With great interest we have read the letter by De Giorgi et al. in which they express their disagreement with the conclusions of our study on the potential value of a Raman spectroscopy device in the clinical diagnosis of cutaneous melanoma. In our paper, we tested the diagnostic accuracy of Raman spectroscopy, expressed as sensitivity, specificity and number needed to treat, in a set of pigmented skin lesions that were deemed suspicious for melanoma by dermatologists. Whereas current clinical diagnosis and dermoscopy rely on recognition of morphological characteristics, Raman spectroscopy provides information about the molecular composition of pigmented skin lesions. Our results indicate that Raman spectroscopy constitutes a valuable diagnostic tool: all melanomas that were analyzed tested positive with Raman spectroscopy (sensitivity 100%), and the estimated number needed to treat was 2.7 (ratio between the number of lesions tested positive by Raman spectroscopy and the total confirmed melanoma). De Georgi et al. disagree with our conclusions which state that the diagnostic model based on Raman spectroscopy has enabled greater sensitivity and specificity in melanoma diagnosis, detecting all thin melanomas and reducing the number of unnecessary excisions by more than two-fold compared with the current clinical practice. They object to the fact that pigmented skin lesions were enrolled in the study after a dermatologist performed a clinical assessment and had excised lesions that were clinically suspicious for melanoma, and state that this does not reflect clinical practice. They furthermore state that such “lesion pre-selection frequently includes many melanomas that are easy to diagnose, and which often have an exceedingly high frequency of malignancies within the lesions examined, thus creating an “artificial” diagnostic setting compared to real practice”. De Giorgi et al. have misinterpreted the objective of our study and our data set. Our results are based on the use of Raman spectroscopy as an add-on to diagnose dermatologist-selected lesions. We do not want to by-pass the dermatologist. The selection of suspicious lesions by a dermatologist is part of the intended clinical practice. This must not be confused with a bias in the case series used. The sample set mostly consisted of difficult to classify lesions, including melanoma in situ and dysplastic nevi, deemed suspicious for melanoma based on visual inspection by dermatologists specialized in pigmented skin lesions. This selection of lesions was in line with the objective of our study; namely to investigate the diagnostic use of Raman spectroscopy as an adjunct technique to distinguish between melanoma and unnecessary diagnostic excisions. This is fully in line with the main conclusion drawn from the results regarding the diagnostic accuracy in an independent validation set, and the possible reduction of the number of unnecessary diagnostic excisions if the Raman instrument were used as an add-on to classify lesions considered suspicious by dermatologists. De Giorgi et al. also criticize the fact that amelanotic lesions were excluded from analysis. All lesions that were excised by the dermatologist for suspicion for melanoma were subjected to Raman spectroscopy. This included unpigmented lesions suspicious for amelanotic melanoma. After histopathological evaluation, the lesions diagnosed as non-melanocytic were excluded from analysis (basal cell carcinoma, seborrheic wart, lichenoid keratosis, dermatofibroma, haemangioma, scar), because the aim of the study at this stage was to distinguish between melanoma and non-melanoma melanocytic lesions. De Giorgi et al. furthermore state that only a melanoma left unexcised represents a clinically relevant false negative diagnosis and that in their experience this does not frequently occur, and likely limited to subjects harboring a clinically “featureless” tumor. We can only refer to the literature. The accuracy and reproducibility of melanocytic skin lesion diagnosis is poor, in particular among general practitioners, as has been demonstrated in several studies. More evidence-based studies are required to provide data about the role of Raman spectroscopy to improve clinical diagnosis of melanoma in different medical settings, including screening of inconspicuous melanocytic skin lesions. With this study we provide evidence that accurate diagnostic results can be obtained by Raman spectroscopy on pigmented skin lesions selected by dermatologists as suspicious for melanoma. We believe that these results represent an important step towards accurate clinical diagnosis of melanoma.

