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Abstract The impact of motivational and demotivational factors on the willingness to work (WTW) as crowdshippers, specifically focusing on different groups of crowdshippers, has been largely neglected or overlooked in the literature. This study therefore aims to address this gap by determining and examining a comprehensive set of potential factors that either hinder or encourage the WTW of crowdshippers and tests their impact on four key groups of potential crowdshippers in Slovenia: employed individuals, retirees, students, and unemployed. Significant interactions between the groups and statistical differences between them were detected using the significance level and correlation approaches. The findings of this study confirm that not only are potential crowdshipper groups heterogeneous, but there is also heterogeneity within crowdshipper groups such as retirees and students. Furthermore, the study highlights that the influence of these factors slightly varies depending on the specific business models (business to customer and business to business).

Abstract Background Research involves the systematic collection and analysis of data to enhance understanding of a particular phenomenon. Participation in medical research is crucial for advancing healthcare practices. However, there has been limited focus on understanding the factors that motivate medical students to engage in research. Additionally, in the era of e-learning, the easy accessibility of online resources has contributed to a widespread ‘copy-paste culture’ among digital-native students, which is recognized in academia as plagiarism. Existing studies suggest that a contributing factor to the increasing prevalence of plagiarism is students’ limited understanding of this act. The purpose of this study was to assess medical students’ attitudes toward research and plagiarism, and to evaluate the psychometric properties of the Attitudes Toward Research (ATR) and Attitudes Toward Plagiarism (ATP) questionnaires. Methods This was a multicenter study conducted among medical undergraduate and postgraduate students attending the three medical universities who were involved in research. Students’ attitudes toward research and plagiarism were assessed using the ATR and ATP questionnaires. The research instruments underwent translation and cultural adaptation in accordance with internationally accepted methodology. The psychometric properties of the ATR and ATP, including validity and reliability, were assessed. Confirmatory factor analysis was used to test the model’s fit to the data. Results The ATR and ATP questionnaires were completed by 793 medical students who were involved in research (647 undergraduates and 146 PhD students). Cronbach’s alpha coefficients of 0.917 and 0.822 indicated excellent and good scale reliability for the ATR and ATP questionnaires, respectively. The five-and three- factor structures of ATR and ATP have been validated with maximum likelihood confirmatory analysis, and the results demonstrated an adequate level of model fit (TLI = 0.930, CFI = 0.942 and TLI = 0.924, CFI = 0.943, respectively). Medical students showed a high degree of positive attitudes toward research and favorable scores across all three domains of attitudes toward plagiarism. In multivariate regression models, age was found to be positively associated with favorable attitudes of research usefulness, positive attitudes, relevance to life subscales and total ATR scale (p

