This paper examines possibilities for improving the existing strategies of consistency management for highly-distributed transactional database in a hybrid cloud environment. With a detailed analysis of the existing consistency models for distributed database and standard strategies including Classic, Quorum and Tree Based Consistency (TBC), it is concluded that an improved advanced model of so-called visible adaptive consistency needs to be applied in a highly-distributed cloud environment, as necessary and sufficient degree of synchronization of all replicas. Along with the proposed model, research and development of an advanced novel strategy for consistency management Rose TBC (R-TBC) approach has been conducted, by improving standard TBC approach. Regarding implementation, a specific agglomerative Rose Tree Algorithm (RTA) has been developed, based on Bayesian hierarchical clustering and Graph Partitioning Algorithm - Multidimensional Data Clustering (GPA-MDC) intelligent partitioning of transactional Cloud Database Management System (CDBMS). The final result is constructed R-TBC model that changes in accordance with dynamic changes of entire heterogeneous CDBMS environment.

Department of Clinical Microbiology, Institute for Health and Food Safety Zenica, Fra Ivana Jukića 2, 72000 Zenica, Bosnia and Herzegovina Department of Epidemiology, Institute for Health and Food Safety Zenica, Fra Ivana Jukića 2, 72000 Zenica, Bosnia and Herzegovina Autoimmune Diseases Department, Vasculitis Research Unit, IDIBAPS, CELLEX 4B, Hospital Clinic Barcelona, Spain Department of Chemistry Diagnostics, Institute for Health and Food Safety Zenica, Fra Ivana Jukića 2, 72000 Zenica, Bosnia and Herzegovina Department for Epizootiology, Institute for Health and Food Safety Zenica, Fra Ivana Jukića 2, 72000 Zenica, Bosnia and Herzegovina

Background and Aims: This study aimed to understand the use of massive transfusion (MT) for gastrointestinal bleeding (GIB). Patients and Methods: We performed a retrospective analysis of patients admitted to our medical Intensive Care Unit (ICU) with GIB for the type of bleeding, quantity of blood products transfused, and risk of transfusion-related acute lung injury (TRALI) and death. MT was defined as transfusion of 10 or more units of red blood cell (RBC) within a 24-h period in a 1-unit RBC: 1-unit fresh frozen plasma: and 1-unit platelet ratio. TRALI was defined as development of acute lung injury (ALI), within 6 h of transfusion, with new bilateral pulmonary infiltrates, absence of circulatory overload, or other explanation for ALI. Results: In a 43-month interval, 169 patients were admitted to the ICU with GIB and received blood products, of whom 13 received MT. Ten patients developed TRALI, of whom 7 (70%) had received MT. MT was associated with an increased risk of TRALI (odds ratio [OR]: 17.9, 95% confidence interval [CI]: 2.9–111.2, P = 0.002) after adjusting for age, sex, body mass index, baseline vitals, and laboratory data. Death was predicted by MT (OR: 5.6, 95% CI: 1.6–19.7, P = 0.007), TRALI (OR: 2.3, 95% CI: 1.1–4.6, P = 0.02), and Acute Physiologic Chronic Health Evaluation II score (OR: 1.17 per unit increase, 95% CI: 1.09–1.26, P < 0.001) after adjusting for age and sex. Conclusions: MT for GIB is associated with an increased risk of TRALI and death. Prospective studies assessing the use of MT in this population are needed to understand and improve outcomes.

Zbog visokog stepena adaptibilnosti i postojanja velikog broja vrsta, stafilokoke spadaju u grupu siroko rasprostranjenih mikroorganizama. Ove bakterije se gotovo redovno mogu naci na koži, krznu i dlaci, te sluznicama nosne supljine i ždrijela razlicitih životinja i ljudi. Pojava otpornosti stafilokoka na razlicite grupe antibiotika, kao i potreba za boljim razumjevanjem mehanizma stafilokokne antibiotske rezistencije, predstavljaju ozbiljan izazov za efikasniju borbu sa ovim globalnim problemom. Meticilin-oksacilin rezistencija danas predstavlja poseban problem u veterinarskoj i humanoj medicini. Ekonomski gubici izazvani stafilokoknim infekcijama u stocarskoj proizvodnji sirom svijeta, jedan su od najvažnijih veterinarskih problema. Visok stepen morbiditeta i dugotrajna lijecenja oboljelih životinja, dodatno intenziviraju i aktualiziraju ovu problematiku. Posebnu grupu meticilin-oksacilin rezistentnih stafilokoka predstavljaju stafilokokni sojevi povezani sa stokom LA-MRSA ( eng . Livestock-associated Methicillin-resistant Staphylococcus aureus ). Zbog cinjenice da je moguc prenos ovih mikroorganizama sa životinja na ljude, ali i obratno, koagulaza pozitivne stafilokoke zauzimaju posebno mjesto u javnom zdravstvu opcenito.