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Abstract Medical imaging is an indispensable and very important step in the diagnosis and treatment of illnesses. However, due to large amounts of resources necessary for training the model, training from scratch may not invariably emerge as the optimal recourse. Transfer learning has emerged as a viable solution, where pretrained weights from ImageNet are initially utilized and fine-tuninned afterwards. This paper presents a novel approach employing transfer learning to classify both respiratory diseases and radiological findings from chest X-rays. The dataset comprises 191 660 X-ray images gathered from public databases and 752 chest X-ray images obtained from a retrospective study at the University Clinical Center of Kragujevac, forming the foundation of Big data analysis. It includes various conditions such as atelectasis, cardiomegaly, infiltration, pleural thickening, non-viral pneumonia, pneumothorax, COVID-19 viral pneumonia, tuberculosis, etc. as well as masses and nodules indicative of tumors and images of healthy subjects. Although there are existing solutions with some diseases, this is the first paper that inlcludes differentiation between healthy and diseased cases, as well as in case of present disease, as much as 18 different classes are inlcuded in the analysis, which has not been done so far. The proposed methodology included transfer learning with DenseNet121 as the backbone and CheXNeXt weights as initialisation scheme, upon which additional layers were added for fine tuning. The results demonstrate the model’s capacity to distinguish between healthy and diseased, with an average area under curve (AUC) of 0.99. The AUC ranges from 0.86 for nodules to 0.99 for pneumonia and 0.99 for COVID-19. Our method outperforms the state-of-the-art in accuracy across all 18 classes, with the exception of classes consolidation, mass, and nodule. These findings are promising for a tested clinical site, though further validation in clinical environment accros multiple sites may be necessary before using the model as a standalone decision system, rather than a decision support system for disease diagnosis based on chest X-rays.

IntroductionThe prevalence of peanut allergies is increasing, emphasizing the need for an animal model to enhance our understanding of peanut allergy pathogenesis and to advance diagnostic tools and therapeutic interventions. While mice are frequently used as model organisms, their allergic responses do not fully mirror those observed in humans, warranting the exploration of a higher animal model. The porcine gastrointestinal system closely resembles that of humans, and exhibits allergy symptoms akin to human responses, making pigs a promising model for peanut allergy research.MethodsIn this study we compared two allergen sensitization protocols involving either topical allergen application after repeated tape stripping (TS) or intraperitoneal (IP) injections to induce peanut-specific allergy and anaphylaxis reactions in mini pigs. Mini pigs sensitized with a combination of peanut protein extract (PE) and cholera toxin (CT) through either the IP or the TS route.ResultsSensitized pigs via both methods developed systemic PE-specific IgG and IgE responses. Following peanut challenge via the IP route, both TS- and IP-sensitized pigs displayed allergy symptoms, including lethargy, skin rashes, vomiting, and a drop in body temperature. However, respiratory distress was observed exclusively in pigs sensitized through the TS route and not in those sensitized through the IP route. However, it is noteworthy that both groups of sensitized pigs maintained peanut hypersensitivity for up to two months post-sensitization, albeit with a reduction in the severity of allergy symptoms. Importantly, both groups exhibited sustained levels of PE-specific IgG, IgE, and elevated concentrations of mast cell protease in their blood following the IP challenges.DiscussionOverall, this study reports TS and IP as two different modes of sensitization leading to onset of peanut specific allergic reactions in mini pigs, but only the TS-sensitization led to systemic anaphylaxis (simultaneous presence of symptoms: breathing difficulty, intense skin rash, and impaired mobility). A distinctive feature of these sensitization protocols is the 100% success rate (N = 4 pigs per group) in sensitizing the subjects.

Peroxisomes are organelles with crucial functions in oxidative metabolism. To correctly target to peroxisomes, proteins require specialized targeting signals. A mystery in the field is the sorting of proteins that carry a targeting signal for peroxisomes and as well as for other organelles, such as mitochondria or the endoplasmic reticulum (ER). Exploring several of these proteins in fungal model systems, we observed that they can act as tethers bridging organelles together to create contact sites. We show that in Saccharomyces cerevisiae this mode of tethering involves the peroxisome import machinery, the ER-mitochondria encounter structure (ERMES) at mitochondria and the guided entry of tail-anchored proteins (GET) pathway at the ER. Our findings introduce a previously unexplored concept of how dual affinity proteins can regulate organelle attachment and communication.

Although acute heart failure (AHF) is a common disease associated with significant symptoms, morbidity and mortality, the diagnosis, risk stratification and treatment of patients with hypertensive acute heart failure (H-AHF) still remain a challenge in modern medicine. Despite great progress in diagnostic and therapeutic modalities, this disease is still accompanied by a high rate of both in-hospital (from 3.8% to 11%) and one-year (from 20% to 36%) mortality. Considering the high rate of rehospitalization (22% to 30% in the first three months), the treatment of this disease represents a major financial blow to the health system of each country. This disease is characterized by heterogeneity in precipitating factors, clinical presentation, therapeutic modalities and prognosis. Since heart decompensation usually occurs quickly (within a few hours) in patients with H-AHF, establishing a rapid diagnosis is of vital importance. In addition to establishing the diagnosis of heart failure itself, it is necessary to see the underlying cause that led to it, especially if it is de novo heart failure. Given that hypertension is a precipitating factor of AHF and in up to 11% of AHF patients, strict control of arterial blood pressure is necessary until target values are reached in order to prevent the occurrence of H-AHF, which is still accompanied by a high rate of both early and long-term mortality.

