At the end of 2019 the world became aware of the existence of a new virus stemming from the Coronaviridae family and causing a specific disease – COVID-19. In less than three months, the virus and its consequences, developed from being a local public health problem in China to a daunting global problem we all had to face. On March 11, 2020 the World Health Organization (WHO) declared a pandemic of COVID-19. On the international scale, even in Bosnia and Herzegovina (BiH), the response of the professionals and scientists has been rapid, although not always consistently efficient enough. Despite the selfless cooperation of scientists and practitioners worldwide, countries with developed economies, good public health and a strong scientific system have had the advantage in the fight against the disease over developing countries. Despite the fact that by these criteria BiH is not one of the most resilient countries, so far, its response to the pandemic has seemed to be satisfactory. The Academy of Sciences and Arts of Bosnia and Herzegovina (ANUBiH) was one of the first institutions of the science system to respond to the pandemic. On the initiative and under the leadership of academician Mirsada Hukić, on March 22, 2020 the development of the project "Epidemic Location Intelligence System (ELIS)" and its Geoportal began on a voluntary basis, with the task of permanently monitoring the spread of COVID-19. Theoretical and professional parts of the project in the areas of medicine, public health and informatics were completed by April 2, 2020. Thanks to the support to the project by the Chairman of the Presidency of Bosnia and Herzegovina, Mr. Šefik Džaferović, the expert system received additional hardware support and was filled in time with data from across the country. This enabled the system to become operational as early as on April 8, 2020. The results of all these efforts are visible in this publication. Initially, the ELIS project was important for the epidemiological and public health area. The abundance of collected data and obtained virus samples enabled the extension of the project idea to the sequencing of viruses found in BiH and their typology. The transition of research to the clinical aspects of COVID-19 is the next phase in the development of the ELIS project. ANUBiH has already started the work on examining the economic and pedagogical consequences of COVID-19 in order to look at this medical phenomenon in the broadest possible context. All the results of ANUBiH in response to the epidemic challenges of COVID-19 are achieved due to the synergistic action of numerous individuals and institutions in different fields of science and public health in cooperation with government. Therefore, I believe that the ELIS project has shown the way to go in solving the burning problems of our society which we will encounter in the future.
Aim The damage caused by the COVID-19 pandemic has made the prevention of its further spread at the top of the list of priorities of many governments and state institutions responsible for health and civil protection around the world. This prevention implies an effective system of epidemiological surveillance and the application of timely and effective control measures. This research focuses on the application of techniques for modelling and geovisualization of epidemic data with the aim of simple and fast communication of analytical results via geoportal. Methods The paper describes the approach applied through the project of establishing the epidemiological location-intelligence system for monitoring the effectiveness of control measures in preventing the spread of COVID-19 in Bosnia and Herzegovina. Results Epidemic data were processed and the results related to spatio-temporal analysis of the infection spread were presented by compartmental epidemic model, reproduction number R, epi-curve diagrams as well as choropleth maps for different levels of administrative units. Geovisualization of epidemic data enabled the release of numerous information from described models and indicators, providing easier visual communication of the spread of the disease and better recognition of its trend. Conclusion The approach involves the simultaneous application of epidemic models and epidemic data geovisualization, which allows a simple and rapid evaluation of the epidemic situation and the effects of control measures. This contributes to more informative decision-making related to control measures by suggesting their selective application at the local level.
Aim To determine preferable type of treatment in our clinical circumstances by following two groups of patients with critical limb ischemia (CLI), who were treated endovascularly and surgically. Methods Research was carried out in the form of a prospective study of 80 patients with CLI and Trans-Atlantic Inter-Society Consensus (TASC) C or D type of arterial disease, with American Society of Anesthesiology (ASA) class III risk, who were randomly divided in two groups as per the treatment they received, surgical and endovascular. Patients were followed during 28 months using clinical examination and Duplex Ultrasound (DUS) in accordance with prescheduled control visits. Results There was a statistical difference between surgical and endovascular group in two years patency (82.5% vs. 55%; p=0.022) but it did not result in the difference in amputation free survival (AFS) (95% vs. 85%; p=0.171) or two-year freedom from major adverse limb events (MALE) (87.5 vs. 77.5; p=0.254). Also, there was no difference in the overall survival of patients (100% vs. 97.5%; p=0.317). Conclusion Initial endovascular treatment is a preferred form of the treatment for selected patient population.