Background Type 1 diabetes is an autoimmune disease affecting over 400,000 children and adults in the United Kingdom for which currently the only available therapy is insulin. Objective(s) To determine the efficacy and safety of the monoclonal antibody ustekinumab targeting the interleukin 12/interleukin 23 immune pathway that generates T helper 1/T helper 17 T cells to slow down the autoimmune process and preserve beta cell production in type 1 diabetes. Design Randomised, double-blind, placebo-controlled, parallel-group phase II trial. Setting Paediatric and young adult diabetes clinics across 16 sites in the United Kingdom. Participants Newly diagnosed with type 1 diabetes and aged 12–18 years. Eligibility criteria Type 1 diabetes confirmed by islet autoantibody testing, within 100 days of first insulin injection, and with residual beta cell function (stimulated C-peptide level > 0.2 nmol/l). Interventions Ustekinumab at the highest approved doses or control (saline) subcutaneously at weeks 0, 4 and 12 and subsequently every 8 weeks to week 44 (seven doses). Main outcome measures Preservation of Mixed Meal Tolerance Test stimulated 2-hour insulin C-peptide area under the curve at week 52 as compared to control (saline) treatment by analysis of covariance adjusted for baseline parameters. Randomisation 2 : 1 Remote computerised randomisation with minimisation by age and baseline C-peptide groups. Blinding Blinding of participants, investigators, laboratory and trial staff. Numbers randomised Seventy-two participants were randomised, 60% male, 18% aged 16–18 years. Recruitment Two hundred and eight potentially eligible patients were approached, and 88 patients were screened. Four participants were lost to follow-up (6%). Four participants withdrew from the treatment but attended the primary end-point assessment. Numbers analysed Six participants were missing baseline data for the primary analysis. The final analysable sample was n = 62. Outcome Ustekinumab was associated with a 49% higher endogenous stimulated insulin production than control at week 52 after adjustments for baseline factors [geometric ratio of ustekinumab to control was 1.49 (95% confidence interval 1.08 to 2.06; p = 0.02)]. Secondary analyses showed no difference in C-peptide at week 28 suggesting that the effect was ‘late’ or ‘delayed’. Ancillary analysis showed a significant reduction in activated T helper 17.1 T cells (p 0.2 nmol/l during MMTT) and autoimmune diabetes confirmed by measurement of islet cell autoantibodies. Participants were given ustekinumab or control (saline) SC at weeks 0, 4 and 12 and subsequently every 8 weeks to week 44 (seven doses) with the dose depending on their body weight: 2 mg/kg (if ≤ 40 kg) or 90 mg (if > 40 kg). These equate to the highest doses used previously in trials in other conditions. Participants were followed up 52 weeks after receiving the first dose of ustekinumab/control. The primary end point was assessed at week 52. The final safety data analysis also occurred at week 52. Minimisation by age (12–15 years vs. 16–18 years) and screened peak C-peptide levels (0.2–0.7 vs. > 0.7 nmol/l) was used to ensure balance between treatment groups. The ustekinumab-to-control ratio was 2 : 1 to provide additional data on drug safety (n = 48 : 24). Results The recruited sample was reflective of the national population of teens with T1D in National Paediatric Diabetes Audit (NPDA) 2019–20 (82% vs. 80% Caucasian) with a slightly higher male-to-female ratio (60% vs. 54%). The sample of 16- to 18-year-olds was lower than planned (18% vs. 40%), and lower than the percentage of 16- to 17-year-olds in the 12- to 17-year-old age group of newly diagnosed individuals in the NPDA (30%). This was possibly due to loss of some potential participants to adult care teams but did not appear to be due to a lower consent rate of eligible participants. Retention of participants and final analysable sample: Retention of participants over 52 weeks to the primary end point was generally good, especially considering overlap with the COVID-19 pandemic, with four participants (6%) lost to follow-up. However, an additional six participants could not be included in the planned primary outcome intention-to-treat analysis due to missing baseline data, so the final analysed sample was n = 62 (86%). The planned sample size in the power calculation was n = 66. Missing participants were balanced across the treatment arms considering the 2 : 1 ratio of recruitment (six ustekinumab, four control). Four participants withdrew from treatment (three ustekinumab, one control) but attended for primary end-point collection. Minimisation by age (12–15 years vs. 16–18 years) and initial C-peptide level ( 0.7 nmol/l) ensured balance of these parameters between the groups. Body mass index z-score was somewhat higher in the control group, while insulin use per kilogram was higher in the treatment group. Age and entry C-peptide were lower in the treatment group and HbA1c was higher, all of which are factors associated with more rapid C-peptide loss post diagnosis. Adjustment for these baseline factors was pre-planned in the analysis. Primary end-point analysis: For the pre-specified primary end-point analysis, ustekinumab was associated with a 49% higher endogenous stimulated insulin production (AUC C-peptide in 2-hour MMTT) than control after adjustments for baseline factors at 52 weeks {geometric ratio of ustekinumab to control was 1.49 [95% confidence interval (CI) 1.08 to 2.06; p = 0.02]}. Additional C-peptide end-point analyses: Despite treatment, there was still substantial loss of C-peptide in both arms over the 52-week period. At this time point, the mean stimulated AUC C-peptide levels was 65% of baseline in the ustekinumab group (0.45 vs. 0.84 nmol/l) and 45% of baseline in the control group (0.3 vs. 0.87 mmol/l). Secondary analysis of C-peptide levels at week 28 was conducted. However, it should be noted that there was more missing data at this time point (n = 55 vs. n = 62 at primary end point). At this time point, the geometric mean ratio of ustekinumab to control was not significantly different (1.15, 95% CI 0.81 to 1.63; p = 0.45). Hence, it appeared that the benefit of ustekinumab predominantly developed ‘late’, in the second 6 months of the study, although the missing data at week 28 resulted in a less precise estimated effect value at this time point. ‘Late’ or ‘delayed’ effects have not previously been seen in immunotherapy studies. Secondary end-point analyses – HbA1c: HbA1c levels rose across both groups from 50 mmol/mol at baseline to around 56 mmol/mol at week 52. No significant difference was seen in HbA1c between the groups, although with insulin use as a covariate (not pre-specified, but found to be relevant), point estimates at weeks 28 and 52 were 2–3 mmol/mol lower in the ustekinumab group. It is noted that sample sizes around two- to threefold larger than in this study would have been required for adequate power to study HbA1c differences. Secondary end-point analyses – other metabolic parameters: Exogenous insulin use increased from baseline to week 52 in both groups (0.42–0.63 U/kg in the control group; 0.51–0.63 U/kg in the ustekinumab) with no significant difference after adjustment for baseline factors. Insulin dose-adjusted HbA1c also increased in both groups (8.23–9.46% in the control group and 8.90–9.69% in the ustekinumab group) with no significant difference between the groups. Data from continuous glucose monitoring (CGM) showed decreasing median percentage of time in range of > 70 mg/dl (3.9 mmol/l) to 3.0 but ≤ 3.9 mmol/l) and 615 (around 9/person/year) were classed as level 2 (a glucose level of ≤ 3.0 mmol/l – clinically important hypoglycaemia). Only one person (in the control group) had an event classed as level 3 (severe cognitive impairment requiring external assistance). Participants in the ustekinumab group reported a lower overall incidence per person-year of all types of hypoglycaemia (39.38) than those in the control group (43.80) but the difference did not reach statistical significance [incidence rate ratio (IRR) 1.11, 95% CI 0.69 to 1.79; p = 0.66]. Data from CGM showed a lower incidence rate of level 2 hypoglycaemic events in the control group than the ustekinumab group (week 28 IRR 0.49, 95% CI 0.21 to 1.15; p = 0.1; week 52 IRR 0.40, 95% CI 0.12 to 1.30; p = 0.12), but the difference did not reach statistical significance. Secondary end-point analyses –participant-reported outcome measures (PROMs): Participant-reported outcomes were collected using the Paediatric Quality of Life Inventory (PedsQL), PedsQL™ (MAPI Research Trust PROVIDE™, Lyon, France) Diabetes Module (PedsQL Diabetes), Diabetes Treatment Satisfaction Questionnaire (DTSQ), Hypoglycaemia Fear Survey-Behaviour (HypoFear-Behaviour, Hypoglycaemia Fear Survey-Worry (HypoFear-Worry) and Hypoglycaemia Fear Survey-Total (HypoFear-Total) at baseline, week 28 and week 52. The DTSQ Change version was used at week 52 to identify changes in level of satisfaction with diabetes treatment. Completion of questionnaires was > 90% at baseline and > 80% during follow-up for almost all questionnaires. There was no significant change in any of the participant PROM scores from baseline to week 52 in either group and no significant differences between the groups. Secondary end-point analyses – parent/ proxy PROMs: There were no significant differences in parent/proxy PROMs between the groups. Secondary end-point analyses – comparison of participant and parent/proxy PROM score: In ancillary analysis, there was a strong correlation between participant and parent PROM scores for all PROMs with a rho of 0.23–0.68 which was significant at all time points. An exception was the HypoFear (behaviour) scores at week 52. Parents had significantly higher HypoFear (particularly ‘Worry’) than participants at all time points and lower PedsQL diabetes quality-of-life scores than participants at baseline and week 28. Sensitivity analyses: Sensitivity analyses were performed to confirm robustness of the conclusions about the analysis of the primary outcome to protocol deviations. Excluding one participant who accidentally became unblinded, one participant whose primary outcome visit was delayed by 6 months and one participant with a hereditary red cell disorder affecting HbA1c separately had no effect on the primary outcome. Hence the model for analysing the primary outcome was robust to small numbers of people with some protocol deviations and extreme values in key covariates. Missing data imputation: According to the pre-specified statistical analysis plan, multiple imputation would be considered if there were > 5% and 3 and 10% of the participants. A decision was made to perform multiple imputation, purely as a sensitivity check for the primary analysis. Multiple imputation showed that the conclusion about treatment group difference might be sensitive to missing values as the geometric ratio of ustekinumab to control changed to 1.36 (95% CI 0.81 to 1.63; p = 0.27) and did not reach statistical significance. The model may therefore be sensitive to missing data. Ancillary end-point analyses – harms: Ustekinumab was very well tolerated. No severe adverse events (AEs) were reported and there were no differences between ustekinumab and control in the proportion of participants overall experiencing mild (87% vs. 88%) or moderate (32% vs. 32%) events. When evaluating the AEs deemed by investigators likely to be attributable to study drug, a higher proportion of participants in the ustekinumab group had one AE deemed likely to be related to the study drug in each level of attributability (mild = 32% of participants in ustekinumab group vs. 20% in control; moderate = 11% in ustekinumab group vs. 8% in control). The bulk of the events were mild (n = 124) with only 12 events of moderate severity. These moderate AEs attributable to the study drug were experienced by seven participants (control: 2; ustekinumab: 5). In evaluating the evidence of infection, we found 37/117 AEs categorised in the Infection and Infestation class deemed to be possibly related to the study drug. These 37 events were experienced by 17 participants. A higher proportion of participants in the ustekinumab group (30%, n = 14) than those in the control group (12%, n = 3) experienced one AE deemed to be possibly related to the study drug. Thirty-four of these events were mild. Two moderate AEs were experienced by one ustekinumab participant. They were fever and upper respiratory tract infection. There were six events of injection reaction experienced by five participants (ustekinumab: 9%, n = 4, control: 4%, n = 1). All six events were mild and resolved with no sequelae. There were no hypersensitivity reactions. Ancillary end-point analyses – immunology: We observed significant differences between the ustekinumab and control groups in relevant T-cell populations targeted by the drug. A significant decline in the CD4+ Th17 and Th17.1 populations but not the Th1 population was seen after 6 months of treatment in the ustekinumab group, which became more pronounced by week 52. The most pronounced effect was seen in cells that expressed all four cytokines [IFN-γ, IL-17, granulocyte-macrophage colony-stimulating factor (GM-CSF+), IL-2+], representing around 0.1% of the CD4 T-cell population, which showed a reduction as early as 3 months after beginning therapy. This was unlikely to be an artefact of multiple testing, as the highly significant changes in T-cell populations (p ≤ 0.001) all clustered around the Th17 positive subpopulations. We additionally analysed the antigen-specific response by using a cytokine FluoroSpot assay. Overall, 28/64 participants had a positive response after in vitro stimulation with proinsulin at baseline. A highly significant fall in beta cell targeted (proinsulin specific) IL-17A-secreting T cells was also seen (p = 0.0003) in comparison to baseline from 3 months in ustekinumab group only. There was no significant change in the IFN-γ FluoroSpot response. Preservation of C-peptide from 28 to 52 weeks after baseline correlated with the reduction in T cells co-secreting IL-17 and IFN-γ (Th17.1 cells, p = 0.04), and in particular with the change in a subset also co-expressing IL-2 and GM-CSF (p = 0.04) representing

