COVID-19 pandemic is plaguing the world and representing the most significant stress test for many national healthcare systems and services, since their foundation. The supply-chain disruption and the unprecedented request for intensive care unit (ICU) beds have created in Europe conditions typical of low-resources settings. This generated a remarkable race to find solutions for the prevention, treatment and management of this disease which is involving a large amount of people. Every day, new Do-It-Yourself (DIY) solutions regarding personal protective equipment and medical devices populate social media feeds. Many companies (e.g., automotive or textile) are converting their traditional production to manufacture the most needed equipment (e.g., respirators, face shields, ventilators etc.). In this chaotic scenario, policy makers, international and national standards bodies, along with the World Health Organization (WHO) and scientific societies are making a joint effort to increase global awareness and knowledge about the importance of respecting the relevant requirements to guarantee appropriate quality and safety for patients and healthcare workers. Nonetheless, ordinary procedures for testing and certification are currently questioned and empowered with fast-track pathways in order to speed-up the deployment of new solutions for COVID-19. This paper shares critical reflections on the current regulatory framework for the certification of personal protective equipment. We hope that these reflections may help readers in navigating the framework of regulations, norms and international standards relevant for key personal protective equipment, sharing a subset of tests that should be deemed essential even in a period of crisis.

COVID-19 pandemic is plaguing the world and representing the most significant stress test for many national healthcare systems and services, since their foundation. The supply-chain disruption and the unprecedented request for intensive care unit (ICU) beds have created in Europe conditions typical of low-resources settings. This generated a remarkable race to find solutions for the prevention, treatment and management of this disease which is involving a large amount of people. Every day, new Do-It-Yourself (DIY) solutions regarding personal protective equipment and medical devices populate social media feeds. Many companies (e.g., automotive or textile) are converting their traditional production to manufacture the most needed equipment (e.g., respirators, face shields, ventilators etc.). In this chaotic scenario, policy makers, international and national standards bodies, along with the World Health Organization (WHO) and scientific societies are making a joint effort to increase global awareness and knowledge about the importance of respecting the relevant requirements to guarantee appropriate quality and safety for patients and healthcare workers. Nonetheless, ordinary procedures for testing and certification are currently questioned and empowered with fast-track pathways in order to speed-up the deployment of new solutions for COVID-19. This paper shares critical reflections on the current regulatory framework for the certification of personal protective equipment. We hope that these reflections may help readers in navigating the framework of regulations, norms and international standards relevant for key personal protective equipment, sharing a subset of tests that should be deemed essential even in a period of crisis.

Active learning is proposed for selection of the next operating points in the design of experiments, for identifying linear parameter-varying systems. We extend existing approaches found in literature to multiple-input multiple-output systems with a multivariate scheduling parameter. Our approach is based on exploiting the probabilistic features of Gaussian process regression to quantify the overall model uncertainty across locally identified models. This results in a flexible framework which accommodates for various techniques to be applied for estimation of local linear models and their corresponding uncertainty. We perform active learning in application to the identification of a diesel engine air-path model, and demonstrate that measures of model uncertainty can be successfully reduced using the proposed framework.

Abstract Purpose: To investigate contemporary results of percutaneous transluminal renal angioplasty (PTRA). Materials and Methods: A multicentre retrospective study analysing all patients treated with PTRA for primary symptomatic renal artery stenosis (RAS) between 2010 and 2013 at four tertiary centres. Procedures during the preceding four years were counted to evaluate for change in PTRA frequency. Results: The number of PTRA procedures decreased by approximately 50% from 2006 to 2013. Patients treated in the post-ASTRAL period (n = 224) had a significant reduction in mean systolic pressure (168 to 146 mmHg, p < 0.01), diastolic pressure (84 to 76 mmHg, p < 0.01), number of anti-hypertensive drugs (3.54 to 3.05, p < 0.01), and anti-hypertensive treatment index (21.75 to 16.92, p < 0.01) compared to before PTRA. These improvements were maintained at one year and at the last clinical evaluation after a mean follow-up of 4.31 years. Renal function increased transiently without sustained improvement, or deterioration, during later follow-up. Thirteen patients (5.8%) eventually required dialysis, nine of these had eGFR <20 ml/min/1.73 m2 before PTRA. There was no difference in outcomes between subgroups differentiated by different indications for PTRA. Conclusion: The frequency of PTRA has decreased, indicating a higher threshold for invasive treatment of RAS in recent years. The reduction in blood pressures, the reduced need for anti-hypertensive medication, and stabilization of renal function over time suggest a clinical benefit for most patients who are now being treated with PTRA.

We present a simple method to quickly explore C-spaces of robotic manipulators and thus facilitate path planning. The method is based on a novel geometrical structure called generalized bur. It is a star-like tree, rooted at a given point in free C-space, with an arbitrary number of guaranteed collision-free edges computed using distance information from the workspace and simple forward kinematics. Generalized bur captures large portions of free C-space, enabling accelerated exploration. The workspace is assumed to be decomposable into a finite set of (possibly overlapping) convex obstacles. When plugged in a suitable RRT-like planning algorithm, generalized burs enable significant performance improvements, while at the same time enabling exact collision-free paths.

