Abstract Proteins diffuse to their sites of action within cells in a crowded, strongly interacting environment of nucleic acids and other macromolecules. An interesting question is how the highly crowded environment of biological cells affects the dynamic properties of passively diffusing particles. The Lorentz model is a generic model covering many of the aspects of transport in a heterogeneous environment. We investigate biologically relevant situations of immobile obstacles of various shapes and sizes. The Monte Carlo simulations for the diffusion of a tracer particle are carried out on a two-dimensional triangular lattice. Obstacles are represented by non-overlapping lattice shapes that are randomly placed on the lattice. Our simulation results indicate that the mean-square displacement displays anomalous transport for all obstacle shapes, which extends to infinite times at the corresponding percolation thresholds. In the vicinity of this critical density the diffusion coefficient vanishes according to a power law, with the same conductivity exponent for all obstacle shapes. At the fixed density of obstacles, we observe that the diffusion coefficient is higher for the smaller obstacles if the object size is defined as the highest projection of the object on one of the six directions on the triangular lattice. The dynamic exponent, which describes the anomalous transport at the critical density, is the same for all the obstacle shapes. Here we show that the values of critical exponents estimated for all disordered environments do not depend on the microscopic details of the present model, such as obstacle shape, and agree with the predicted values for the underlying percolation problem. We also provide the evidence for a divergent non-Gaussian parameter close to the percolation transition for all obstacle shapes.

Aim To determine the prevalence of new-onset atrial fibrillation (NOAF) following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) and its effect on 6-month cardiovascular outcomes. Methods This prospective study included 40 patients diagnosed with LMCAD, in the period from 2017 to 2018. The patients with LMCAD and low or intermediate SYNTAX score were randomized to PCI with zotarolimus-eluting stents versus CABG. Outcomes were analyzed according to the development of NOAF during the initial hospitalization following revascularization. Results Among 40 patients without atrial fibrillation on presentation, NOAF developed 3.1±1.3 days during hospitalization in three CABG treated patients, and one PCI treated patient. One patient that was CABG treated developed NOAF after two months. Patients with versus patients without NOAF had a significantly longer duration of hospitalization, probably because they were discharged on anticoagulant therapy. Myocardial infarction was presented in one CABG treated patient after 3 months, and also in one PCI treated patient after 4 months. One patient died 2 months after the operation, and one developed stroke 5 months after the CABG operation. Conclusion The NOAF was common after CABG, but extremely rare after PCI, and it occurred almost exclusively following CABG. There was a clear statistical tendency for all-cause death, cardiovascular death and stroke at 6-month follow-up period.

Temperature distribution at depth is of key importance for characterizing the crust, defining its mechanical behavior and deformation. Temperature can be retrieved by heat flow measurements in boreholes that are sparse, shallow, and have limited reliability, especially in active and recently active areas. Laboratory data and thermodynamic modeling demonstrate that temperature exerts a strong control on the seismic properties of rocks, supporting the hypothesis that seismic data can be used to constrain the crustal thermal structure. We use Rayleigh wave dispersion curves and receiver functions, jointly inverted with a transdimensional Monte Carlo Markov Chain algorithm, to retrieve the VS and VP/VS within the crust in the Italian peninsula. The high values (>1.9) of VP/VS suggest the presence of filled‐fluid cracks in the middle and lower crust. Intracrustal discontinuities associated with large values of VP/VS are interpreted as the α−β quartz transition and used to estimate geothermal gradients. These are in agreement with the temperatures inferred from shear wave velocities and exhibit a behavior consistent with the known tectonic and geodynamic setting of the Italian peninsula. We argue that such methods, based on seismological observables, provide a viable alternative to heat flow measurements for inferring crustal thermal structure.