Identifying at-risk students is a crucial step in different learning settings. Predictive modeling technique can be used to create an early warning system which predicts students’ success in courses and informs both the teacher and the student of their performance. In this paper we describe a course-specific model for prediction of at-risk students. The proposed model uses the case-based reasoning (CBR) methodology to predict at-risk students at three specific points in time during the first half of the semester. In general, CBR is an approach of solving new problems based on solutions of similar previously experienced problem situation encoded in the form of cases. The proposed model classifies students as at-risk based on the most similar past cases retrieved from the casebase by using the k-NN algorithm. According to the experimental evaluation of the model accuracy, CBR model that is being developed for a specific course showed potential for an early prediction of at-risk students. Although the presented CBR model has been applied for one specific course, the key elements of predictive model can be easily reused by other courses.
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This article describes the life and medical activities of Jadwiga Olszewska (1855-1932) in Serbia from 1895-1899, AustroHungarian (AH)-occupied and annexed Bosnia and Herzegovina (BH) from 1899-1918, and the newly founded Kingdom of Yugoslavia, from 1919-1932. In summer 1899, Olszewska replaced Teodora Krajewska as an AH official female physician in Tuzla. Born in Congress Poland, Olszewska had enrolled in 1873 in the medical courses for women in St. Petersburg but had left Russia in 1880 to study medicine in France. She had lived as a student and single parent in Paris since 1883, and she was awarded her Doctorate in Medicine from the University of Paris in 1894. She could not practice medicine in Russian-occupied Poland because of her French diploma, and she could not practice in most Western countries due to her gender. Therefore, she decided to move to Serbia, where she worked as an assistant physician in the district hospitals of Loznica (1895-1897?) and Požarevac (1897-1899). Driven by the need for a higher income to fund her son's education, she engaged her network of Polish compatriots and procured the position of an AH official female physician of Tuzla in 1899, where she performed her duties in an exemplary manner. After the breakdown of the Austro-Hungarian Empire (AHE) in 1918, Olszewska remained in Tuzla and retired as a Yugoslav official physician in 1923. When she died in Tuzla in 1932, local colleagues had to arrange for a proper funeral because Olszewska did not leave any savings due to her insufficient pension. Olszewska's grave never received a tombstone, and it is untraceable today. CONCLUSION: Jadwiga Olszewska (1855-1932) was a woman pioneer of medicine from Poland, who practiced her profession first as an assistant physician in Serbia (1895-1899) and then as an AH and Yugoslavian official female doctor in Tuzla, BH (1899-1923).
In contrast to classical appendectomy where the appendiceal stump is secured by a single or double ligature, in laparoscopic appendectomy various ways of securing the stump are mentioned. Each of these methods has advantages and disadvantages. Since different possibilities exist for closing the stump, it is very important to find the optimum method for closure of the appendiceal stump, bearing in mind their simplicity, biocompatibility and price. The aim of this review article has been to present the problem of securing the base of the appendix during laparoscopic appendectomy.
Modeling of pressure rise in SF6 GIS (Gas Insulated Switchgear) due to internal arc faults is a complex and challenging task, due to a large number of highly variable factors, which influence the whole process. This is especially the case in GIS with high rated short circuit currents, where the effects, such as material evaporation and erratic arc behavior, and consequently the pressure build-up rate, are much more pronounced. These severe conditions ultimately determine the design limits and must therefore be carefully investigated. The enhanced internal arc simulation model, presented in this paper, considers the impact of evaporation of different materials on gas properties and the pressure rise, as well as the dependence of released arc energy, thermal transfer and evaporation intensity on the state of gas. The experimental set-up and the test configuration, used to validate the calculation results, are evaluated and discussed. An evident finding, which is supported by measurements, is that the implemented improvements of the basic simulation model (introduced in the Technical Brochure 602 by the CIGRÉ working group A3.24) increase the prediction accuracy of GIS withstand performance during internal arc faults.
Introduction: Pseudo journals, hijacked journals, fraudulent journals, fake journals, and predatory journals waste valuable research when authors publish their studies in them. Aim: This article described novel suggested features for the identification of fraudulent journals and aimed to explain this issue to help inexperienced scientists avoid publishing in predatory journals. Methods: The articles related to this topic in were retrieved from PubMed and trustable Internet sources. Results: Unfortunately, some fake journals have made their way into reputable databases, such as PubMed, PubMed Central, MEDLINE, SCOPUS, and Web of Science; thus, the serious question has been raised regarding how we should address this problematic phenomenon. We recommended 28 suggested characteristics of predatory journals for readers to take into consideration. Conclusion: Unaware of the detrimental effects associated with publishing in disreputable journals, inexperienced researchers can fall victim to them. Together, as both readers and writers, we should completely boycott predatory journals.