IntroductionACE2 and TMPRSS2 represent the major gateways for SARS-CoV-2 cell entry. The presence of functional ACE2 and TMPRSS2 genetic polymorphisms that affect gene expression may affect the risk of severe form of COVID-19 and its fatal outcome.Material and patientsThis observational study enrolled 178 hospitalized patients diagnosed with SARS-CoV-2 infection at the University Clinical Centre of Kragujevac, Serbia. Demographic, clinical, and laboratory data were gathered at admission. Genotyping for single nucleotide polymorphisms of ACE2 (rs2106809 and rs2074192) and TMPRSS2 (rs2070788 and rs4818239) was performed using the Real-Time PCR method with TaqMan assays.ResultsControlling for other factors of influence, such as CCI, N/L ratio, LDH level, and pO2, we showed that females with TMPRSS2 rs2070788 A/A genotype were less likely to develop severe COVID-19 (odds ratio [OR] [95% confidence interval (95% CI)]: 0.030 [0.001; 0.862]). Additionally, the likelihood of dying of SARS-CoV-2 infection was lower in female carriers of at least one ACE2 rs2106809 C allele (OR [95% CI]: 0.004 [0.000; 0.981]).ConclusionOur findings indicate TMPRSS2 rs2070788 and ACE2 rs2106809 polymorphisms as independent predictors of severity and outcome of COVID-19 in females.

Background and Objectives: Cardiac tamponade is managed through echo- or fluoroscopy-guided percutaneous pericardiocentesis. The European Society of Cardiology’s Working Group on Myocardial and Pericardial Diseases proposed a triage strategy for these patients. This study evaluated the triage score and compared the safety and efficacy of fluoroscopy- versus echo-guided procedures without additional visualization control. Materials and Methods: This prospective observational study included 71 patients with cardiac tamponade from February 2021 to June 2022. Pericardiocentesis was performed using fluoroscopy or echo guidance based on clinical assessment and catheterization laboratory availability, without the additional control of needle/guidewire position or ECG monitoring. Patients were followed for three months. Results: The study included 71 patients (52.1% female, mean age 59.7 ± 15.7 years). Malignancy was the most common comorbidity (59.2%). Echo criteria led to urgent procedures in 47.9%, with subcostal access used most often (60.6%), particularly in fluoroscopy-guided procedures (93.8%, p = 0.003). The success rate was 97.1%, with minor complications in 14% of patients. Diabetes and malignancy predicted complications regardless of access site or guiding method. The triage score did not affect complication rates or short-term mortality. Conclusions: Fluoroscopy- and echo-guided pericardiocentesis without additional visualization control showed no difference in safety or efficacy. Delaying the procedure for patients with a triage score ≥6, or performing it early for those with a low score, did not impact complication rates or mortality, which were more influenced by the progression of the underlying disease.

Pesticides used in agriculture can contaminate foods like fruits and vegetables, posing health risks to consumers and highlighting the need for effective residue monitoring. This study explores aqueous two-phase systems (ATPSs) comprising phosphonium or ammonium ionic liquids (ILs) combined with ammonium sulfate as an alternative pre-treatment method for extracting and concentrating the pesticides clomazone, pyraclostrobin, and deltamethrin from strawberry samples. Liquid–liquid equilibrium measurements for each ATPS were conducted, followed by extraction experiments to determine the most efficient systems for pesticide extraction. Results showed that all three pesticides migrated effectively to the IL-rich phase across the tested ATPSs. For the most promising system, tetrabutylphosphonium salicylate ([TBP][Sal]) with ammonium sulfate, extraction efficiencies for each pesticide exceeded 98% under optimized conditions for parameters such as pH, temperature, and ATPS composition. Application of this ATPS to strawberries resulted in significant pesticide preconcentration, reaching mg/L levels suitable for detection by liquid chromatography. The method’s sustainability was supported by green chemistry metrics, with AGREEprep and AGREE scores of 0.68 and 0.55, respectively, underscoring its alignment with eco-friendly practices.

