defense system in conditions when the other state institutions (including local self-government) will not be able to cope with the crisis, when there are threats to critical infrastructure and when the security and borders of the country are endangered. Whenever support is sought from the Army, it should be borne in mind that Armed Forces units should not be the first responder. The Armed Forces has to be engaged only in a situation where the crisis or state of emergency exceeds the capacities and capabilities of other state institutions and local authorities. The situation caused by the COVID 19 outbreak put to the test the civil readiness and resilience of the society in dealing with such situations and brought to the surface the necessity of engaging the capacities and capabilities of the Armеd Forces in different circumstances. Also, there was a need for normative and legal regulation of engagement of the Armed Forces units in support of civilian authorities and citizens in peacetime, in natural disasters, in crisis and state of emergency, as well as to prevent its possible abuse. The need for building resilience and response mechanisms in case of natural disasters and emergencies are an active component both at the national level of each country and in the context of integral and solidarity engagement of the Alliance. NATO’s approach to building resilience is based on the concepts of the Whole of Government Approach and the Whole of Society Approach