Although the frequency of myocarditis in the general population is very difficult to accurately determine due to the large number of asymptomatic cases, the incidence of this disease is increasing significantly due to better defined criteria for diagnosis and the development of modern diagnostic methods. The multitude of different etiological factors, the diversity of the clinical picture, and the variability of the diagnostic findings make this disease often demanding both for the selection of the diagnostic modality and for the proper therapeutic approach. The previously known most common viral etiology of this disease is today overshadowed by new findings based on immune-mediated processes, associated with diseases that in their natural course can lead to myocardial involvement, as well as the iatrogenic cause of myocarditis, which is due to use of immune checkpoint inhibitors in the treatment of cancer patients. Suspecting that a patient with polymorphic and non-specific clinical signs and symptoms, such as changes in ECG and echocardiography readings, has myocarditis is the starting point in the diagnostic algorithm. Cardio magnetic resonance imaging is non-invasive and is the gold standard for diagnosis and clinical follow-up of these patients. Endomyocardial biopsy as an invasive method is the diagnostic choice in life-threatening cases with suspicion of fulminant myocarditis where the diagnosis has not yet established or there is no adequate response to the applied therapeutic regimen. The treatment of myocarditis is increasingly demanding and includes conservative methods of treating heart failure, immunomodulatory and immunospressive therapy, methods of mechanical circulatory support, and heart transplantation. The goal of developing new diagnostic and therapeutic methods is to reduce mortality from this complex disease, which is still high.

Bronze items from the Noua-Sabatinovka cultures mainly come from hoards or are strayfinds, while being very rare found in settlements. They are usually represented by pins, awls, chisels, sometimes ornaments, knives, daggers, or socketed axes. In the collection of the National Museum of History of Moldova, there are more than 70 such items, some of which have been published. The goal of this paper is the presentation of this collection, as well as the analysis of the chemical composition of the metal, which will clarify some issues of the metal objects spread in the settlements of the Noua-Sabatinovka cultures on the territory of the Republic of Moldova.

Abstract Objectives Preoperative anxiety is common and might affect surgical treatment outcomes. The aim was to translate and validate the Serbian version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Methods Following translation and initial evaluation, the Serbian version (S‐APAIS) was administered to 385 patients. Internal consistency, construct validity, prognostic criteria validity, and concurrent validity between S‐APAIS and Visual Analogue Scale for Anxiety (VAS‐A) were evaluated. Results Factor analysis revealed two factors: APAIS‐anesthesia (items 1, 2, 3) and APAIS‐procedure (items 4, 5, 6). The whole scale, APAIS‐anesthesia, and APAIS‐procedure subscales showed an adequate level of internal consistency (Cronbach's αs: 0.787, 0.806, and 0.805, respectively). High concurrent validity was observed between APAIS‐anesthesia and VAS‐A (ρ = 0.628, p

Background/Aim. Despite technological advances in diagnosis and treatment, in-hospital mortality with acute aortic dissection type B is still about 11%. The purpose of this study was to assess the risk factors for early and long-term adverse outcomes in patients with acute aortic dissection type B treated medically or with conventional open surgery. Methods. The present study included 104 consecutive patients with acute aortic dissection type B treated in our Center from January 1st, 1998 to January 1st, 2007. Patient demographic and clinical characteristics as well as in-hospital complications were reviewed. Univariate and multivariate testing was performed to identify the predictors of in-hospital (30-day) and late (within 9 years) mortality. Results. 92 (88.5%) patients were treated medically, while 12 (11.5%) patients with complicated acute aortic dissection type B were treated by open surgical repair. In-hospital complications occurred in 35.7% patients, the most often being acute renal failure (28%), hypotension/shock (24%), mesenteric ischemia (12%), and limb ischemia (8%). The in-hospital mortality rate was 15.7% and the 9-year mortality rate was 51.9%. Independent predictors of early mortality in patients with acute aortic dissection type B were uncontrolled hypertension (HR-20.69) and a dissecting aorta diameter >4.75 cm (HR-6.30). Independent predictors of late mortality were relapsing pain (HR-7.93), uncontrolled hypertension (HR-7.25), and a pathologic difference in arterial blood pressure (>20 mmHg) (HR-5.33). Conclusion. Knowledge of key risk factors may help with a better choice of treatment and mortality reduction in acute aortic dissection type B patients.

