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Aim To evaluate the incidence, modalities of treatment and outcome in paediatric patients with traumatic brain injury (TBI). Methods A retrospective cross-sectional study including 353 paediatric patients with head injury was carried out in the Department of Neurosurgery of University Clinical Centre Sarajevo during the period 1 July 2006 - 30 June 2012 (72 months). For each patient the lowest Glasgow Coma Scale (GCS) was established and the patient was accordingly classified as suffering from mild, moderate or severe TBI. Neuroimaging data included computer tomography (CT). Survival rates and method of treatment were compared according to age group, and matched with the total number of patients examined. Results A total of 353 children with head trauma were identified. A severe TBI (GCS < 8) was found in 33 (out of 353) children, mostly in the age group 11-18. Falls were the most common cause of trauma, followed by traffic accidents. Falls were the most common mechanism in the infants, preschool, and school children up to 10 years old; children aged 11-18 showed a higher rate of traffic accidents comparing to children younger than 3 years. Of 353 patients, 49 (13,9%) required surgical procedure, 304 (86.1%) were threated conservatively. Survival rate was 96.6 %. Conclusion The majority of hospitalized patients qualify for medical treatment and surgical intervention is reserved for selected cases. Thus, the adequate pre-hospital care is essential.

Suzana Savić, Larisa Gavran, Gordana Tešanović

Aim To assess obesity and weekly physical activity among medical students at the University of Banja Luka, Bosnia and Herzegovina, related to gender and years of study profile. Methods This is a prospective, descriptive study conducted among the student population across all six years, comprised of a validated survey instrument Youth Risk Behaviour Survey Questionnaires. The study was approved by the Ethics Committee of the School of Medicine and carried out as an anonymous survey, during the winter semester of the academic year 2017/2018. Results Of the total 601 students, the study included 543 students, 327 (60.2%) females and 216 (39.8%) males. The majority of students 337 (62.1%) had normal weight, and 13 (2.4%) had class 1 obesity. Most female students, 255 (75.7%) had normal weight, while 132 (61.1%) males were overweight. Physical inactivity was found among 349 (64.3%) students; 11 (2%) exercised regularly twice a week and 16 (2.9%) exercised five times a week. Conclusion This study should help better understanding and identifying the onset of obesity among the students of the School of Medicine in Banja Luka and promote awareness of the obesity problem among them that would have benefit for health of this population group.

Kosana Stanetić, V. Petrović, Bojan Stanetić, Vesna Kević, M. Stanetić, Jelena Matović, S. Kusmuk, M. Račić

Aim To examine the prevalence of undiagnosed depression among primary care elderly patients in the entity of the Republic of Srpska (Bosnia and Herzegovina) as well as the sociodemographic and clinical risk factors associated with depression. Methods A cross-sectional study was conducted between April and June 2019 in nine towns of the Republic of Srpska. The study sample included 1,198 primary care patients older than 65 years of age. Research instruments included a sociodemographic questionnaire and Geriatric Depression Scale - Short Form (GDS-SF). Results Positive screening test (GDS-SF score > 5), which indicates depression was found in 484 (40.4%) participants. Multivariate regression analysis showed that lower education levels [OR = 1.565, 95% CI (1.13-2.17)], divorced and widowed [OR = 1.366, 95% CI (1.16-1.62)], poor financial situation [OR = 1.690 , 95% CI (1.25-2.29)], non-home residents [OR = 2.200, 95% CI (1.41- 3.44)], non-hobby patients [OR = 2.115, 95% CI (1.54-2.91) ], non-friends [OR = 3.881, 95% CI (2.70-5.57)], patients suffering from chronic pain [OR = 2.414, 95% CI (1.72-3.39)], patients with daily life limitation activities [OR = 1.415, 95% CI (1.03-1.95)], patients with three or more chronic diseases [OR = 1.593, 95% CI (1.12-2.27)], patients using five or more drugs [OR = 1.425. 95% CI (1.00-2.03)], and patients with history of previous depression [OR = 2.858, 95% CI (1.94-4.21)] were at higher risk for depression. Conclusion The prevalence of undiagnosed depression in the elderly in Republic of Srpska is high. Future strategies are needed to strengthen screening of geriatric depression in primary health care.