Introduction: Hyperparathyroidism is a common endocrine disorder with potential complications of bone, renal, neurocognitive and cardiovascular system. Aim: To determine the correlation between the size of parathyroid glands and parathormone values in the patients with hyperparathyroidism. Methods: We analyzed a retrospective-prospective database of 79 consecutive patients who underwent parathyroidectomy for hyperparathyroidism at our institution between January 2011 and February 2018. The values of parathormone, calcium and phosphorus were determined in all patients before and after surgery. Ultrasonography were performed before surgery. Imaging results were confirmed by pathology. We analyzed the correlation between the sizes parathyroid glands obtained trough ultrasonography and pathology with parathormone values. Results: The median age of the patients were 51 age (range 20-73) and 67,1% of the patients were female. Our study demonstrated that between actual glands sizes (volumes), expresses in millimeters, measured on pathohistological analysis and ultrasound examination and size value of parathormone its increased value does not affect the size of the gland. We investigate the correlation between the size of glands measured according to the pathohistological finding and the value of parathormone we obtained the correlation results close to the statistical features. The correlation value of parathormone and glands sizes according to the pathohistological finding measured trough the determined assessment scale we determined the statistically important of medium value. Conclusion: One of the important factors for parathyroidectomy is the value of parathormone. Serum parathormone level might be predictable by a total size of parathyroid glands and could be an effective the predictor of gland localisation.

Aim To determine the prevalence of depressive episodes and recurrent depressive disorders despite of the length of therapy and type of antidepressants. Methods The study was conducted among 508 patients aged 19-65 years who were treated for depression for at least 3 months (mild and moderate episodes were controlled and the effects of treatment monitored by family physicians, while severe episodes were controlled by a psychiatrist) during 2013- 2015 in Zenica-Doboj Canton using the Hamilton Depression Rating Scale (HDRS). Results The average age of the patients was 48.98±11.585 years. Depressive disorder was most commonly represented in patients with high-level education, 22%, more frequently in non-productive workers (non-productive vs. manufacturing 58%:35%). A significant number of patients who were treated for depression were unemployed (57%). All respondents were suffering from the most serious episode of depression with an average depression rate at the Hamilton scale 18.49±8.603, with a very serious depression level of 32%, severe 17%, moderate 21%, and mild 20%. Most patients were treated with paroxetine, 27%, fluoxetine 22% and sertraline 17%. Efficacy of depression treatment with different types of selective serotonin reuptake inhibitors antidepressants (SSRIs) was not significantly different (p=0.502). Conclusion Success of the treatment with the absence of symptoms of depression was achieved in 10% and the maintenance of depressive episodes occurred in 90% of cases. Adverse reactions with the most commonly prescribed SSRI in our country should be important in creating procedures and strategies for the future treatment of depression in family medicine.

OBJECTIVE To investigate the level and causes of stress and the risk of onset of burnout syndrome among physicians employed at the Primary Health Care Centre, Banja Luka. SUBJECTS AND METHODS Between March 1, 2018, and May 31, 2018 all physicians from the Primary Health Care Centre, Banja Luka were offered the following questionnaires to fill in: a socio-demographic questionnaire, a questionnaire for self-assessment of the level of stress and the Maslach Burnout Inventory for assessment of the risk of burnout syndrome. RESULTS Out of 211 physicians, 85.8% were female. A high level of stress was found in 77.7% of the subjects. Older doctors had higher levels of emotional exhaustion compared to younger doctors with a shorter length of service (r=0.236, P=0.01). Emotional exhaustion was significantly correlated with a high level of depersonalization, a low level of personal accomplishment and a high level of stress (r=0.380, r=-0.174 and r=0.574, P=0.01, P=0.04 and P<0.01, respectively). Depersonalization correlated with a low level of personal accomplishment and stress (r=-0.347 and r=0.283, P<0.01 and P=0.01, respectively), while the level of personal accomplishment was in a negative correlation with stress (r=-0.281, P=0.01). A high stress level was associated with a high degree of emotional exhaustion (OR 56.543; 95% CI 11.35-213.09; P<0.001) as well as lack of personal accomplishment (OR 0.155; 95% CI 0.04-0.50; P=0.003). CONCLUSION A high level of stress was associated with older age, female gender, as well as with a high degree of emotional exhaustion and a lack of personal accomplishment. Preventive measures are warranted.