Despite a large amount of research on synchronous and mutually induced kidney and heart damage, the basis of the disease is still not fully clarified. Healthy mitochondria are essential for normal kidney and heart function. Mitochondrial dysfunction occurs when the clearance or process of generation and fragmentation of mitochondria is disturbed. The kidney is the second organ after the heart in terms of the number of mitochondria. Kidney tubules are rich in mitochondria due to the high energy requirements for absorption of large amounts of ultrafiltrate and dissolved substances. The place of action of oxidative stress is the influence on the balance in the production and breakdown of the mitochondrial reactive oxygen species. A more precise determination of the place and role of key factors that play a role in the onset of the disease is necessary for understanding the nature of the onset of the disease and the creation of therapy in the future. This underscores the urgent need for further research. The narrative review integrates results found in previously performed studies that have evaluated oxidative stress participation in cardiorenal syndrome type 3.

As cancer remains a significant global health challenge, there is an increasing need for novel therapeutic approaches. We investigated the antitumor potential of Juniperus communis berry essential oil on cervical cancer HeLa and colorectal HCT 116 cells. Cytotoxicity was evaluated through the MTT assay, revealing concentration-dependent reductions in cell viability. A clonogenic assay demonstrated long-term cytotoxic effects. Apoptosis markers were assessed via flow cytometric analysis and showed an induction of the intrinsic pathway in both cell lines, demonstrated by the elevated levels of cleaved caspase-3, Bax/Bcl-2 ratio, JC-10 monomer formation, and cytochrome C migration to the cytosol. The treatment inhibited cell-survival pathways in HCT 116 cells and arrested HeLa cells in the S phase. An extensive molecular docking screening provided insight into the binding affinity and interaction patterns of the essential oil components with NADH ubiquinone oxidoreductase and superoxide dismutase enzymes, further confirming the induction of the intrinsic pathway of apoptosis. The obtained in silico and in vitro results indicated the anticancer potential of J. communis berry essential oil as it interferes with cancer cell molecular mechanisms. Our findings highlight J. communis berry essential oil as a promising natural agent with anticancer potential.

Leaf spot disease caused by Cercospora beticola Sacc. is the most destructive foliar disease of beet. Cercospora leaf spot is controlled primarily by fungicides because the non-chemical alternatives do not provide commercially viable control. One of the ways of reducing chemical application is the use of different essential oils (EOs) or antagonistic plant growth-promoting rhizobacteria (PGPB). This study evaluates several EOs and PGPB belonging to Pseudomonas chlororaphis as possible control agents of this pathogen. Antifungal properties were determined by in vitro microdilution method against five C. beticola monosporial isolates originated from the locality Brus, Serbia (53°53' N, 21°04'E and 429 m above sea level) using EOs from medicinal plants: Turkish pickling herb (Echinophora tenuifolia), oregano (Origanum vulgare), basil (Ocimum basilicum), and myrtle (Myrtus communis) obtained by a hydro-distillation method. All tested oils displayed some antifungal activity against the fungal isolates. Origanum vulgare EO demonstrated the strongest antifungal activity (MIC - 0.0055±0.0051mg/mL), Ocimum basilicum slightly lower (MIC - 0.075±0.045mg/mL), followed by Myrtus communis (MIC - 0.775±0.045 mg/mL) and Echinophora tenuifolia (MIC - 7.75±4.5 mg/mL). Five tested P. chlororaphis strains exhibited some antagonistic effect against C. beticola. Overnight culture (ONC) of P. chlororaphis strain E65 induced the highest percentage of inhibition (75.8%), followed by N3 (72.0%). A cell-free supernatant (CFS) and the CFS treated with EDTA (CFS-EDTA) of these strains showed similar inhibition of 60.2 and 56.0%, and both strains suppressed C. beticola growth. P. chlororaphis strains M1 and K113 also reduced the fungal growth by 67-70% using ONC and between 48-57% using different CFS fractions. The strains L1 and B25 caused inhibition of 60% using ONC and 50% by CFS. The lowest inhibition (~40%) by CFS-EDTA and heat-treated cell-free supernatant (HT-CFS) was recorded for B25, which was used as a reference strain. The tested isolates of C. beticola were susceptible to all selected essential oils and P. chlororaphis strains Е25, N3, M1, and K113 in vitro, making them a promising non-chemical control agent. It is recommended that these findings should be tested in field conditions. [ABSTRACT FROM AUTHOR]

Allergenic pollen affects the quality of life for over 30% of the European population. Since the treatment efficacy is highly related to the actual exposure to pollen, information about the type and number of airborne pollen grains in real-time is essential for reducing their impact. Therefore, the automation of pollen monitoring has become an important research topic. Our study is focused on the Rapid-E real-time bioaerosol detector. So far, vanilla convolutional neural networks (CNNs) are the only deep architectures evaluated for pollen classification on multi-modal Rapid-E data obtained by exposing collected pollen samples of known classes to the device in a controlled environment. This study contributes to the further development of pollen classification models on Rapid-E data by experimenting with more advanced concepts of CNNs, residual, and inception networks. Our experiments included a comprehensive comparison of different CNN architectures, and obtained results provided valuable insights into which convolutional blocks improve pollen classification. We propose a new model which, coupled with a specific training strategy, improves the current state-of-the-art by reducing its relative error rate by 9%.

Gold nanoparticles (GNPs) have been used in the development of novel therapies as a way of delivery of both stimulatory and tolerogenic peptide cargoes. Here we report that intradermal injection of GNPs loaded with the proinsulin peptide C19-A3, in patients with type 1 diabetes, results in recruitment and retention of immune cells in the skin. These include large numbers of clonally expanded T-cells sharing the same paired T-cell receptors (TCRs) with activated phenotypes, half of which, when the TCRs were re-expressed in a cell-based system, were confirmed to be specific for either GNP or proinsulin. All the identified gold-specific clones were CD8+, whilst proinsulin-specific clones were both CD8+ and CD4+. Proinsulin-specific CD8+ clones had a distinctive cytotoxic phenotype with overexpression of granulysin (GNLY) and KIR receptors. Clonally expanded antigen-specific T cells remained in situ for months to years, with a spectrum of tissue resident memory and effector memory phenotypes. As the T-cell response is divided between targeting the gold core and the antigenic cargo, this offers a route to improving resident memory T-cells formation in response to vaccines. In addition, our scRNAseq data indicate that focusing on clonally expanded skin infiltrating T-cells recruited to intradermally injected antigen is a highly efficient method to enrich and identify antigen-specific cells. This approach has the potential to be used to monitor the intradermal delivery of antigens and nanoparticles for immune modulation in humans.