Background and Objectives: It has been suggested that intense feelings of fear/anxiety and significant patient concerns may affect the perioperative course. Those findings emphasize the importance of surgical patients’ preoperative feelings. Still, current knowledge in this area is based on a limited number of studies. Thus, we think that there is a need to further explore patients’ preoperative fears, better characterize risk factors and reasons for their occurrence, and evaluate patients’ perspectives associated with anesthesia. Materials and Methods: A total of 385 patients undergoing vascular surgery were preoperatively interviewed using a questionnaire that included demographics and questions related to patients’ fears and perceptions of anesthesia. Statistical analyses included descriptive statistics, Pearson’s χ2 and McNemar tests, and multivariate ordinal logistic regression. Results: The main causes of patients’ preoperative fear were surgery (53.2%), potential complications (46.5%), and anesthesia (40%). Female sex was a predictor of surgery and anesthesia-related fear (OR = 3.07, p = 0.001; OR = 2.4, p = 0.001, respectively). Previous experience lowered the fear of current surgery (OR = 0.65, p = 0.031) and anesthesia (OR = 0.6, p = 0.017). Type of surgery, type of anesthesia, educational and socioeconomic status, and personal knowledge of an anesthesiologist affected specific anesthesia-related fears. Over 25% of patients did not know that an anesthesiologist is a physician, and only 17.7% knew where anesthesiologists work. Level of education and place of residence influenced patients’ perceptions of anesthesia. Conclusions: Anesthesia-related fears are affected by the type of surgery/anesthesia, experience with previous surgery, and personal knowledge of an anesthesiologist. Women, patients with lower education levels, and patients with poorer socioeconomic status are at higher risk of developing those fears. The perception of anesthesiologists is inadequate, and knowledge of anesthesia is poor. Promotion of patient education regarding anesthesia is needed to alleviate those fears and increase understanding of anesthesia.

Pulmonary thromboembolism is a very common cardiovascular disease, with a high mortality rate. Despite the clear guidelines, this disease still represents a great challenge both in diagnosis and treatment. The heterogeneous clinical picture, often without pathognomonic signs and symptoms, represents a huge differential diagnostic problem even for experienced doctors. The decisions surrounding this therapeutic regimen also represent a major dilemma in the group of patients who are hemodynamically stable at initial presentation and have signs of right ventricular (RV) dysfunction proven by echocardiography and positive biomarker values (pulmonary embolism of intermediate–high risk). Studies have shown conflicting results about the benefit of using fibrinolytic therapy in this group of patients until hemodynamic decompensation, due to the risk of major bleeding. The latest recommendations give preference to new oral anticoagulants (NOACs) compared to vitamin K antagonists (VKA), except for certain categories of patients (patients with antiphospholipid syndrome, mechanical valves, pregnancy). When using oral anticoagulant therapy, special attention should be paid to drug–drug interactions, which can lead to many complications, even to the death of the patient. Special population groups such as pregnant women, obese patients, patients with antiphospholipid syndrome and the incidence of cancer represent a great therapeutic challenge in the application of anticoagulant therapy. In these patients, not only must the effectiveness of the drugs be taken into account, but great attention must be paid to their safety and possible side effects, which is why a multidisciplinary approach is emphasized in order to provide the best therapeutic option.

In this paper, we examine the characteristics of organizational culture in Ernst Young Serbia. Employee perceptions of organizational culture were compared with the proclaimed company values. Interviews were conducted with 16 employees using the standardized questionnaire while the survey provided demographic and socio-economic profile of informants. Other research methods such as observation and participant observation were also used in the study. Based on the premise that organizational culture refers to a system of shared meaning held by members that distinguishes the organization from other organizations, we noticed a variety of employee perceptions including the collection of interpersonal relations, values, beliefs, attitudes, practices, rituals, rules and procedures. Ernst Young company defines its organizational culture in relation to the three core elements: inclusiveness, development and engagement. Proclaimed values of the company represent the desired employee behavior dimensions derived from above mentioned elements. These are: a) Integrity, respect, and teaming; b) Energy, enthusiasm, and the courage to lead; c) Building of relationships based on doing the right thing. Research has shown that the value system of the company has been successfully implemented in Serbia.

Background and Objectives: Despite the relatively large number of publications concerning the validation of these models, there is currently no solid evidence that they can be used with absolute precision to predict survival. The goal of this study is to identify preoperative factors that influenced 30-day mortality and to create a predictive model after open ruptured abdominal aortic aneurysm (RAAA) repair. Materials and Methods: This was a retrospective single-center cohort study derived from a prospective collected database, between 1 January 2009 and 2016. Multivariate logistic regression analysis was used to identify all significant predictive factors. Variables that were identified in the multivariate analysis were dichotomized at standard levels, and logistic regression was used for the analysis. To ensure that dichotomized variables were not overly simplistic, the C statistic was evaluated for both dichotomized and continuous models. Results: There were 500 patients with complete medical data included in the analysis during the study period. Of them, 37.6% were older than 74 years, and 83.8% were males. Multivariable logistic regression showed five variables that were predictive of mortality: age > 74 years (OR = 4.01, 95%CI 2.43–6.26), loss of consciousness (OR = 2.21, 95%CI 1.11–4.40), previous myocardial infarction (OR = 2.35, 95%CI 1.19–4.63), development of ventricular arrhythmia (OR = 4.54, 95%CI 1.75–11.78), and DAP < 60 mmHg (OR = 2.32, 95%CI 1.17–4.62). Assigning 1 point for each variable, patients were stratified according to the preoperative RAAA mortality risk score (range 0–5). Patients with 1 point suffered 15.3% mortality and 3 points 68.2% mortality, while all patients with 5 points died. Conclusions: This preoperative RAAA score identified risk factors readily assessed at the bedside and provides an accurate prediction of 30-day mortality after open repair of RAAA.