Aim To investigate the usage of chest computed tomography (CT) scan score for improvement in diagnostic and treatment efficacy of repetitive pleural effusion. Methods CT scan scoring system was used as a part of diagnostic procedures in patients with repetitive pleural effusion. Patients with at least two pleurocentesis were included in the study. Chest and abdominal ultrasound, chest x-ray, bronchoscopy, biochemical, microbiological and cytological analysis of pleural fluid specimen were performed for all patients. Results In a two-year period (during 2017-2018) 79 patients were analysed, 27 (34.17%) female and 52 (65.82%) male patients. Malignant pleural diseases were confirmed in 32 cases (40.5%), nonmalignant pleural effusions in 38 (48.1 %) cases, and nine (11.4%) patients rested without exact cause of pleural effusion after two pleurocenteses. Binary regression model showed odds ratio of 1.314; CI 95% 1.119-1.543) (p=0.00088). Confirmed malignancies with pleural effusion were in high correlation with the number of points in CT scan score. Conclusion CT scan scoring system was helpful for diagnostic and treatment decision making in patients with repetitive pleural effusion.

E. Hodzic, S. Pušina, Salem Bajramagić, M. Salibašić, Sandin Holjan

Introduction: Tumors of Fallopian tubes are rare in general, and they are the rarest tumors of female genital tract. According to clasification of World health organisation (WHO), papillomas, cystadenoma, adenofibroma, cystadenofibroma (CAF), metaplastic papillary tumors and endometrioid polyps belong to group of benign tumors. Serous papillary cystadenofibroma (SPCAF) is rare tumor and it is ususally located on fimbrial end of the tube and it is considered that it has „Müllerian“ origin. Aim: The aim of this article is to show a rare case of cystadenofibroma of Fallopian tube which was found as random sample during histopathological analysis of specimen which was extracted during laparatomy due to the large tumor mass in abdomen. Case report: A 43-year-old patient underwent surgery for a large tumor mass in the abdomen, unknown lesions and pathohistology, which was radiologically verified four years before hospitalization. We removed the specimen that made up the tumor, along with the uterus and adnexes, weighing 14 kg and sent for histopatology. A large tumor mass is made up of a giant uterine myoma, and in the analysis of the other preparation, in addition to endometrial adenocarcinoma, there is also a rare Fallopian tube cystadenofibroma. On the sixth day of hospitalization, the patient is discharged home. At control after three months, the patient was without problems, with ongoing adjuvant brachytherapy. Conclusion: Improvement of prevention measures and work on the continuing education of patients and physicians at the primary care level are needed to ensure that patients receive the best treatment in a timely manner. Cystadenofibroma is a rare tumor in general and gynecologic oncology, and as authors it is a great honor for us to contribute to the world literature and to present the twentieth case of this tumor.

Yu Wang, Guan Gui, Nan Zhao, Hao Huang, Miao Liu, Jinlong Sun, Haris Gačanin, H. Sari et al.

Modulation signal classification (MSC) is an indispensable technique to make the possible applications of non-cooperative communications. Currently, convolutional neural network (CNN) based MSC techniques can achieve an outstanding performance at a fixed noise regime. However, they are hard to generalize to all of noise scenarios. Because these conventional methods are trained on specific signal samples with fixed SNR and they only perform well under corresponding noise condition. Unlike the conventional methods, in this paper, we propose a robust CNN based generalized MSC (GMSC) method with powerful generality capability. This capability stems from the mixed dataset, containing in-phase and quadrature (IQ) samples under various SNR regimes. Experimental results show that the proposed method is robust under varying noise conditions, while merely losing a slight performance with comparing with conventional methods.