Acute pancreatitis (AP) is a complex inflammatory condition that can lead to systemic inflammatory responses and multiple organ dysfunction. This study investigates the role of Galectin-3 (Gal-3), a β-galactoside-binding lectin, in modulating acquired immune responses in AP. Acute pancreatitis was induced by ligation of the bile-pancreatic duct in wild-type and Galectin-3-deficient C57BL/6 mice. We determined the phenotypic and molecular features of inflammatory cells, serum concentrations of amylase, pancreatic trypsin activity, and pancreatic and lung pathology. Galectin-3 deficiency decreased the total number of CD3+CD49− T cells and CD4+ T helper cells, downregulated the production of inflammatory cytokine and IFN-γ, and increased the accumulation of IL-10-producing Foxp3+ T regulatory cells and regulatory CD4+ T cells in the pancreata of diseased animals. The deletion of Galectin-3 ameliorates acute pancreatitis characterized by lowering serum amylase concentration and pancreatic trypsin activity, and attenuating of the histopathology of the lung. These findings shed light on the role of Galectin-3 in acquired immune response in acute pancreatitis and identify Galectin-3 as an attractive target for investigation of the immunopathogenesis of disease and for consideration as a potential therapeutic target for patients with acute inflammatory disease of the pancreas.

Polyphenols are natural compounds with enhanced antioxidant properties. They are present in relatively high concentrations in fruit/vegetable by-products. Therefore, there is a need for the development of efficient and cost-effective methods for the separation and purification of these valuable compounds. Traditional extraction with organic solvents needs to be switched to novel methods that are more efficient, with reduced extraction times and low consumption of organic solvents. Aiming at developing sustainable processes for the separation and purification of phenolic compounds, we used three model compounds, namely resveratrol, quercetin, and gallic acid, to investigate ionic liquid-based aqueous biphasic systems (IL-ABSs) formed by cholinium-based IL in combination with polypropylene glycol with a molecular mass of 400 g/mol (PPG400). The ABS composition in the two-phase region was selected according to a previously determined phase diagram. Extraction studies indicated the preferential partition of resveratrol and quercetin toward the hydrophobic PPG-rich phase that is mainly dominated by its hydrophobic nature and the strong salting-out effect of ILs. On the other hand, due to its considerably hydrophilic nature, gallic acid preferentially migrates toward the IL phase. The achieved results from grape stem extract demonstrated high extraction efficiencies of cholinium dihydrogen phosphate (~99% for resveratrol for the PPG phase and 78% for gallic acid for the IL phase), with considerable selectivity, demonstrating promising outcomes for potential applications.

Objectives: The excessive release of the antidiuretic hormone vasopressin is implicated in many diseases including cardiovascular disease, diabetes, obesity, and metabolic syndrome. Once thought to be elevated as a consequence of diseases, data now supports a more causative role. We have previously identified CREB3L1 as a transcription factor that co-ordinates vasopressin synthesis and release in the hypothalamus. The objective here was to identify mechanisms orchestrated by CREB3L1 that co-ordinate vasopressin release. Methods: We mined Creb3l1 knockdown SON RNA-seq data to identify downstream target genes. We proceeded to investigate the expression of these genes and associated pathways in the supraoptic nucleus of the hypothalamus in response to physiological and pharmacological stimulation. We used viruses to selectively knockdown gene expression in the supraoptic nucleus and assessed physiological and metabolic parameters. We adopted a phosphoproteomics strategy to investigate mechanisms that facilitate hormone release by the pituitary gland. Results: We discovered glucagon like peptide 1 receptor (Glp1r) as a downstream target gene and found increased expression in stimulated vasopressin neurones. Selective knockdown of supraoptic nucleus Glp1rs resulted in decreased food intake and body weight. Treatment with GLP-1R agonist liraglutide decreased vasopressin synthesis and release. Quantitative phosphoproteomics of the pituitary neurointermediate lobe revealed that liraglutide initiates hyperphosphorylation of presynapse active zone proteins that control vasopressin exocytosis. Conclusion: In summary, we show that GLP-1R signalling inhibits the vasopressin system. Our data advises that hydration status may influence the pharmacodynamics of GLP-1R agonists so should be considered in current therapeutic strategies.

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Background and Objectives: Mitral valve pathology and mitral regurgitation (MR) are very common in patients with hypertrophic cardiomyopathy (HCM), and the evaluation of mitral valve anatomy and degree of MR is important in patients with HCM. The aim of our study was to examine the potential influence of moderate or moderately severe MR on the prognosis, clinical presentation, and structural characteristics of HCM patients. Materials and Methods: A prospective study examined 176 patients diagnosed with primary asymmetric HCM. According to the severity of the MR, the patients were divided into two groups: Group 1 (n = 116) with no/trace or mild MR and Group 2 (n = 60) with moderate or moderately severe MR. All patients had clinical and echocardiographic examinations, as well as a 24 h Holter ECG. Results: Group 2 had significantly more often the presence of the obstructive type of HCM (p < 0.001), syncope (p = 0.030), NYHA II class (p < 0.001), and atrial fibrillation (p = 0.023). Also, Group 2 had an enlarged left atrial dimension (p < 0.001), left atrial volume index (p < 0.001), and indirectly measured systolic pressure in the right ventricle (p < 0.001). Patients with a higher grade of MR had a significantly higher E/e′ (p < 0.001) and, as a result, higher values of Nt pro BNP values (p < 0.001) compared to Group 1. Kaplan–Meier analysis demonstrated that the event-free survival rate during a median follow-up of 88 (IQR 40–112) months was significantly higher in Group 1 compared to Group 2 (84% vs. 45% at 8 years; log-rank 20.4, p < 0.001). After adjustment for relevant confounders, the presence of moderate or moderately severe MR remained as an independent predictor of adverse outcomes (HR 2.788; 95% CI 1.221–6.364, p = 0.015). Conclusions: The presence of moderate or moderately severe MR was associated with unfavorable long-term outcomes in HCM patients.

Vessels of the shipping industry produce sludge during the operation of the main engine, various types of auxiliary engines, and the handling of fuel oil on board ships. The sludge can be stored in special tanks and disposed of ashore or burned on board. In the European Union, according to the Port Reception Facilities Directive (EU) 2019/883, ships have to pay a port waste fee for the delivery of ship waste, which is calculated according to the size of the ship. Such an approach does not take into account the capacity of port green waste logistics. In this paper, the case of delivery of ship sludge to ports that are similar in terms of waste logistics capacity is analysed. It is presented as a mathematical game between ships and ports to improve green waste logistics and match the amount of oil sludge that can be discharged from ships to the capacity of ports. The goal of the game is to discourage free-riders, which can occur on both sides, between suppliers and ports. The waste rate can be used as a regulator and incentive that discourages sludge dumping when recycling is not feasible. A model evaluation is proposed using a numerical example.