The incidence of atrial fibrillation (AF) in acute coronary syndrome (ACS) ranges from 2.3–23%. This difference in the incidence of AF is explained by the different ages of the patients in different studies and the different times of application of both reperfusion and drug therapies in acute myocardial infarction (AMI). About 6–8% of patients who underwent percutaneous intervention within AMI have an indication for oral anticoagulant therapy with vitamin K antagonists or new oral anticoagulants (NOAC).The use of oral anticoagulant therapy should be consistent with individual risk of bleeding as well as ischemic risk. Both HAS-BLED and CHA2DS2VASc scores are most commonly used for risk assessment. Except in patients with mechanical valves and antiphospholipid syndrome, NOACs have an advantage over vitamin K antagonists (VKAs). One of the advantages of NOACs is the use of fixed doses, where there is no need for successive INR controls, which increases the patient’s compliance in taking these drugs. The use of triple therapy in ACS is indicated in the case of patients with AF, mechanical valves as well as venous thromboembolism. The results of the studies showed that when choosing a P2Y12 receptor blocker, less potent P2Y12 blockers such as Clopidogrel should be chosen, due to the lower risk of bleeding. It has been proven that the presence of AF within AMI is associated with a higher degree of reinfarction, more frequent stroke, high incidence of heart failure, and there is a correlation with an increased risk of sudden cardiac death. With the appearance of AF in ACS, its rapid conversion into sinus rhythm is necessary, and in the last resort, good control of heart rate in order to avoid the occurrence of adverse clinical events.

The urban microclimate is gradually changing due to climate change, extreme weather conditions, urbanization, and the heat island effect. In such an altered environment, outdoor thermal comfort can have a strong impact on public health and quality of life in urban areas. In this study, three main urban areas in Serbia were selected: Belgrade (Central Serbia), Novi Sad (Northern Serbia), and Niš (Southern Serbia). The focus was on the temporal assessment of OTC, using the UTCI over a period of 20 years (1999–2018) during different seasons. The main aim is the general estimation of the OTC of Belgrade, Novi Sad, and Niš, in order to gain better insight into the bioclimatic condition, current trends and anomalies that have occurred. The analysis was conducted based on an hourly (7 h, 14 h, and 21 h CET) and “day by day” meteorological data set. Findings show the presence of a growing trend in seasonal UTCI anomalies, especially during summer and spring. In addition, there is a notable increase in the number of days above the defined UTCI thresholds for each season. Average annual UTCIs values also show a positive, rising trend, ranging from 0.50 °C to 1.33 °C. The most significant deviations from the average UTCI values, both seasonal and annual, were recorded in 2000, 2007, 2012, 2015, 2017, and 2018.

Septic shock substantially alters the pharmacokinetic properties of β-lactams with a subsequently high risk of insufficiently low serum concentrations and treatment failure. Considering their pharmacokinetic (PK)/pharmacodynamic (PD) index, prolonged infusions (PI) of β-lactams extend the time that the unbound fraction of the drug remains above the minimal inhibitory concentration MIC (ft >MIC) and may improve patient survival. The present study is a monocentric, retrospective before-and-after analysis of septic shock patients treated with β-lactams. Patients of the years 2015–2017 received intermittent bolus application whereas patients of 2017–2020 received PI of β-lactams. The primary outcome was mortality at day 30 and 90 after diagnosis of septic shock. Mortality rates in the PI group were significantly lower on day 30 (PI: 41%, n = 119/290 vs. IB: 54.8%, n = 68/114; p = 0.0097) and day 90 (PI: 47.9%, n = 139/290 vs. IB: 62.9%, n = 78/124; p = 0.005). After propensity-score matching, 30- and 90-day mortality remained lower for the PI group (−10%, p = 0.14). PI was further associated with a reduction in the duration of invasive ventilation and a stronger decrease in SOFA scores within a 14 day-observation period. PI of β-lactams was associated with a significant reduction of mortality in patients with septic shock and may have beneficial effects on invasive ventilation and recovery from sepsis-related organ failure.