Constructed wetlands, as an alternative to conventional methods, are systemsdesigned on the basis of the application of natural purification processes that take placein watery and swampy overgrown habitats, with certain microbiological groups. In thewastewater treatment process various types of constructed wetlands can be combinedto achieve a higher efficiency of the purification.In this study, the removal effectiveness of the organic substances from municipalwastewater was monitored, using a horizontal pilot - scale constructed wetlandutilizing Typha latifolia and Phragmites australis. In addition to the measurement oforganic substances content through COD, BOD and KMnO4 consumption, and totaldissolved substances (TDS) in influent and effluent, microbiological sample analysis wasperformed, monitored by total number of coliform bacteria.The aim of this study was to calculate the effectiveness of removing organicsubstances from municipal wastewater, depending on the season, as well as theeffectiveness of eliminating total coliform bacteria.The results of one-year research have shown that the removal effectiveness ofthe organic substances from municipal wastewater, expressed as the chemical oxygendemand (COD), was the highest in summer - 87.82% ± 2.83%, and the lowest in thewinter - 64.51% ± 5.89%. During the study, effectiveness of elimination of total coliformbacteria was 97.88 ± 0.80% and total dissolved substances 71.27% .

Victims and witnesses may be reluctant to give information and evidence because of perceived or actual intimidation or threats against themselves or members of their family. This concern may be exacerbated where people who come into contact with the criminal justice system are particularly vulnerable. For instance, by virtue of their age and developing levels of maturity, children require that special measures be taken to ensure that they are appropriately assisted and protected by criminal justice processes.Victims who receive appropriate and adequate care and support are more likely to cooperate with the criminal justice system in bringing perpetrators of crime to justice. However, inadequacies of criminal justice systems may mean that victims are not able to access the services they need and may even be re-victimized by the criminal justice system itself.

In this paper, we strive to point out the special protection of children with developmental disabilities and invalids as victims of crime and violence, in accordance with international and national law. Through the analysis of the judgment of the European Court against Bosnia and Herzegovina, we want to point out the secondary victimization of such persons who have been mistreated by civil servants and responsible for the state of Bosnia and Herzegovina. In the law on civil servants, it is necessary to incorporate responsibility for the execution of secondary victims of victimization in a manner that is personally liable for these violations of citizens' rights and that the damages caused are borne by themselves and that they are removed from the civil service.

Communication between two or more participants is obtained through a non ideal transmission medium. Such medium is usually characterised by different types of distortions which affect transmitted signal. Many of them are not completely avoidable. In order to minimize their effect at the receiver end, adequate performance measure of distortion-to-signal influence is needed. As the one of the most reliable measures for evaluating total distortion on transmitted signal, from transmitter to receiver end, we consider a bit error rate. In this paper, we propose a low-cost bit error rate measuring system constructed as RTL-SDR based wireless Hardware-In-The-Loop system. The proposed measuring system is tested in indoor environments on BPSK modulated signals. Obtained results show high matching with theoretical expectations. Also, for the proposed system adequate graphical user interface is created in the Matlab.

The advancement of LED technology in the last 10 years has completely put other light technologies into the fore-ground. LED has almost entered all spheres of life. When it comes to products that use LED technology, one of the most important issues is lifetime. This paper contains a detailed overview of the research in the field of lifetime testing of LED components and products which have an LED element. Mathematical models for accelerated LED ageing tests are given in this paper. Ageing tests with constant temperature and constant current were analyzed. In this paper a simplified model of the lifetime of LEDs in products is proposed. The results of testing several samples for a product with an LED based technology are given.

O objetivo do estudo é apresentar uma revisão integrativa sobre métodos de avaliação de equilíbrio postural em pessoas com AR. Foram incluídos ensaios clínicos randomizados e não-randomizados, estudos transversais com a temática de equilíbrio postural em pessoas com AR em português, espanhol e inglês publicados nas duas últimas décadas nas bases PubMed, SCOPUS e plataforma PEDro. Foram incluídos os estudos que apresentavam no título ou resumo termos mencionados nas estratégias de busca. A descrição dos artigos selecionados indicou: autor, ano de publicação, número de participantes, objetivos, instrumentos ou método utilizados para avaliar o equilíbrio postural, outras avaliações além do equilíbrio postural e principais resultados. De 70 estudos encontrados, foram selecionados 22 para discussão e análise. A maioria não apresenta avaliações com testes específicos para as diferentes dimensões de controle do equilíbrio postural empregando testes-extra às avaliações. Frente às limitações encontradas nos instrumentos avaliados, verifica-se que para melhor determinar os déficits é necessário empregar um conjunto de avaliações que incorporem as principais dimensões de controle do equilíbrio postural, fornecendo informações mais completas e abrangentes a programas de reabilitação e prevenção de quedas na AR.