Corporate and organizational performance assessment is an important activity for both the managers and other stakeholders, as it provides them with an asset to evaluate their own strengths and weaknesses in relation to the competition, as well as guidelines for selecting appropriate measures to address the existing problems. The issue of criteria selection has been overcome through the literature review and the issue of criteria weights is handled by applying group decision making procedure. The procedure itself consists of using predefined linguistic expressions that are modelled by triangular fuzzy numbers and the aggregation of decision makers’ opinion based on the rules of rough sets algebra. The values of the decision matrix are determined by prognosis method and they are described by crisp values. The proposed algorithm is tested on the insurance companies that operate in the Republic of Serbia

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.

Abstract Occurrence of urosepsis is not uncommon following urinary tract infections (UTI). However, there is a lack of evidence explaining the risk factors predisposing to urosepsis in patients with chronic kidney disease (CKD). This retrospective study was undertaken to evaluate the incidence and possible risk factors for urosepsis among patients hospitalized with UTI in a cohort of CKD patients. Patients were divided into the urosepsis group and the non-urosepsis group. Of 489 hospitalized patients with UTI, 70 (14.3%) acquired urosepsis. Stepwise multivariate logistic regression demonstrated that diabetes, urinary catheter and length of hospital stay (p

The article explains how civic education is included in the subject of history in elementary and secondary schools in Slovenia. History is a compulsory subject taught in elementary and secondary schools and plays an important role in the cultural, social and political education of young people – young citizens. The analysis of current history curricula indicates that they contain civic and patriotic elements in the general and specific objectives and learning outcomes, as well as in the content. The analysis of selected history textbooks shows that Slovenian textbooks include more European history than Slovenian history. The article explains what social and civic competences can be developed and fostered in the subject of history and how elementary and secondary school students can use various examples from the past to develop a positive attitude towards Slovenian identity and the protection of Slovenian cultural heritage, a respectful attitude towards human rights and democratic citizenship, towards different cultures, religions and nations, and responsible socio-political activity. It has been noted that history teachers have many opportunities to teach students the relevant values of democratic citizenship and to enable them to know and understand themselves as individuals and as members of the local and global communities. However, more attention should be paid to contemporary Slovenian history and active citizenship.

The extent of heavy-metal-induced cardiotoxicity is proportional to the levels of metal bioaccumulation, and it was previously assumed that heavy metals accumulate uniformly in the myocardium. Therefore, the aim of this study was to investigate concentrations of metals and metalloids in two distant regions of the left ventricle (LV), the base of the LV, and apex of the LV using inductively coupled plasma mass spectrometry (ICP-MS). We also examined the potential correlation between metal levels and the thickness of the interventricular septum in twenty LV specimens (ten from the base of LV and ten from the apex of LV) from 10 individuals (mean age 75 ± 6 years). We found significantly higher concentrations of arsenic and lead in the LV apex compared to the base of the LV. We also found a positive correlation between the concentrations of arsenic in the myocardium of LV and the thickness of the interventricular septum. Our results indicate that arsenic and lead accumulate to a higher extent in the apex of the LV compared to the base of the LV. Therefore, future studies designed to measure levels of metals in heart muscle should consider non-uniform accumulation of metals in the myocardium.

No Abstract

Copyright of Matica Srpska Journal for Natural Sciences is the property of Matica Srpska, Department of Natural Studies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To improve the supply chain performance in all three aspects of sustainability (social, economic, and environmental), a comprehensive sustainable performance measurement system that captures all the supply chain partners’ efforts and commitments is required. Warehouse, as the second largest logistics source of environmental pollution in the supply chain has been almost completely overlooked and ignored in the past studies. To fill this gap, a warehouse performance metrics framework for environmental and social performance measures was proposed using a novel Fuzzy Delphi and Best-worst methodological approach. The method is less time-consuming than the Analytic Hierarchy Process or Analytic Network Process, it does not address whether criteria are dependent or independent, requires fewer comparisons of criteria, but still produces reliable and credible results. The presented framework consists of 32 equally formulated environmental and social performance indicators, including formulas and measurement units. The 14 most important indicators are ranked according to the requirements of different stakeholders.

The ongoing research in the field of decision-making can be analyzed from different perspectives. Research trends indicate that multi-attribute decision-making (MADM) methods have a significant impact on engineering and management scientific areas. Since many of the problems existing in the mentioned areas are associated with a certain level of uncertainty, type 2 fuzzy sets represent a common solution for the enhancement of conventional MADM methods. In this way, the decision-makers are encouraged to use linguistic expressions for the assessment of attributes’ relative importance and their values. The purpose of this paper is to review a determination of attributes’ relative importance, and their values, as well as the extension of ranking methods with type 2 fuzzy sets. The papers are systematically adjoined to groups consisting of hybrid models with the following characteristics: (1) indicating the procedure for modeling attribute relative importance and their values, (2) determining the extension of MADM methods with type 2 fuzzy sets to determine attributes’ vector weights, and (3) the extension of MADM for attributes ranking with type 2 fuzzy sets. This study reviewed a total of 42 papers in the domain of engineering and management published from 2013 to 2023 in different journals indexed by the Springer, Science Direct, Emerald, Wiley, ProQuest, Taylor, and Francis research platforms.

In the past few years, huge advances have been made in techniques to analyse cells at an individual level using RNA sequencing, and many of these have precipitated exciting discoveries in the immunology of type 1 diabetes (T1D). This review will cover the first papers to use scRNAseq to characterise human lymphocyte phenotypes in T1D in the peripheral blood, pancreatic lymph nodes and islets. These have revealed specific genes such as IL-32 that are differentially expressed in islet –specific T cells in T1D. scRNAseq has also revealed wider gene expression patterns that are involved in T1D and can predict its development even predating autoantibody production. Single cell sequencing of TCRs has revealed V genes and CDR3 motifs that are commonly used to target islet autoantigens, although truly public TCRs remain elusive. Little is known about BCR repertoires in T1D, but scRNAseq approaches have revealed that insulin binding BCRs commonly use specific J genes, share motifs between donors and frequently demonstrate poly-reactivity. This review will also summarise new developments in scRNAseq technology, the insights they have given into other diseases and how they could be leveraged to advance research in the type 1 diabetes field to identify novel biomarkers and targets for immunotherapy.