Introduction: The source of scientific information, methods for their evaluation, and methodology of their use are critical for serious scientific research and publishing of the scientific research results. Certain methodological principles should be inexcusably followed when designing clinical or observational research to avoid bias and presentation of results that do not reflect the truth about the phenomenon that is the object of the study. Aim: The aim of this study was to compare the methodological quality of clinical trials and observational studies published in medical journals from ex-Yugoslav countries indexed in Web of Science (WoS) and Pubmed/MEDLINE. Methods: Clinical studies published in medical journals of ex-Yugoslav countries were retrieved from the WoS and Pubmed database, and the sample for analysis was randomly chosen from the retrieved publications. The rate of the most common errors in the design of clinical/observational studies was established by a careful reading of the sampled publications and their checking against predefined criteria. Results: Number and percent of the evaluated studies that failed to meet each of the methodological criteria tested, number of the evaluated criteria not satisfied per database and number of studies that satisfied more than 4 criteria were analyzed per database. When explanatory potential of journal impact factor, number of citations, time elapsed from publication and a database where a journal is referred were tested by linear regression in regard to the number of methodological criteria satisfied per study, the linear regression model was obtained by backward deletion method and achieved R2 adjusted of 0.166 (F=13.827, df1 = 2, df2 = 127, p=0.000). The methodological quality of studies was directly related to impact factor of the journals (B = 0.976, 95% confidence interval 0.539 – 1.413, p=0.000) and inversely with the database where a journal is referred (B =–0.444, 95% confidence interval–0.824 – -0.064, p = 0.022). Each additional unit of impact factor increased number of satisfied methodological criteria for about 1, while referring a journal only in WoS decreased number of satisfied criteria for 0.45 points in comparison with journals referred in both WoS and Pubmed/MEDLINE, and for 0.9 points in comparison to journals referred only in MEDLINE. Conclusion: Methodological and scientometric quality of clinical studies published in medical journals from ex-Yugoslav region varies significantly, and the variations are higher in journals referenced only in WoS than in journals referenced in Pubmed/MEDLINE only, or in both Pubmed and Web of Science databases.
Aim To determine a status of systolic function in patients with diabetes mellitus (DM) type 2 with ST-segment elevation acute myocardial infarction (STEMI), to determine values of cardiac biomarkers in patients with DM type 2 with STEMI and correlate the parameters with ejection fraction of left ventricle (EFLV). Methods A total of 80 patients were divided into two groups, the study group (group I) consisting of 40 patients admitted with the diagnosis of DM type 2 and STEMI, and a control group (group II) with 40 patients with STEMI without diagnosed DM type 2. Cardiac biomarkers - creatine kinase MB fraction (CKMB), and troponin I were monitored. The EFLV was evaluated echocardiographically (using Simpson method) five days after primary percutaneous coronary intervention (pPCI). Results In the group I the EFLV five days after pPCI was significantly correlated with troponin values (with a minimum r = -0.47; p=0.002, a maximum r = -0.339; p = 0.032, as well as with an average value of r = -0.389; p=0.013), and with an average CK value (r = -0.319; p=0.045). In the group II there was a significant negative correlation of EFLV with the maximum value of troponin (r = -0.309; p=0.05). Conclusion Troponin values have an effect on the EFLV after STEMI, and thus on the left ventricular status, as well as on the pharmacological modality itself.
Introduction: Upper gastrointestinal bleeding can be a life-threatening condition and requires careful evaluation from the very first episode in order to reduce the risk of rebleeding, hemorrhagic shock and death. The outcome of a patient with upper gastrointestinal bleeding depends on resuscitation measures taken during admission to the hospital and an adequate assessment of the patient’s risk level. Aim: The aim of the study is to compare Glasgow Blatchford score and Rockall score and to identify the most accurate score used in predicting unfavorable outcomes and the need for intervention. Methods: This study involves 237 patients with upper gastrointestinal bleeding. The accuracy of the scoring systems was assessed by plotting receiver-operating characteristic curves (ROC curves) and was calculated for GBS and RS with 95% confidence interval (CI). Results: As for mortality prediction, RS was superior to GBS (AUC 0.806 vs. 0.750). The GBS had a higher accuracy in detecting patients who needed transfusion units and was superior to the RS (AUC 0.810 vs.0.675). In predicting the need for intervention, RS was superior to GBS (AUC 0.707 vs. 0.636. Conclusion: GBS and RS are developed to help clinicians to triage patients appropriately in order to assess endoscopic therapy within a suitable time frame, as well as identify low risk patients for possible outpatient management. High accuracy of the GBS in predicting a need for transfusion represents an important endpoint to assess. RS was superior to GBS in predicting a need for intervention as well as mortality. Currently, a combination of these scoring systems is the best way for proper assessment.