Aim To develop and validate a screening questionnaire for migraine without aura with sufficient diagnostic accuracy to be used in primary care settings. Methods The study was designed as cross-sectional, multicentric, diagnostic accuracy trial of new questionnaire for screening patients who visit general practitioners, with an aim to reveal migraine without aura. The instrument was constructed for the purpose of this study, and validated on the sample of 429 primary care outpatients. The gold standard of diagnosing migraine without aura was clinical estimate by a neurologist based on the International Classification of Headache Disorders 3rd edition (ICHD-III) criteria. Diagnostic accuracy of the instrument was tested through construction of the Receiver Operator Curve. Results The Balkan Migraine Screening Questionnaire (BMSQ) instrument showed good diagnostic accuracy (sensitivity 83.4% and specificity 79.9%) for migraine without aura, with significant screening yield among previously undiagnosed patients of 75.9%. The study also confirmed a high percentage of patients with hidden migraine without aura (MWA) (52.9%) revealed by the BMSQ and the ICHD-III criteria that would otherwise remain undiagnosed. Conclusion The BMSQ is a valid and reliable clinical instrument for revealing migraine without aura, which could be easily selfadministered by patients. It has high screening yield, discovering majority of patients with previously undiagnosed migraine without aura, whose definite diagnosis should later on be confirmed by the attending physicians using the ICHD-III criteria.

Aim To systematically review the scientific evidence of biomarker validity, reliability, specificity and sensitivity in identifying malnutrition in the elderly. Methods Peer-reviewed journals were searched using PUBMED and EBSCO from January 1998 to April 2018. The articles included description of the association between malnutrition blood biomarkers and validated nutritional status assessment instruments and studies were conducted among community-dwelling elderly or nursing home residents. Results The research strategy identified a total of 293 studies. This literature review picked out seven articles for follow-up evaluation. A total of sixteen blood biomarkers were identified. Six studies found a significant association between the nutritional assessment score and albumin level. Conclusion Combining serum concentrations of malnutrition biomarkers with nutritional status assessment tools has a great potential in identifying the risk of malnutrition in the elderly, while also increasing sensitivity and specificity.

INTRODUCTION As non-carious cervical lesions (NCCLs) may compromise aesthetics and function, knowledge of their aetiological covariables enhances management of clinical complaints and success of restorative treatments. AIMS The primary aim of this study was to assess the presence of NCCLs among the general population of the Republic of Srpska, Bosnia and Herzegovina and the potential association with patient-related risk factors. METHODS A prevalence study of NCCLs included 738 respondents from eight towns/municipalities. Two dental practitioners examined all respondents. NCCLs were diagnosed according to the Smith and Knight tooth wear index, measured using a Williams periodontal probe. Data regarding risk factors were obtained through a structured questionnaire. Multivariate logistic regression was used to analyse the association of risk factors and the occurrence of NCCLs. RESULTS Non-carious cervical lesions were diagnosed in 384 (52%) respondents. Multivariate regression analysis showed that several variables were independently associated with the risk of developing NCCLs, including frequent consumption of acid food (P = 0.001), frequent consumption of acid drinks (P = 0.001), retaining drink in the mouth (P = 0.001), alcohol consumption (P = 0.030), bruxism (P = 0.018) and gastro-oesophageal reflux (P = 0.023). First mandibular premolars were the most affected teeth (left: 46.0%; right: 44.0%), followed by the second right maxillary premolars (37.3%), second left maxillary premolars (33.6%) and finally by the first right maxillary premolars (34.0%). CONCLUSION The results of the current study suggest that NCCLs occur frequently and have a multifactorial aetiology. The lowest prevalence was recorded among individuals younger than 20 years of age. As the majority of risk factors are modifiable, regular dental care could lead to the early detection of NCCLs.

Abstract This paper elaborates the concept of the renewable district heating system (DHS) in Municipality of Visoko, Bosnia and Herzegovina, as part of the CoolHeating project funded by the EU’s Horizon 2020 programme, which is going to be integrated into the planned DHS supplied by a combined heat and power facility (CHP). Forecast of the demand, type and capacities of the production units, as well as optimization of the production plan, was performed by the software EnergyPRO. Calculations are based on inputs such as climate conditions, connection rate for housing facilities, prices of all energy sources, energy efficiency performance of the facilities, temperature level of DHS, heat losses, investment costs, operating costs such as maintenance costs, fuel and electricity prices, taxes, subsidies and finally operating time, while the period for the optimization was calculated per hour throughout the year. The overall approach leads to a flexible modular DHS solution based on RES and CHP. Much better economic and environmental sustainability indicators, demonstrated on real inputs of the Visoko project, have been noticed as opposed to the existing heating solution. Similar concepts can be developed for other communities to ensure replication and thus multiply the effects and contribution to sustainable development.

