Introduction: The main route of acquiring infectious blood and body fluids in hospital conditions is accidental exposure to stinging incidents. Aim: The aim of this study was to determine the epidemiological characteristics of accidental exposures to blood-borne pathogens among different professional groups of health care workers (HCWs). Materials and Methods: A cross-sectional study was conducted using the “Questionnaire on the HCWs exposure to blood and blood transmitted infections” at the University Clinical Centre Tuzla, Bosnia and Herzegovina, from the 1st of March to the 31st of December 2014. Study sample consisted of 1031 participants (65% of total employees) stratified into three occupational groups: doctors, nurses and support staff. Results and Discussion: Exposure incident was recorded in 1231 participants (54.8%) at least once in the last 12 months. An average number of exposure incidents per HCWs in total years of service was 7.07± 8.041. Out of total sample, 70% reported at least one type of exposure incident. Nurses had a higher frequency of multiple contacts compared to doctors and support staff (χ2=37.73; df=4; p<0.001). The frequency of reported incidents among nurses at the surgical departments was almost two times higher (1.7). 75.5% (778/1031) of the participants, reported not having been exposed to these incident. Doctors were significantly less likely to report exposure incidents than nurses and support staff. There were significant differences in reporting rate (χ2=32,66; df=4; p<0.001). Conclusion: HCWs in hospitals have a high prevalence of occupational exposure to blood-borne infections. Seventy percent of the HCWs is periodically or constantly exposed to or contact related to blood. Nurses are most frequently exposed occupational group among HCWs, while the lowest reporting rate on an exposure incident is among doctors.

SUMMARY – Lung cancer as the major cause of cancer mortality worldwide includes several histologic subtypes evolving from numerous genetic and epigenetic changes emerging in alveolar, bronchiolar and bronchial epithelium. The majority of cases are diagnosed in advanced stage (i.e. stages IIIB and IV), often with scanty amount of tissue in transbronchial biopsies or cytology specimens. The aim of the present study was to investigate the expression of the scaffolding protein neural precursor cell expressed, developmentally downregulated 9 (NEDD9) in small biopsies of lung adenocarcinoma. The expression of NEDD9 was analyzed immunohistochemically in 71 formalin-fixed and paraffin-embedded transbronchial biopsy specimens of primary lung adenocarcinoma. Nuclear and cytoplasmic NEDD9 expression was detected indicating activation of the epithelial-mesenchymal transition process. Direct relationship between the expression of NEDD9 and survival was not demonstrated.

Objective: To investigate the efficiency and safety of the fixed combination of perindopril/amlodipin in a treatment if grade I and grade II arterial hypertension and arterial stiffness values after only two weeks of treatment. Design and method: The open clinical prospective controlled study was designed. The study was designed for two weeks and two group were formed. The first group was comprised of arterial hypertension grade I patients and group 2 of arterial hypertension grade 2. The cardiovascular risk profile was notified for all patients. The peripheral and central blood pressure, pulse wave velocity, stroke volume, augmentation index, pulse pressure, heart rate, the reflection index were analyzed before and two weeks after treatment. For the grade I arterial hypertension the fixed combination of perindopril/amlodipin was used in a dose of 5 mg/5 mg, and for grade 2 arterial hypertension dosage was 10 mg/10 mg. Therapy was given as a single tablet advised to be taken in the evening. The average grade I hypertension values were 158/92mmHg, and for grade II the average value was 162/102mmHg. The average vascular age for grade I arterial hypertension was 4,5 years, and for grade II arterial hypertension the average vascular age was 8,5years. Results: Results obtained from this short study showed significant lowering of blood pressure and the improvement of arterial stiffness values and in the vascular age was detected as well in both group. The average values of arterial hypertension felt within normal range after treatment in a both groups after two weeks of therapy. Patient compliance and satisfaction was notified. There were no side effects. Conclusions: The fixed combination of perindopril/amlodipin in a dose of 5 mg/5 mg for grade I arterial hypertension and 10 mg/10 mg for grade II arterial hypertension was proven to be effective in all patients. No adverse events were observed. The compliance of patients was excellent and evening dose is more preferable than morning regime. The arterial stiffness values are not constant and permanent. They are rather flexible and arterial hypertension values major dependent. The lower arterial hypertension, the lower arterial stiffness and vasc ular age.