Introduction: Microdissection testicular sperm extraction (microTESE) is considered the gold standard method for surgical sperm retrieval among patients with non-obstructive azoospermia (NOA). Aim: This study aimed to evaluate the correlation between histopathological findings after failed microTESE procedure and outcomes of the „second-look“ procedure and to provide insight into the most common histopathological patterns after testicular biopsy within our population. Methods: The retrospective study included 33 selected patients with NOA, who had undergone unsuccessful sperm retrieval. The diagnosis of NOA was made after the assessment of the patient’s history data, a physical examination, semen analysis, the hormonal profile, and genetic studies. After negative sperm retrieval, histopathological report has been analyzed for „second-look“ microTESE attempt. Results: Five testicular histopathological patterns were found: hypospermatogenesis (9,1%), Sertoli cell-only syndrome (43%), germ cell maturation arrest (15%), seminiferous tubule hyalinization (15%), mixed pattern (21%). Y-microdeletions were detected in 5 patients, of which 3 patients showed AZFc region deletions. Only 3 patients (9,1%) underwent a „second-look“ procedure after the evaluation of histopathological reports. After the stimulation therapy and „second-look“ procedure, we had a positive outcome in a single patient (33,3%). Mean FSH value in patients with confirmed spermatogenesis was 17.26±3.11IU/l, while mean FSH value in patients without presence or germ cell statistically significantly exceeded and was 24.28±4.71IU/L (p=0.038). Conclusion: Histopathological reports following the microTESE procedure are obligatory for the proper selection of patients who are candidates for the „second-look“ microTESE attempt. Patients with Sertoli cell-only syndrome and hypospermatogenesis particularly can benefit from the “second-look” procedure.
Aim To evaluate a correlation of serum level of neutrophil gelatinase-associated lipocalin (NGAL) to the risk of the occurrence of complications in patients with the early phase of ST-segment elevation myocardical infarction (STEMI) treated with fibrinolytic therapy prior to percutaneous coronary intervention (PCI). Methods A total of 54 patients with the diagnosis of STEMI treated with fibrinolytic therapy (alteplase) prior to PCI were included. Patients were admitted to the Intensive Care Unit (ICU) of Clinic for Heart, Blood Vessel and Rheumatic Diseases in the period January to March 2018. All patients underwent coronary angiography and PCI within the maximum of 48 hours delay after fibrinolysis, according to the hemodynamic and electrical stability and PCI availability. Blood samples were taken immediately after admission prior to fibrinolytic administration. Patients were divided into two groups according to NGAL values (less or more than 134.05 ng/mL). Results Higher values of NGAL have effect on a higher mean systolic and diastolic pressure (p=0.001 and p=0.003, respectively). Patients with higher NGAL values also have higher values of brain natriuretic peptide (p=0.0001) and highly sensitive troponin I (p=0.002). In that group relative risk (RR) for lethal outcome was 6.4 times significantly higher (p=0.002), for the development of heart failure 2.88 times (p=0.0002), for post-myocardial infarction angina pectoris 2.24 times (p=0.0158), and for ventricular rhythm disturbances (ventricular tachycardia, ventricular fibrillation) 1.96 times higher (p=0.0108). Conclusion Increased NGAL value is related to an unfavourable outcome of patients in the early phase of STEMI treated with fibrinolytic therapy prior to PCI.
In this paper, we approach the problem of ensuring safety requirements within human-robot collaborative scenarios. The safety requirements considered herein are consistent with the paradigm of speed and separation monitoring. In such a setup, safety guarantees for human operators usually imply limited robot velocities and/or significant distance margins, which in turn may have adverse effects regarding the productivity of the robot. In this paper, we propose a novel approach that minimally affects the productivity while being consistent with such a safety prescription. A comprehensive simulation study shows that our method outperforms the current state of the art algorithm.
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