In limited resources settings, Health Technology Management (HTM) presents specific challenges, which significantly differ from those faced in higher income settings. In Sub-Saharan Africa (SSA), HTM requires holistic approaches based on reliable information on medical devices operationalized in local medical locations, which may differ significantly from the USA or European ones. Computerized Maintenance Management System (CMMS) tools offer unprecedented opportunities to optimize medical device organization and management in SSA. Nonetheless, CMMS for SSA should be designed to meet real local needs and facing local economic and organizational constraints. This paper describes the results of a project aimed to design and deploy a context-driven CMMS tool, called “GMaint-KM Benin”, which was designed, developed, tested, validated and deployed in the Department of Biomedical Engineering, Ecole Polytechnique d’Abomey-Calavi, University of Abomey-Calavi, Benin. The methods followed to design the CMMS, was inspired by closed-loop control theory. It is based on the idea that an effective CMMS could have been designed using as reference international standards and best practices, while controlling and optimizing CMMS inputs and outputs basing upon information and data measured in Beninese medical locations, following a closed-loop feedback control strategy. The tool is currently fully functional in three Beninese hospitals. The successful method used to design this tool represents a best-practice of optimal co-design for Sub-Saharan Africa, which could be adapted and reused in similar projects aiming to design and deploy health technologies for low-income settings. In perspective, the project aims to enhance “GMaint-KM Benin” and scale it up at the national level. The adoption of such a tool could represent an effective base for comparative studies among African countries.

In limited resources settings, Health Technology Management (HTM) presents specific challenges, which significantly differ from those faced in higher income settings. In Sub-Saharan Africa (SSA), HTM requires holistic approaches based on reliable information on medical devices operationalized in local medical locations, which may differ significantly from the USA or European ones. Computerized Maintenance Management System (CMMS) tools offer unprecedented opportunities to optimize medical device organization and management in SSA. Nonetheless, CMMS for SSA should be designed to meet real local needs and facing local economic and organizational constraints. This paper describes the results of a project aimed to design and deploy a context-driven CMMS tool, called “GMaint-KM Benin”, which was designed, developed, tested, validated and deployed in the Department of Biomedical Engineering, Ecole Polytechnique d’Abomey-Calavi, University of Abomey-Calavi, Benin. The methods followed to design the CMMS, was inspired by closed-loop control theory. It is based on the idea that an effective CMMS could have been designed using as reference international standards and best practices, while controlling and optimizing CMMS inputs and outputs basing upon information and data measured in Beninese medical locations, following a closed-loop feedback control strategy. The tool is currently fully functional in three Beninese hospitals. The successful method used to design this tool represents a best-practice of optimal co-design for Sub-Saharan Africa, which could be adapted and reused in similar projects aiming to design and deploy health technologies for low-income settings. In perspective, the project aims to enhance “GMaint-KM Benin” and scale it up at the national level. The adoption of such a tool could represent an effective base for comparative studies among African countries.

Auditory attention identification methods attempt to identify the sound source of a listener's interest by analyzing measurements of electrophysiological data. We present a tutorial on the numerous techniques that have been developed in recent decades, and we present an overview of current trends in multivariate correlation-based and model-based learning frameworks. The focus is on the use of linear relations between electrophysiological and audio data. The way in which these relations are computed differs. For example, canonical correlation analysis (CCA) finds a linear subset of electrophysiological data that best correlates to audio data and a similar subset of audio data that best correlates to electrophysiological data. Model-based (encoding and decoding) approaches focus on either of these two sets. We investigate the similarities and differences between these linear model philosophies. We focus on (1) correlation-based approaches (CCA), (2) encoding/decoding models based on dense estimation, and (3) (adaptive) encoding/decoding models based on sparse estimation. The specific focus is on sparsity-driven adaptive encoding models and comparing the methodology in state-of-the-art models found in the auditory literature. Furthermore, we outline the main signal processing pipeline for how to identify the attended sound source in a cocktail party environment from the raw electrophysiological data with all the necessary steps, complemented with the necessary MATLAB code and the relevant references for each step. Our main aim is to compare the methodology of the available methods, and provide numerical illustrations to some of them to get a feeling for their potential. A thorough performance comparison is outside the scope of this tutorial.