Introduction Most individuals newly diagnosed with type 1 diabetes (T1D) have 10%–20% of beta-cell function remaining at the time of diagnosis. Preservation of residual beta-cell function at diagnosis may improve glycaemic control and reduce longer-term complications.Immunotherapy has the potential to preserve endogenous beta-cell function and thereby improve metabolic control even in poorly compliant individuals. We propose to test ustekinumab (STELARA), a targeted and well-tolerated therapy that may halt T-cell and cytokine-mediated destruction of beta-cells in the pancreas at the time of diagnosis.Methods and analysis This is a double-blind phase II study to assess the safety and efficacy of ustekinumab in 72 children and adolescents aged 12–18 with new-onset T1D.Participants should have evidence of residual functioning beta-cells (serum C-peptide level >0.2nmol/L in the mixed-meal tolerance test (MMTT) and be positive for at least one islet autoantibody (GAD, IA-2, ZnT8) to be eligible.Participants will be given ustekinumab/placebo subcutaneously at weeks 0, 4 and 12, 20, 28, 36 and 44 in a dose depending on the body weight and will be followed for 12 months after dose 1.MMTTs will be used to measure the efficacy of ustekinumab for preserving C-peptide area under the curve at week 52 compared with placebo. Secondary objectives include further investigations into the efficacy and safety of ustekinumab, patient and parent questionnaires, alternative methods for measuring insulin production and exploratory mechanistic work.Ethics and dissemination This trial received research ethics approval from the Wales Research Ethics Committee 3 in September 2018 and began recruiting in December 2018.The results will be disseminated using highly accessed, peer-reviewed medical journals and presented at conferences.Trial registration number ISRCTN14274380.

The main objective of this paper is the analysis of the impact of recycling equipment in the automotive industry in terms of circular economy (CE). Also, paper point out the opportunities and benefits of applications equipment for recycling and principles of CE in the automotive industry in Serbia. Analysis of market needs and examining the existing equipment for recycling team who work on the project TR 35033 made: mobile baling press for baling shellfish and other scrap metal, a device for dispensing oil and automatic shredder for recycling cables. Application of the circular economy in the automotive industry is reflected in the remanufacturing a wide variety of components and parts (engines, water pumps, alternators etc.). The main benefits of applications equipment for recycling and CE in the automotive industry include: maximizing the utilization of resources and increasing the reuse of materials from products that have completed their "life cycle", maximizing the life of the product, reduce environmental pollution, reducing costs etc.

This paper explains the importance of ELV recycling in the Republic of Serbia as well as the influence of the circular economy on the automotive industry. The advantages and significance of recycling of motor vehicles at the end of the life cycle, as well as the justification for the reuse of resources and the preservation of the environment, have been presented. Also, the paper presents the development of ELV recycling equipment and its importance for the entire state industry and economy.

Choosing an optimal bunkering port that minimises the increase in the operating costs in a hub and spoke system is a multi-criteria decision-making (MCDM) problem. Furthermore, the criteria are related to the port particularities, the environment, fuel price, and some criteria are quantitative while others are qualitative. It is therefore necessary to create a model that takes such features into consideration. Firstly, in this paper a set of the most used criteria will be defined. Then, a method to choose suitable criteria for a hub and spoke system will be proposed. Secondly, using a Fuzzy AHP, weights will be defined and used in a multi-criteria goal function. The outcome is a bunkering policy MCDM model based on the aggregation of fuel consumption and price to criteria related to port characteristics, local aspects and service particularities. All these factors must be considered by a chief engineer (superintendent) in the process of defining a sustainable bunker policy. A case study based on the North Adriatic port system demonstrates the applicability of the proposed model. In addition, the case study highlights that in hub and spoke systems with short loops, feeder ships can regulate cargo capacity and stay at a port with bunkering policy planning.

In recent decades, many researchers and practitioners have believed that reaching a high level of business excellence leads to the continuous realization of a set of business goals. In the literature, a vast number of models for business excellence evaluation that contain different criteria depending on the cultural, technological, organizational, and socio-economic factors can be found. The aims of the proposed fuzzy two-stage model are to address some of the main shortcomings of the EFQM2020 model and to adapt it to the needs of process manufacturing. The relative importance of quality criteria and their values are presented by pre-defined linguistic expressions modeled by the triangular fuzzy numbers. The determination of the weight vector of criteria is stated as a fuzzy group decision-making problem and determined by using the fuzzy best-worst method. The proposed fuzzy multi-objective optimization by ratio analysis is implemented for determining the rank of enterprises. The management initiatives that should lead to the improvement of business excellence should be based on the business practices of enterprises that are highly placed in the rank. Testing and verification of the proposed model are performed on real data originating from enterprises operating in the same economic sector.

Markers used in everyday clinical practice cannot distinguish between the permanent impairment of renal function. Sodium and potassium values and their interdependence are key parameters in addition to volemia for the assessment of cardiorenal balance. The aim of this study was to investigate volemia and electrolyte status from a clinical cardiorenal viewpoint under consideration of renal function utilizing artificial intelligence. In this paper, an analysis of five variables: B-type natriuretic peptide, sodium, potassium, ejection fraction, EPI creatinine-cystatin C, was performed using an algorithm based on the adaptive neuro fuzzy inference system. B-type natriuretic peptide had the greatest influence on the ejection fraction. It has been shown that values of both Na+ and K+ lead to deterioration of the condition and vital endangerment of patients. To identify the risk of occurrence, the model identifies a prognostic biomarker by random regression from the total data set. The predictions obtained from this model can help optimize preventative strategies and intensive monitoring for patients identified as at risk for electrolyte disturbance and hypervolemia. This approach may be superior to the traditional diagnostic approach due to its contribution to more accurate and rapid diagnostic interpretation and better planning of further patient treatment

Project-oriented manufacturing companies aim to produce high-quality products according to customer requirements and a minimum rate of complaints. In order to achieve this, performance indicators, especially those related to product quality, must be measured and monitored by managers. This research proposes a fuzzy multi-criteria model for the selection of key performance indicators that are critical to product quality. The uncertainties in the relative importance of decision-makers, performance indicators, and their values are described by sets of natural language words that are modeled by the interval-valued intuitionistic fuzzy numbers. The assessment of the relative importance of the decision-makers and the determination of their weights are based on the inclusion comparison probability between the closeness intuitionistic fuzzy sets. The determination of the weights vector of performance indicators is based on the integration of an interval-value fuzzy weighted geometric operator and the inclusion comparison probability between the closeness intuitionistic fuzzy sets. TOPSIS expanded with interval-valued intuitionistic fuzzy numbers for ranking performance indicators is proposed. The developed model was tested on the real data collected from three manufacturing companies in the Republic of Serbia. Based on the obtained results, the top-ranked performance indicators were marked as critical for product quality and selected as quality key performance indicators.