Research question: This paper investigated the correlation between the perceptions of strategies that affect professional development and the obstacles to successful implementation of technology-based professional development. Motivation: The research sought to determine elements that make professional development effective in the eyes of teachers, so that they may be more apt to use what they learn in classroom practice. The concept draws upon the TPACK framework while discussion and recommendations draw upon the UTAUT stages that teachers pass through when faced with new innovations. This study looks at the variables of a) time spent teaching, b) level of education, c) knowledge/use of computers, d) class preparation, and e) technology seminars of survey participants, to determine what demographical characteristics may have an impact on certain belief patterns surrounding professional development and technology use. Idea: The idea of this study is to look at the effectiveness of professional development to integrate technology into classroom practice and to allow for recommendations for improved technology-based professional development. Data: Data collected from a paper-based survey was completed by elementary school teachers in the school district of the city

This preliminary study is an inventory of the main resources and difficulties in adaptation of the Crop Growth Monitoring System (CGMS) used by Agri4cast unit of IPSC from Joint Research Centre (JRC) - Ispra of European Commission to conditions of Romania.In contrast with the original model calibrated mainly with statistical average yields at national level, for local calibration of the model the statistical yields at lower administrative units (macroregion or county) must be used. In addition, for winter crops, the start of simulation in the new system will be in the autumn of the previous year. The start of simulation (and emergence day) in the genuine system is 1st of January of the current year and the existing calibration was meant to provide a compensation system for this technical physiological delay.Proposed approach provides a better initialisation of the water balance (emergence occurs after start of simulation), as well as a better account for impact of wintering conditions, but obviously a new calibration for all cultivar dependent parameters is necessary. For the preoperational run, the localized model will use the weather data available till the last day available and the missing data from the rest of the year will be replaced either by the daily values of the long term averages or by the values from a year considered similar with the current one.Proposed adaptations permit a better use of information available on local scale and the localized model may be the core of a regional system for crop monitoring and in the same degree as the original system it can be used as tool for specific researches, such as studying the impact of climate changes.

The CRISPR/Cas9 system has been applied in a large number of animal and plant species for genome editing. In chickens, CRISPR has been used to knockout genes in somatic tissues, but no CRISPR-mediated germline modification has yet been reported. Here we use CRISPR to target the chicken immunoglobulin heavy chain locus in primordial germ cells (PGCs) to produce transgenic progeny. Guide RNAs were co-transfected with a donor vector for homology-directed repair of the double-strand break, and clonal populations were selected. All of the resulting drug-resistant clones contained the correct targeting event. The targeted cells gave rise to healthy progeny containing the CRISPR-targeted locus. The results show that gene-edited chickens can be obtained by modifying PGCs in vitro with the CRISPR/Cas9 system, opening up many potential applications for efficient genetic modification in birds.

Abstract: Starting from estrone 3-benzyloxy-17-hydroxy-16,17-secoestra-1,3,5(10)-triene- 16-nitrile (1) was synthesized in several synthetic steps. This compound was the key intermediate in the syntheses of other 17-substituted-16,17-secoestrone derivatives. Among them 3-hydroxy-17-bromo-16,17-secoestra-1,3,5(10)-triene-16-nitrile (5) is of special interest, because of its antiestrogenic activity, with no estrogenic properties. For this reason an alternative pathway for the synthesis of this compound was sought. The structures of 3-benzyloxy-17-bromo-16,17-secoestra-1,3,5(10)-triene- 16-nitrile (compound 2) and 3-hydroxy-17-p-toluenesulphonyloxy-16,17-secoestra 1,3,5(10)-triene-16-nitrile (compound 4), intermediates in the two different synthetic pathways used to obtain the desired compound 5, were unambiguously proved by appropriate X-ray structural analyses. The puckering, asymmetry parameters and torsion angles of compounds 2 and 4 are discussed and molecular-mechanic calculations for them were performed.

Yttria-stabilized tetragonal zirconia (Y-TZP) ceramics have excellent mechanical properties. However, such materials cannot undergo plastic deformation at room temperature due to their high hardness and brittleness values, hindering machinability. To overcome these limitations, we propose a zirconia-yttria-titania ceramics, based on zirconia containing 3mol% yttria and up to 15mol% titania. The zirconia-yttria-titania powders were synthesized by co-precipitation method, uniaxially pressed and sintered at 1400°C/5 h. Sample characterizations were carried out by X-ray diffraction, scanning electron microscopy and mechanical properties through Vickers hardness and toughness measurements. Compared to the Y-TZP ceramics, the yttria stabilised tetragonal zirconia ceramics co-doped with 10mol%Ti showed noticeable increase of tetragonality parameter, higher toughness and lower hardness values, indicating plasticity at room temperature. Furthermore, the atomistic simulation by Density Functional Theory methodology suggests the occurrence of spatial arrangement of the atoms, explaining the proposed plasticity.