IrO 2 is the most stable oxygen evolution reaction (OER) catalyst in acidic media and it has been widely used as co-catalyst to mitigate cell reversal damages in the anode of PEM fuel cells (PEMFCs). In this study, a mechanistic understanding of the degradation of an IrO 2 anode co-catalyst under transient operation of a PEMFC is provided. Thermogravimetric analysis (TGA) in reductive atmosphere (3.3 vol.% H 2 /Ar) shows that IrO 2 is not stable in H 2 containing atmosphere at operational temperatures of PEMFCs. By conducting a series of physical-chemical and electrochemical analyses, it is proven that H 2 under the operating conditions in a PEMFC anode can chemically reduce a few outer monolayers of the surface of IrO 2 nanoparticles to metallic Ir. The metallic Ir formed on the IrO 2 surface can then dissolve during fuel cell start-up/shut-down (SUSD) cycles. At least part of the dissolved Ir species formed in the anode electrode are shown to diffuse through the membrane to the cathode electrode, where they lead to a deterioration of the oxygen reduction reaction (ORR) activity of the Pt cathode catalyst. The consequences of Ir dissolution on the cell reversal tolerance of the anode are also discussed.

The EU has long been suffering a legitimacy crisis. In this article we argue that multilingual Europarties, that is, European political parties operating in all the various languages spoken by their members via interpreting and translation, rather than resorting to a lingua franca, could contribute to providing an effective democratic linkage between EU citizens and EU institutions. Moreover, by drawing inspiration from an analysis of Belgium, Canada and Switzerland, we argue that centripetal institutions such as an EU-wide electoral district, presidentialism, and direct democracy could provide favourable institutional conditions for the development of such multilingual Europarties.

Abstract In the most developed countries the first estimations of Gross Domestic Product (GDP) are available 30 days after the end of the reference quarter. In this paper, possibilities of creating an econometric model for making short-term forecasts of GDP in B&H have been explored. The database consists of more than 100 daily, monthly and quarterly time series for the period 2006q1-2016q4. The aim of this study was to estimate and validate different factor models. Due to the length limit of the series, the factor analysis included 12 time series which had a correlation coefficient with a quarterly GDP at the absolute value greater than 0.8. The principal component analysis (PCA) and the orthogonal varimax rotation of the initial solution were applied. Three principal components are extracted from the set of the series, thus together accounting for 73.34% of the total variability of the given set of series. The final choice of the model for forecasting quarterly B&H GDP was selected based on a comparative analysis of the predictive efficiency of the analysed models for the in-sample period and for the out-of-sample period. The unbiasedness and efficiency of individual forecasts were tested using the Mincer-Zarnowitz regression, while a comparison of the accuracy of forecast of two models was tested by the Diebold-Mariano test. We have examined the justification of a combination of two forecasts using the Granger-Ramanathan regression. A factor model involving three factors has shown to be the most efficient factor model for forecasting quarterly B&H GDP.

Abstract Objectives Psychotic disorders have large treatment gap in low- and middle-income countries (LMICs) in South-Eastern Europe, where up to 45% of affected people do not receive care for their condition. This study will assess the implementation of a generic psychosocial intervention called DIALOG+ in mental health care services and its effectiveness at improving patients’ clinical and social outcomes. Methods This is a protocol for a multi-country, pragmatic, hybrid effectiveness–implementation, cluster-randomised, clinical trial. The trial aims to recruit 80 clinicians and 400 patients across 5 South-Eastern European LMICs: Bosnia and Herzegovina, Kosovo*, Montenegro, Republic of North Macedonia and Serbia. Clusters are clinicians working with patients with psychosis, and each clinician will deliver the intervention to five patients. After patient baseline assessments, clinicians will be randomly assigned to either the DIALOG+ intervention or treatment as usual, with an allocation ratio of 1:1. The intervention will be delivered six times over 12 months during routine clinical meetings. TThe primary outcome measure is the quality of life at 12 months [Manchester Short Assessment of Quality of Life (MANSA)]; the secondary outcomes include mental health symptoms [Brief Psychiatric Rating Scale (BPRS), Clinical Assessment Interview for Negative Symptoms (CAINS), Brief Symptom Inventory (BSI)], satisfaction with services [Client Satisfaction Questionnaire (CSQ-8)] and economic costs at 12 months [based on Client Service Receipt Inventory (CSRI), EQ-5D-5L and Recovering Quality of Life (ReQOL-10)]. The study will assess the intervention fidelity and the experience of clinicians and patients’ about implementing DIALOG+ in real-life mental health care settings. In the health economic assessment, the incremental cost-effectiveness ratio is calculated with effectiveness measured by quality-adjusted life year. Data will also be collected on sustainability and reach to inform guidelines for potentially scaling up and implementing the intervention widely. Conclusion: The study is expected to generate new scientific knowledge on the treatment of people with psychosis in health care systems with limited resources. The learning from LMICs could potentially help other countries to expand the access to care and alleviate the suffering of patients with psychosis and their families. Trial registration: ISRCTN 11913964

Abstract This article reframes the formation of the Ottoman-Habsburg frontier after 1699 in social historical terms. By going beyond diplomatic and military factors, it identifies how the contraction of Ottoman borders affected taxation, landholding, and Muslim-Christian relations in Bosnia. The article argues that peasants in Ottoman Bosnia experienced the mounting pressures of increasing taxation, manipulation over landownership, and religiously inflected hostility, often driven by those Muslim noblemen who tried to capitalize on the destabilizing wake of several wars that the Ottoman Empire fought with the Habsburg, Venetian, and Russian states in the eighteenth century. Through these processes, by the end of the century the meaning of the reaya or raya—an Ottoman term for taxpaying “subjects” that theoretically applied to all denominations, including Muslims—had become synonymous with “Christians,” acquiring a new political significance.

The HERe2Cure project, which involved a group of breast cancer experts, members of multidisciplinary tumor boards (MTB) from health-care 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 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 MTB comprised of at least: A medical oncologist, a pathologist, a radiologist, a surgeon, and a radiation oncologist/radiotherapist.