Objective: The aim of this study was to evaluate corelation of serum level of NGAL to severity of hypertension and diastolic disfunction in patients with ST- segment elevation myocardial infarction treated with fibrinolytic therapy. Design and method: We included 54 consecutive ST-segment elevation myocardial infarction patients treated with fibrinolytic therapy (alteplase). The median follow-up time was 6 days (interquartile range, 5 to 7 days). Blood samples were drawn immediately after admission prior to fibrinolytic administration. The endpoints were mean systolic and diastolic pressure (continuously monitored) and mean E/A ratio as a measure of diastolic function. Results: Patients with high NGAL (above 134,05 &mgr;g/l; 75th percentile) had significantly higher mean systolic and mean diastolic blood pressure compared to patients with low NGAL (under 134,05 &mgr;g/l; 75th percentile), p = 0,001 and p = 0,003; respectively. Patients with high NGAL (above 134,05 &mgr;g/l; 75th percentile) had significantly lower E/A ratio compared to patients with low NGAL (under 134,05 &mgr;g/l; 75th percentile), p = 0,004. Conclusions: High NGAL significantly corelates with severity of hypertension and diastolic dysfunction in patients with acute STEMI.

In a traditional teaching models students are passive learners and usually share a common learning path that is in most cases predefined and fixed. In this paper we describe the case-based model for personalized learning path recommendation in example-based learning activities. According to the proposed model, the primary source of the knowledge for recommendation is represented in the form of cases that represent previously experienced learning paths. A recommended learning path comprises appropriate learning examples and learning resources for a student to go through in order to achieve desired learning outcomes. To validate the effectiveness of the proposed model, we conducted an experimentation to evaluate the impact of the model to student learning progress.

Satureja subspicata and S. horvatii are endemic species of the Balkan Peninsula and often used in traditional medicine in Bosnia and Herzegovina to treat different health conditions. We aimed to analyze the unevaluated apoptotic, genotoxic and cytotoxic effects of two Satureja species, as well as their content of phenolics that are mainly responsible for the plant's biological activity. Apoptotic and geno/cytotoxic activities of S. subspicata and S. horvatii were investigated in vitro in human lymphocyte culture and in vivo in mice. The content of the main phenolics in plant extracts was determined by ultra-high pressure liquid chromatography-MS-MS (UHPLC–MS/MS). Genotoxic and cytotoxic activities of Satureja extracts were evaluated in vitro by applying a cytokinesis-block micronucleus cytome assay in human lymphocyte culture and in vivo applying a mice reticulocytes micronucleus assay. SALSA RT-MLPA R011-C1 apoptosis assay was used for measuring the relative expression of 44 genes associated with the regulation of the apoptotic pathways in human lymphocyte cultures treated with different concentrations of two Satureja extracts. The first analysis of phenolic compounds in S. horvatii and S. subspicata determined by an UHPLC-MS/MS method revealed high levels of rosmarinic and caffeic acids. Minor genotoxic potential was determined in relation to the tested concentrations while no cytostatic and cytotoxic effects were revealed in vitro. However, when applied in concentrations of 200 mg/kg per os, aqueous extracts of two Satureja species significantly decreased frequency of reticulocytes micronuclei in treated mice against controls. Extracts of S. subspicata and S. horvatii in concentrations of 0.2 mg/mL, regardless of solvent used, downregulated pro-apoptotic and upregulated anti-apoptotic genes, showing anti-apoptotic activity. Our results indicate that the registered anti-genotoxic and anti-apoptotic activity is most likely related to the high level of phenolic acids (particularly rosmarinic and caffeic) in the tested extracts.

In this paper, we investigate pilot allocation problem in two-tier time division duplex (TDD) heterogeneous network (HetNet) with mMIMO. First, we propose a new pilot allocation scheme to maximize ergodic downlink sum rate of macro users (MUs) and small cell users (SUs), where the uplink pilot overhead and cross-tier interference are jointly considered. Then, we theoretically analyze the formulated problem and propose a low complexity one-dimensional search algorithm to obtain the optimum pilot allocation. In addition, we propose two suboptimal pilot allocation algorithms to simplify the computational process and improve SUs' fairness, respectively. Finally, simulation results show that the performance of the proposed scheme outperforms that of the traditional schemes.