In this study, we evaluated the effect of temperature on the fast chlorophyll fluorescence (ChlF) transient (OJIP) and OJIP-derived parameters in Antarctic lichens Xanthoria elegans, Usnea antarctica, and Dermatocarpon polyphyllizum. Samples were exposed to a range of temperatures (-5 to +45°C) and measured after 15-min equilibration. High temperature (+45°C) caused a decrease of ChlF, an increased J-step, and shortened time to reach peak ChlF (FP). Temperature below +5°C caused the increase of ChlF and J-step. The K-band was identified in X. elegans (above +20°C), U. antarctica (+35°C), and D. polyphyllizum (+45°C). L-band was well distinguishable in X. elegans (+45°C). As indicated by the OJIP-derived parameters, high temperature inhibited photosystem II function. The inhibition was apparent as less effective energetic connectivity. The OJIP transients and auxiliary measurement of ChlF temperature curves suggested that X. elegans had the lowest termostability among the experimental species. [ABSTRACT FROM AUTHOR]

Considering the pandemic of both cardiovascular diseases and oncological diseases, there is an increasing need for the use of chemotherapy, which through various pathophysiological mechanisms leads to damage to heart function. Cardio toxicity of chemotherapy drugs can manifest itself in a variety of clinical manifestations, which is why establishing a valid diagnosis is a real mystery for clinicians. Acute systolic heart failure (AHF) due to the use of 5-fluorouracil (5-FU) is a rare occurrence if it is not associated with myocardial infarction, myocarditis or Takotsubo cardiomyopathy. Therefore, we decided to present a case of an 52-year-old male who was diagnosed with stage IV RAS wild-type adenocarcinoma of the rectum and in whom the direct toxic effect 5-FU is the main reason for the appearance of toxic cardiomyopathy.

Nowadays, it is relevant to consider changes in the structure of the fuel and energy balance of industrial regions and the availability of imported fuel and energy resources, especially in the areas that lack energy sources. The ongoing structural shifts in energy consumption systems and the growing uncertainty in energy markets encourage the development of tools for improving the sustainable development of regional energy systems. To refine the theoretical and methodological basis of the study, we defined its conceptual framework, described the difference s betwee n sustainabl e functionin g an d developmen t o f th e energy sector and determined the factors of its regional differentiation and manifestations of the energy crisis. Further, we identified the shortcomings of the existing methods for forecasting the demand for electricity. We paid special attention to quality factors of strategic planning in the region, in particular, the used statistics and documents. Based on the analysis of integrated resource planning (IRP) methodology, our experience in forecasting fuel and energy balances, assessment of sectoral indicators of energy efficiency and energy demand in the region, we proposed a model for predictive and analytical justification of regional programmes for energy development. Such a model significantly increases the information reliability of these programmes’ implementation. Considering organisational tools to support sustainable development, we developed a regional energy management scheme and a mechanism stimulating local energy companies to improve energy efficiency in the consumption sector, enhance regional competition and attract investments in the renewal of fixed assets. The study has practical significance due to recommendations and tools for adjusting regional energy policy based on the coordination of the predicted parameters for various participants in the energy supply process.

The training of digital economy specialists requires new approaches to the educational process, which should contain updated training materials and flexible teaching formats and methods. Moreover, it should create competencies for working in the conditions of uncertainty and maintain readiness to solve complex problems in the process of professional activity. Close integration of scientific and educational activities is the only possible approach to attain this goal. Thus, we suggested a mechanism for rapidly transferring the latest results of scientific research to the educational process at universities in order to organize anticipatory learning. We demonstrated the organizational principles, content and methods of this mechanism on the example of managerial training. We have substantiated and described the research area «Pre-emptive management in rapidly developing industries and sectors», as well as the key provisions of anticipatory learning and its knowledge base. Further, we have discussed the possibilities of applying the technology platforms for designing branded educational products with flexible modular structure. Thanks to such structure, the training programs function as a continuous conveyor for continuous competency building. In the paper, we present a conceptual project and an operational mechanism of a university-based scientific and educational platform. Testing on the Ural Federal University (UrFU) has proved the efficiency of the suggested methods and validity of the research results. The proposed platform can be used for establishing world-class Research and Educational Centres in the region aimed at developing global research and industrial cooperation in order to create breakthrough innovations.

Stephen D Persell, 1, 2 Kunal N Karmali, 3 Ji Young Lee, 1 Danielle Lazar, 4 Tiffany Brown, 1 Elisha M Friesema, 1, 2, 5 Michael S Wolf 1 1Division of General Internal Medicine and Geriatrics, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; 2Center for Primary Care Innovation, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; 3Division of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; 4Access Community Health Network and the ACCESS Center for Discovery and Learning, Chicago, IL, USA; 5Carlson School of Management, University of Minnesota, Minneapolis, MN, USACorrespondence: Stephen D PersellDivision of General Internal Medicine and Geriatrics, Department of Medicine Feinberg School of Medicine, Northwestern University, 750 North Lake Shore Drive, 10th Floor, Chicago, IL 60611, USATel +1 312 503 6464Fax +1 312 503 2755Email spersell@nm.orgPurpose: Examine associations between health literacy and several medication self-management constructs among a population of adults with uncontrolled hypertension.Patients and Methods: Cross-sectional study of health center patients from the Chicago area with uncontrolled hypertension enrolled between April 2012 and February 2015. Medication self-management constructs—applied to hypertension medications, chronic condition medications and all medications—included: 1) medication reconciliation, 2) knowledge of drug indications, 3) understanding instructions and dosing, and 4) self-reported adherence over 4 days (no missed doses). We determined associations between health literacy and self-management outcomes using multivariable generalized linear regression.Results: There were 1460 patients who completed screening interviews; 62.9% enrolled and had complete baseline data collected, and were included in the analysis. Of 919 participants, 47.4% had likely limited (low), 33.2% possibly limited, and 19.4% likely adequate health literacy. Compared to participants with likely adequate health literacy, participants with low health literacy were less likely to have chronic medications reconciled (18.0% versus 29.6%, p=0.007), know indications for chronic medications (64.1% versus 83.1%, p< 0.001), and demonstrate understanding of instructions and dosing (68.1% versus 82.9%, p=0.001). Self-reported adherence to hypertension medications was higher among the low health literacy group (65.6% versus 56.0%, p=0.010). In multivariable models, health literacy was strongly associated with knowledge of drug indications, and understanding of instructions and dosing.Conclusion: Low health literacy was associated with worse medication self-management in several domains. However, non-adherence was greatest in the most health literate in unadjusted analysis. Among a population of patients with uncontrolled hypertension, the drivers of poor control may vary by health literacy.Keywords: health literacy, hypertension, medication reconciliation, community health centers