An e-bike sharing system (e-BSS) solves many of the shortcomings of BSS but requires high financial investments compared to BSS. This article proposes a sustainable and targeted extension of the existing BSS with e-bikes and charging piles. The existing BSS in the selected city area is divided into sub-areas using the Voronoi diagram and reference points (landmarks). Then, the integrated approach of the Analytic Hierarchy Process (AHP) and Data Envelopment Analysis (DEA) is used to assess the adequacy of the existing bike-sharing stations for updating with e-bikes and charging piles. The joint approach allows decision-makers to look at the whole process and highlight the link between the criteria assessment and user preferences in the context of the chosen reference point. This can encourage future users to use e-BSSs. Based on a thorough literature review, the defined system of criteria takes into account all dimensions of sustainability: the requirements of most stakeholders and the structural features and needs of e-BSS. Finally, the super-efficiency DEA is used to classify the suitable candidates for bike-sharing so that only the most suitable stations are updated. The test of the proposed algorithm in Ljubljana city centre confirms several suitable options for updating the BSS, depending on the reference point.

The HERe2Cure project, which involved a group of breast cancer experts, members of multidisciplinary tumor boards from healthcare institutions in Bosnia and Herzegovina, was initiated with the aim of defining an optimal approach to the diagnosis and treatment of HER2 positive breast cancer. After individual multidisciplinary consensus meetings were held in all oncology centers in Bosnia and Herzegovina, a final consensus meeting was held in order to reconcile the final conclusions discussed in individual meetings. Guidelines were adopted by consensus, based on the presentations and suggestions of experts, which were first discussed in a panel discussion and then agreed electronically between all the authors mentioned. The conclusions of the panel discussion represent the consensus of experts in the field of breast cancer diagnosis and treatment in Bosnia and Herzegovina. The objectives of the guidelines include the standardization, harmonization and optimization of the procedures for the diagnosis, treatment and monitoring of patients with HER2-positive breast cancer, all of which should lead to an improvement in the quality of health care of mentioned patients. The initial treatment plan for patients with HER2-positive breast cancer must be made by a multidisciplinary tumor board comprised of at least: a medical oncologist, a pathologist, a radiologist, a surgeon, and a radiation oncologist/radiotherapist.

Background: Superinfections contribute to mortality and length of stay in critically ill COVID-19 patients. The aim of this study was to determine the incidence and pathogen distribution of bacterial and fungal superinfections of the lower respiratory tract (LRTI), urinary tract (UTI) and bloodstream (BSI) and to determine the predictive value of biomarkers of inflammatory response on their ICU survival rates. Methods: A retrospective observational study that included critically ill COVID-19 patients treated during an 11-month period in a Croatian national COVID-19 hospital was performed. Clinical and diagnostic data were analyzed according to the origin of superinfection, and multivariate regression analysis was performed to determine the predictive values of biomarkers of inflammation on their survival rates. Results: 55.3% critically ill COVID-19 patients developed bacterial or fungal superinfections, and LRTI were most common, followed by BSI and UTI. Multidrug-resistant pathogens were the most common causes of LRTI and BSI, while Enterococcus faecalis was the most common pathogen causing UTI. Serum ferritin and neutrophil count were associated with decreased chances of survival in patients with LRTI, and patients with multidrug-resistant isolates had significantly higher mortality rates, coupled with longer ICU stays. Conclusion: The incidence of superinfections in critically ill COVID-19 patients was 55.3%, and multidrug-resistant pathogens were dominant. Elevated ferritin levels and neutrophilia at ICU admission were associated with increased ICU mortality in patients with positive LRTI.

Despite arriving with the required language qualifications, many international students struggle with the linguistic demands of a university degree. Using the International English Language Testing System (IELTS) as an example, this study explored how short but intensive preparation programmes may affect high-stakes English-proficiency test scores with which students apply for university places. The participants were 89 Chinese speakers of English as a foreign language in Shanghai. They were tested twice, four weeks apart, on IELTS and three other measures of English ability: The Oxford Online Placement Test, a vocabulary test, and the speed and accuracy of sentence comprehension. Between the two testing points, 45 participants underwent testspecific training consisting of previous IELTS papers, offered by a large test-preparation establishment with a network of over 1,000 training centres. The remaining 44 participants did not engage in any test preparation at the time. Teaching to the test led to a half a band rise in IELTS scores above the gain from test repetition alone, suggesting that the training was effective. Importantly, the IELTS gain did not generalise to the other measures of English ability; the groups performed similarly on all other language tests at both times. This suggests that test-specific, curriculum-narrowing courses could be inflating the scores with which international students apply for university places, with important consequences for test-developers, universities and students.

The goal of each company today is to improve business and increase profit through the reorganization and simplification of its processes, decrease of costs and resources utilization etc. Improving the business is usually implemented through different techniques and methodologies that have been developed. One of the ways to improve service processes, and health system processes also, is the implementation of the lean concept. This study shows benefits from using Lean tools value stream mapping (VSM) and simulations to simplify the laboratory work process. Using the VSM and simulation in department of clinical biochemistry authors showed significant improvement of the clinical processes such as eliminating non-value added times (NVAT) by minimum 30 working days/year, increasing number of laboratories analyses by approximately 80.000 analyses/year, eliminating unnecessary movement of 39,000 - 52,000 meters/year for samples and 78,000 - 104,000 meters/year for stuff and decreasing patient waiting times from average 70 to 20 min/patient.

Background: The purpose of this study was to compare home and office BP in the adjustment of antihypertensive treatment. Methods: This study was an open, prospective, noninterventional, multicenter clinical trial that occurred between July 2019 and February 2020, in 34 cities in the territory of the Republic of Serbia, which monitored 1581 participants for 6 months. Depending on the used blood pressure monitoring method used, all patients were divided into control (office BP monitoring) and experimental (home BP telemonitoring) groups. We collected anamnestic data and data about systolic blood pressure (SP), in mmHg, diastolic blood pressure (DP), in mmHg, and heart rate (HR), in beats/minute, from all patients. Results: SP values were significantly different at baseline, and at the second, third, and fourth visits between the two tested groups. Home and office BP decreased significantly (p < 0.000) during the 6-month follow-up. We observed a statistically significant influence of the presence of diabetes mellitus and dyslipidemia on the dynamics of differences between SP monitoring values. Conclusions: Our study suggests that novel technologies in BP monitoring can be excellent alternatives for BP assessment in hypertensive patients with other cardiovascular risk factors such as diabetes and dyslipidemia.