T. Douthat, John D. Morgan, Haris Alibašić, Aneurin Grant

Abstract Passive design and landscape variables (e.g., rooftop albedo and shading vegetation) are frequently proposed as important green building techniques. However, there is a paucity of literature demonstrating their large-scale effects with empirically measured building stocks and observed residential energy consumption. This paper uses a spatial Durbin error model (SDEM) approach to test the effects of passive building performance indicators, such as orientation, albedo, and NDVI, on city-wide summertime household billed energy data in Gainesville, FL. Our findings suggest that vegetation and albedo reduce energy consumption, but our model did not produce similar significant results for building orientation and footprint compactness. These results provide evidence to suggest high albedo roofing and purposeful shading are important energy conservation strategies for energy-efficient residential neighborhoods.

Aim To determine stereological structural parameters of the parenchymal part of the placenta, placental weight and volume of adolescent pregnant women and their correlation with newborns' birth weight. Methods This prospective study was conducted on a total of 60 human placentas of term pregnancy, divided into two groups according to the age of pregnant women. Experimental group consisted of 30 placentas of pregnant women aged 13-19 years. Control group consisted of 30 placentas of pregnant women aged 20-35 years. Stereological analysis was performed. Results Volumetric density of terminal villi of adolescent placentas was significantly higher than the one of control group (p <0.0001). The volumetric density of fibrinoid of adolescent placentas was significantly lower than of the control group (p <0.0001). Total volume of terminal villi of adolescent placentas was significantly higher than of the control group (p<0.0001). The total volume of fibrinoid of adolescent placentas was significantly lower than of the control group (p<0.0001). Newborns of adolescent pregnancies had in average lower birth weight of 439.01 g compared to the newborns of the control group (p <0.00001). Conclusion Adolescent pregnancy affects placental structure, weight and volume. Newborns of adolescent pregnancy have optimal body weight.

Aim To compare the quality of the conditions for endotracheal intubation and muscle relaxation between rocuronium bromide and vecuronium bromide using the ''timing principle'' method for induction in anaesthesia. The "timing principle" includes the administration of muscle relaxants before the hypnotic agent during induction in anaesthesia. Method Sixty patients who had undergone elective surgery were randomly allocated into two equal groups using muscle relaxants: rocuronium (group R) and vecuronium (group V). The intubation conditions were assessed using Cooper's scoring system, based on jaw relaxation, vocal cords position and response to intubation. The quality of muscle relaxation was evaluated by recording the time of clinical weakness, a count of ''train of four'' (TOF) twitches at intubation, the time of loss TOF response and duration of direct laryngoscopy. Results The intubation conditions were excellent in 100% of patients in the group R versus excellent in 80% and good in 20% of patients in the group V (p<0.05). The time of clinical weakness was statistically significantly shorter in the group R than in the group V (p<0.000). The time of loss of TOF response was statistically significantly shorter in the group R (p<0.000). The absence of TOF twitches (the level of muscle relaxation of 100%) at intubation recorded in 25 (83.3%) patients in the group R versus five (16.7%) patients in the group V (p<0.000). Duration of direct laryngoscopy did not significantly differ between the groups. Conclusion Rocuronium bromide provides better intubation conditions and greater quality of muscle relaxation than vecuronium bromide using ''timing principle'' technique.

Aim To present combined measles cases data and phylogenetic analysis of the virus circulated in 2018 in the Federation of Bosnia and Herzegovina (FB&H, the entity of Bosnia and Herzegovina), in order to analyse endemic transmission patterns of circulating strains and its implications for elimination efforts. Methods The data were derived from epidemiological case investigations and laboratory diagnoses based on serology, molecular detection and genotyping of the measles virus. Results During 2018 16 measles cases were reported in FB&H, of which five were classified as laboratory confirmed cases, one was an epidemiologically linked case and 10 were clinically compatible cases. Among them 12 (75.00%) cases were unvaccinated or had unknown vaccination status. The most affected population was up to 14 years of age (13/16; 81.25%). None of the cases was fully vaccinated. Viruses of other genetic lineages had been introduced in FB&H in the recent period. Two virus lineages of genotype B3 were identified. Phylogenetic analysis indicated the presence of a unique sequence of measles B3 virus in FB&H (Sarajevo). Conclusion Further strengthening of measles surveillance system and renewed efforts to increase vaccination levels are necessary to prevent disease and for elimination setting.