Introduction: In this study we wanted to examine the hormonal responses due to stress exposure during laparoscopic cholecystectomy with standard (12-15 mm / Hg) (LCSP) and low (6-8 mm / Hg) (LCLP) intraabdominal pressure and open cholecystectomy (OC), with particular emphasis on stress hormone responses. Aim: Determination of adrenocorticotropic hormone (ACTH) and cortisol stress hormones before and after laparoscopic cholecystectomy with standard and low insufflation pressure, determination of ACTH and cortisol values before and after open cholecystectomy and comparison of ACTH and cortisol values between the patient sub-groups. Methods: In a prospective study conducted between July 2016 and February 2018, we involved 110 patients which were divided into two groups: 70 patients with laparoscopic cholecystectomy (LC) and 40 patients with open cholecystectomy (OC). The first group of patients was further divided into two subgroups of 35 patients, (subgroup LC with standard and subgroup LC with low intraabdominal pressure). All patients met the preset inclusion and exclusion criteria of the study. There were no statistically significant differences in the demographic characteristics of patients between the investigated groups. The stress hormones determined were adrenocorticotropic hormone (ACTH) and cortisol. Results: During the first, second and seventh day postoperative day (POD),ACTH values were significantly lower (p <0.0001) in LCLP than in LCSP and OC groups. This was also the case for comparison in LCSP and OC groups. By comparing LC and OC groups during first, the second and seventh POD, there was a significant difference (p <0.0001) in the ACTH levels. The concentration of this hormone was higher in the OC group in all three cases. The first, second and seventh POD were also statistically significant (p <0.0001) in cortisol values and between LC and OC groups there was an increase in cortisol levels in patients operated by open method. There was also a significant difference (p <0.0001) in cortisol values measured between LCLP and LCSP groups in the investigated days. Cortisol levels were higher in patients in the LCSP group. Conclusion: During open and laparoscopic cholecystectomy the response of the body to stress increased. The stress response of the organism during laparoscopic cholecystectomy was less than during open cholecystectomy. The stress response of the organism during laparoscopic cholecystectomy with low insufflation pressure ( 6-8mmHg) was less than during laparoscopic cholecystectomy with standard insufflation pressure (12-15mmHg).

The periodicity of Vostok ice core climate temperature and gas concentration data indicate inherent long term past regularity of Earth’s climate, with a period of around 100,000 years, warming around 15,000 and cooling of around 85,000 years. At this point we are at the top of one of the warming periods. Vostok data cover around 430,000 years, ie 4 climate cycles (warming-cooling), of similar but not quite the same duration. In this paper we perform a detailed time and frequency analysis of these data for each of the cycles as well as their various combinations, including a full tested period of 430,000 years. Time correlation analysis allows for more accurate time lag estimate in each cycle already noted between temperature change and carbon dioxide content. We estimate these lags to lie between 1000-2500 years, longer than previously concluded. On the frequency side we perform Fast Fourier Analysis and identify full spectrum of harmonics for various cycles, and then perform energy analysis to identify which of the harmonics contributes the most. The idea is to reduce the computational load for further modeling and analysis using Kalman Filter based prediction method. Once the prediction model is defined (a follow up paper) data will be split into two segments, Learning and Testing, in preparation of a Machine Learning fine tunning methodology. We can use last three or last two or even just last cycle to learn on, and then the current on going cycle to test on. This will result in real time prediction of relevant climate data. Assuming causal time regularity, more of these cycles are employed in training, more the prediction error for the next cycle should be reduced. Hence it is critical to perform very detailed time and frequency analysis of Vostok data as a solid data base for the prediction model to follow.