The subject of the analysis of our paper is the social and cultural practice of amateur basketball played by employees of the multinational company Ernst Young in Belgrade. We observed the amateur team as a folklore group, and their participation in sports is interpreted not only as a physical activity, but as a modality of shaping attitudes, values and beliefs related to the company, important for strengthening cohesion among employees and reinforcing their motivation to perform work tasks. Basketball as a sport in which each player aligns on an individual level with the collective strategy of the team is somewhat reminiscent of the activities of Ernst Young employees, such as teamwork, personal and professional development, as well as an organizational culture oriented towards the company’s development and growth on the market. The material in this paper was collected using the technique of semi-structured interviews with members of the amateur basketball team Ernst Young, which competes in the Rekreativ League of Belgrade and is composed mainly of employees in this organization. In addition to this base of our ethnographic material, informal interviews were conducted and employee statementsobtained. Using the concept of idioculture of the American sociologist, social psychologist and folklorist Gary Alan Fine, the material related to the creation, expression and subsistence of the group’s identity (composed mostly of amateur basketball players) was analyzed and interpreted. Members of this sports community differentiate themselves from other employees in the multinational company through the mentioned group identity. The group is recognized as such by other employees in this organization, which was shown by further analysis performed in accordance with the theoretical and methodological framework of the “folklore diamond” established by Gary Alan Fine. However, Fine himself never applied this framework consistently according to all its elements of analysis. The selection of these elements is made with regard to what is being examined, hence Fine’s “folklore diamond” is used as a source from which analytical concepts are taken and combined. The cultural context, as another element, gives a more complete picture of the overall analysis. This gives us an impetus for further ethnological and anthropological research of amateur sports in Serbia, especially in the corporate work environment.

The liquidity crunch arising out of volatile market conditions is a significant concern for investors across the globe. The trading activity in the market is an important attribute determining the liquidity as well as the volatility of any stock market. Given this triangular relationship, this study analyzes the relationship between liquidity, volatility and trading activity in the Indian stock market. Employing OLS regression estimates, the study identifies a contraction in liquidity in response to greater trading activity which is found to be increasing volatility in the market. It finds that higher volatility in Indian market is associated with greater illiquidity in the market. Even after adjusting for the impact of trading activity, volatility is found to be exhibiting a statistically significant impact on liquidity.Keywords: Indian stock market, intraday liquidity, OLS regression, trading activity, volatilityJEL Classifications: C1, G11, G12DOI: https://doi.org/10.32479/ijefi.7268

Vehicles’ breaking system is one of the basic elements that lead to the maintenance of technical and road safety during transport activities on public roads or other special conditions. Therefore, particular attention is paid to all maintenance work planned or occasionally carried out on such system, as a high coefficient of vehicles availability results in an increased percentage of their productivity. Of course, there is diagnosis equipment for each element, and the brake booths within MOT centres accurately indicate the values of the measured parameters, following repair, adjustment and control operations for troubleshooting. Still, there are certain cases requesting the check of breaking system either analytically or by field experiments, i.e. when vehicles are driven on rough and rugged ground, during military specific missions and activities, where their performance no longer allows specialized equipment or when such equipment does not exist. This works presents alternatives to determine the technical condition of the braking system by means of typical solutions for the general diagnosis type.