J. Mušanović, Azra Metović, Faruk Husremović, Samir Bejić, A. Hasković, A. Babić, S. Šljuka

Aim To determine differences in quantitative traits of digital dermatoglyphics between breast cancer women and the women in the control group (healthy women). Methods This case-control study included digital dermatoglyphics of 50 patients with confirmed breast cancer diagnosis compared with 50 healthy examinees with the absence of familial history of any type of cancer. Collecting samples was performed among Bosnian-Herzegovinian population by Printake method. The comparison of the mean values between the examined groups was made by the Student's t-test and Mann-Whitney U test. Results The results showed that, with regards to the pattern intensity, no statistically significant difference was detected between the two examined groups (p>0.05).The absence of any significant difference in the number of papillary ridges on an individual finger between the breast cancer patients and the control group was found (p>0.05), although the total number of papillary ridges on all ten fingers had somewhat lower values in the examined group. Conclusion This research confirms the existence of genetic predisposition for breast cancer development, emphasizing the relevance of hereditary factors in the ethiopathogenesis of this disease. The quantitative traits of digital dermatoglyphics were not a reliable and predictive tool for detecting a potential risk for breast cancer in small populations.

B. Wohlers, Stefan Dziwok, Faruk Pasic, A. Lipsmeier, Matthias Becker

Abstract The processes for manufacturing and operating modern technical products require expertise in multiple disciplines like mechanical engineering, electrical engineering, and software engineering. Assessing the current condition and quality of these processes and the machines involved is challenging due to the inherent complexity of the products and the required expertise in multiple engineering domains. Globalization and increasing competition make it necessary to reduce production costs while at the same time ensuring high throughput and product quality. Without the ability to precisely assess the condition and quality of production processes and involved machines, taking action to steer these metrics is nearly impossible and results in unnecessary high production costs. In our previous publications, we introduced the concept of Key Performance Indicators (KPIs) for mechatronic systems as a concept to assess the condition and quality of products and production processes in a graspable yet substantial and efficient way. In this paper, we further refine our KPI concepts und evaluate them for two different use cases: we apply our KPI concept to a manufacturing process in the mechatronic system domain and an operation process in the food production domain. We provide detailed insights in how we applied our concepts within these domains and report about lessons learned. In addition, we provide a business case estimation for our software solution that assesses the KPIs of our food production domain example.

One of the frequently occurring tasks during the development of a warehouse management system is the implementation of a routing algorithm of some kind. Whether it is for guiding workers during order picking, routing delivery vehicles or for routing company representatives, this task has proven to be challenging in the technical as well as the social sense. In other words, the task is heavily dependent on various company-specific constraints and it directly dictates the way employees should do their job. This paper describes a strategic approach to the development and gradual integration process of such algorithms which makes sure that all constraints are satisfied and, more importantly, ensures that route suggestions are viewed by the employees as a helpful tool rather than a threat to their job. Described through a real-world case study in a medium-to-large warehouse, the routing efficiency is almost doubled in comparison to the previous approach and critical factors are analysed and discussed throughout different stages of the process.

D. Abueidda, S. Koric, N. Sobh

The field of optimal design of linear elastic structures has seen many exciting successes that resulted in new architected materials and designs. With the availability of cloud computing, including high-performance computing, machine learning, and simulation, searching for optimal nonlinear structures is now within reach. In this study, we develop two convolutional neural network models to predict optimized designs for a given set of boundary conditions, loads, and volume constraints. The first convolutional neural network model is for the case of materials with a linear elastic response while the second developed model is for hyperelastic response where material and geometric nonlinearities are involved. For the nonlinear elastic case, the neo-Hookean model is utilized. For this purpose, we generate datasets, composed of the optimized designs paired with the corresponding boundary conditions, loads, and constraints, using topology optimization framework to train and validate both models. The developed models are capable of accurately predicting the optimized designs without requiring an iterative scheme and with negligible computational time. The suggested pipeline can be generalized to other nonlinear mechanics scenarios and design domains.

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