As the age of the Internet of Things (IoT) continues to flourish, the concept of smart healthcare has taken an unprecedented turn due to interdisciplinary thrusts. To carry the big healthcare data ema nating from the plethora of bi 0-sens ors and machines in the IoT sensing plane to the central cloud, next generation high-speed delivery networks are essential. On the other hand, once the IoT data are delivered to the cloud, the massive IoT healthcare data are processed and analyzed em-ploying the state-of-the-art analytics tools such as deep machine learning and so forth. However, given the explosion of big data (from various sources in addition to the healthcare data), the delivery network as well the cloud may experience network and computational congestion, respectively. This may impact the realtime analytics of the healthcare data, e.g., critical for in-house patients and senior citizens aging at home. To address this issue, the emerging IoT edge analytics concept can be regarded as a promising solution to process the big healthcare data close to the source. For larg e-s cale IoT dep loym ents, this fu nctio nality is critical because of the sheer volumes of Data being generated. In this paper, we propose a deep learning based IoT edge analytics approach to support intelligent healthcare for residential users. The performance of the proposal is validated using computer-based simulation for online training of a real dataset. The reported results of our proposal exhibit encouraging performance in terms of low loss rate, high accuracy, and low execution time to support near real-time actionable decision making on the healthcare data.

The IEEE 1901 powerline standard can be deployed using orthogonal frequency division multiplexing (OFDM) since it is robust over impulsive channels. However, the powerline channel picks up impulsive interference that the conventional OFDM driver cannot combat. Since the probability density function (PDF) of OFDM amplitudes follow the Rayleigh distribution, it becomes difficult to correctly predict the existence of impulsive noise (IN) in powerline systems. In this study, we use companding transforms to convert the PDF of the conventional OFDM system to a uniform distribution which avails the identification and mitigation of IN. Results show significant improvement in the output signal-to-noise ratio (SNR) when nonlinear optimization search is applied. We also show that the conventional PDF leads to false IN detection which diminishes the output SNR when nonlinear memoryless mitigation scheme such as clipping or blanking is applied. Thus, companding OFDM signals before transmission helps to correctly predict the optimal blanking or clipping threshold which in turn improves the output SNR performance.

In Prague on 4th May 2018 was organized Special Topic Conference dedicated to acknowledging and honoring of Prof. Jana Zvarova, founder and Editor in Chief of both this European Journal for Biomedical Informatics and the International Journal on Biomedicine and Healthcare, who suddenly and unexpectedly passed away in July 2017...

Antoine Remond (1917-1998) is a French researcher, neurologist and clinical electrophysiologist. He is considered one of the founders of cognitive neuroscience (1-4). He was born in Argentina in 1917 in a scientific family...

There is no journal in the Balkans covering the area of medical informatics (1). By searching scimagojr.com, the term “medical informatics” is not in options, and by clicking on the term “health informatics” there are no journals in the Balkans, the Mediterranean countries or Eastern Europe. Acta Informatica Medica is the last journal in this geographic area covering the field of Medical informatics...

Background: Nephrotic syndrome (NS) is one of the most frequent glomerular diseases among children. While most of the children with primary NS respond to steroid treatment, 10 to 20% of the patients are steroid-resistant, and the best therapy for such cases has never been defined. Objective: The present study aimed to evaluate steroid-resistant nephrotic syndrome (SRNS) patients. Materials and methods: Our research included 50 children (56% female and 44% male) with NS. NS was defined as the presence of edema, massive proteinuria, hypoalbuminemia and hyperlipidemia. Patients with NS were treated according to international protocol. SRNS was diagnosed in patients with idiopathic NS based on lack of complete remission despite treatment with steroids. Renal biopsy was performed in 22 patients with SRNS at the Pediatric Clinic II of the University Clinical Center in Sarajevo (UCCS). Histopathologic analyzes of renal biopsy were performed at the Department of Pathology, University Clinical Center in Tuzla (UCCT). Patients with SRNS, after kidney biopsy were treated with nonsteroidal immunosuppressant’s. Results: Eight (36.4%) of the 22 patients who had undergone renal biopsies had minimal change disease (MCNS) and seven (31.8%) had focal segmental glomerulosclerosis (FSGS). The immunosuppressive drugs used in SRNS were Cyclosporine (CsA), Cyclophosphamide (CYC), Mycophenolat mofetil (MMF) and Rituximab (RTX). Three patients (13.6%) did not respond to any treatment and had developed end - stage renal disease (ESRD). Conclusion: With current treatments, some children will ultimately achieve a sustained remission with one of the second line or third line of the proposed drugs. Patients with refractory NS will go to progression towards ESRD. The rapid development of molecular genetics will give a new contribution to the pathogenesis and treatment of this disease.