OBJECTIVE:The aim of this study was to evaluate the results of endovascular therapy on the treatment of different types of iliac occlusions. MATERIALS AND METHODS:A bi-center prospective, non-randomized study was conducted on 100 patients (mean age 59.14 ± 8.53; 64 men) who underwent endovascular treatment of iliac occlusive disease between January 2013 and November 2017. We evaluated baseline data, procedure, and follow-up results for the entire group, and according to Trans-Atlantic Inter-Society Consensus (TASC II) classification. The majority of patients (60%) were treated for severe claudication; 56 (56%) patients had TASC B occlusions, 28 patients TASC C, and 16 patients TASC D. RESULTS:The mean length of the occluded segments was 61.41 ± 35.15 mm. Procedural complications developed in 6 patients (6%). Mean ankle-brachial pressure index increased from 0.40 ± 0.12 preoperatively to 0.82 ± 0.16 postoperatively. The mean follow-up was 33.18 ± 15.03 months. After 1 and 5 years, the primary patency rates were 98% and 75.1%, and the secondary patency rate was 97% respectively. Regarding occlusion complexity there were no statistical significant differences in primary patency rates (TASC B vs. C vs. D: p = 0.19). There were no statistically significant differences in primary patency rates between patients in different clinical stages, as well as between the type of stents, and location of the occlusion. CONCLUSION:In our study, endovascular treatment for iliac artery occlusions proved to be a safe and efficient approach with excellent primary and secondary patency rates regardless of the complexity of occlusions defined by TASC II classification. This study is aligned with the notion that in well selected patients, endovascular therapy can be the treatment of choice even in complex iliac lesions if performed by experienced endovascular interventionists in high volume centers.

Innovative economic development requires principally updated approach to the process of managers training, taking into account the increase in the complexity and scale of the problems that must be addressed to managers. The purpose of the work is to improve the methodological approach to the formation of the manager’s competence in the innovative economy. The paper analyzes the existing problems of managers’ education, the new paradigm of the educational process is substantiated. The need to strengthen the learning process in a multidisciplinary approach and the technical and economic training is shown. The model of manager professionalism representing interdisciplinary complex interdependent competencies is proved. Experimental testing of methods and technologies of an interdisciplinary approach to managers’ training in the organizational form of a research and educational center (REC «INZHEK», Ural Federal University) is demonstrated. Implementation of the results obtained by the authors will mainstream managers’ training in the context of real-world problems of industries modernization.

The article deals with a promising approach to solving the problem of investment in the regional electric power industry — the application of demand-side management, the essence of which lies in proactive interaction of energy companies with customers, based on the balance of economic interests. The features of the concept and its tools are revealed, positive results of its implementation for energy market players and the region are shown, and examples of demand-side management programs are given. Institutional and mental barriers to effective implementation of demand-side management tools in power generation are analyzed. The article also proposes algorithms for implementing demand-side management programs in the region, and a mix of motivational activities that combines methods of administrative enforcement and economic stimulus for energy companies and consumers of energy and power, as well as guidelines on project funding and effectiveness evaluation.

Genetic screening on chromosomopathy has been performed on 2000 pregnant women in their first trimester of pregnancy by determining Pregnancy associated plasma protein-A and free-beta HCG biomarkers in maternal serum. After obtaining a normal fetal karyo type, the pathological values of the biomarkers have been correlated with other pregnancy disorders, and the possible causes of the positive genetic screening have been tested. 340 false positive biomarkers (17%) have been detected. The increased free-beta HCG (48.24%) had a significant influence. A significant correlation (p > 0.01) between the increased free-beta HCG and bleeding during pregnancy has been established. Complications occurred in 78.52% pregnancies with pathological biomarkers, MISSed in 13.82%, miscarriages in 10.88%, induced pregnancy terminations caused by fetal anomalies in 8.82% and births with disturbed fetal vitality in 45%. The research results have shown a significant correlation (p > 0.01) between the increased value of the free-beta HCG biomarkers and fetal hypoxia. The false positive genetic screening, caused by the increased free-beta HCG, can indicate placental dysfunction and fetal vitality disruption. .

To evaluate the changes in serum neuron specific enolase and protein S-100B, after carotid endarterectomy performed using the conventional technique with routine shunting and patch closure, or eversion technique without the use of shunt.Prospective non-randomized study included 43 patients with severe (>80%) carotid stenosis undergoing carotid endarterectomy in regional anesthesia. Patients were divided into two groups: conventional endarterectomy with routine use of shunt and Dacron patch (csCEA group) and eversion endarterectomy without the use of shunt (eCEA group). Protein S-100B and NSE concentrations were measured from peripheral blood before carotid clamping, after declamping and 24 hours after surgery.Neurologic examination and brain CT findings on the first postoperative day did not differ from preoperative controls in any patients. In csCEA group, NSE concentrations decreased after declamping (P

Autor je izvijestio o zanimljivim podrobnostima iz priložene korespondencije P. Skoka s njegovim suvremenicima koja osvjetljava zanimljivu atmosferu tadašnjega gledanja na toponomastičku problematiku i na metode toponomastičkog skupljanja građe i njezine obradbe.

Abstract Advanced renal cell carcinoma accompanied by tumor thrombus in the venous system is present in up to 10% of cases. Extension of tumor thrombus above the diaphragm or into the right atrium represents level IV disease. Level IV tumors are typically treated with sterno-laparotomy approach with or without deep hypothermic circulatory arrest and veno-venous bypass. In this case report, the surgical technique for the resection of advanced RCC were described, with the concomitant use of transesophageal echocardiography for thrombus extraction without the veno-venous or cardiopulmonary bypass.