We study, from theoretical and phenomenological angles, the Higgs boson oblique parameter Ĥ, as the hallmark of off-shell Higgs physics. Ĥ is defined as the Wilson coefficient of the sole dimension-6 operator that modifies the Higgs boson propagator, within a Universal EFT. Theoretically, we describe self-consistency conditions on Wilson coefficients, derived from the Källén-Lehmann representation. Phenomenologically, we demonstrate that the process gg → h∗ → V V is insensitive to propagator corrections from Ĥ, and instead advertise four-top production as an effective high-energy probe of off-shell Higgs behaviour, crucial to break flat directions in the EFT.

Javor negundovac (Acer negundo L.) je listopadno drvo iz Sjeverne Amerike, a u Hrvatsku je uvezen početkom 20. stoljeća. Cijenjen je u pčelarstvu, šumarstvu, krajobraznom uređenju te je vrlo invazivna vrsta. Najrasprostranjeniji je u kontinentalnom i submediteranskom dijelu Hrvatske. Javor negundovac (Acer negundo L.) slabo je zastupljena dendrološka vrsta na javnim gradskim krajobraznim površinama Knina, kao soliter, u drvoredu ili u skupinama. Metodom promatranja je uočeno da je u pogledu održavanja i njege stabala negundovca (A. negundo) na krajobraznim površinama nužno posvetiti više pažnje. Nisu uočena njegova stabla izvan gradskih krajobraznih površina. Temeljem anketnog istraživanja ispitanici su dodijelili vrlo dobre ocjene ukrasnim karakteristikama i ugodnosti javora negundovca (A. negundo) na krajobraznim površinama Knina. Ponešto su lošije ocijenili njegovu ulogu u pčelarstvu, šumskim melioracijama i urbanom šumarstvu. Veći broj ispitanika ne zna da je javor negundovac (A. negundo) vrlo invazivna vrsta.

Myeloid-derived suppressor cells (MDSC) emerged as major factors driving the tumor progression due to numerous immunosuppressive mechanisms they possess. Prostaglandin (PG)E2 is shown critical for the induction of MDSC and their suppressive functions in vivo, but it is poorly understood how it affects the capacity of MDSC to induce different subsets of regulatory T cells (Treg). By using a novel protocol for the generation of mononuclear (M)-MDSC, we showed that PGE2 potentiates the GM-CSF/IL-6-dependent induction of CD33+CD11b+HLA-DR−CD14+ M-MDSC in vitro. PGE2 diminished the capacity of GM-CSF/IL-6 M-MDSC to produce proinflammatory cytokines upon activation and augmented their capacity to produce IL-27, IL-33, and TGF-β. These results correlated with an increased potential of GM-CSF/IL-6/PGE2 M-MDSC to suppress T cell proliferation, expand alloreactive Th2 cells, and reduce the development of alloreactive Th17 and cytotoxic T cells. Interestingly, GM-CSF/IL-6/PGE2 M-MDSC displayed a lower capacity to induce TGF-β-producing FoxP3+ regulatory Treg compared to GM-CSF/IL-6 M-MDSC, as a consequence of reduced IDO-1 expression. In contrast, GM-CSF/IL-6/PGE2 M-MDSC potentiated IL-10 production by CD8+T, Th2, and particularly CD4+FoxP3− type 1 Treg, the latter of which depended on ILT3 and ILT4 expression. Cumulatively, PGE2 potentiated the suppressive phenotype and functions of GM-CSF/IL-6-induced M-MDSC and changed the mechanisms involved in Treg induction, which could be important for investigating new therapeutic strategies focused on MDSC-related effects in tumors and autoimmune diseases.