Introduction Heart rhythm disorders are common in the post-operative period following surgical myocardial revascularization (CABG). The incidence of any type of arrhythmia in the postoperative period can go up to 85%. While most are transient and short-term, it does not lead to deterioration of the postoperative course, in a smaller number of patients they can be predictors of various events that result in fatal outcome. Arrhythmias occur suddenly and need to be recognized and reacted in time. Standard monitoring consists of 12-channel electrocardiogram (ECG), laboratory findings and, if necessary, 24-hour HOLTER monitoring. Persistent arrhythmias increase overall morbidity and mortality, and costs treatments are increasing enormously. Patients and methods The prospective study analyzed patients of all age groups and sexes in whom angiographically coronary arterial disease was confirmed and who underwent surgery CABG. A total of 60 patients were screened during 2016. All age groups of both sexes in whom no rhythm disorders were previously recorded were included in the study. Results A total of 60 patients undergoing CABG were analyzed. The average age of patients was 63.56 8.55 years. The most preoperative factor was hypertension, which was recorded in 53 (88.33%) patients. The higher number of patients was operated using CPB 75.86%. The most commonly performed 3 aorto-coronary by-pass 45 (75%). The most common form of rhythm disorder was POAF, which occurred in 18 (30%) patients. In 24 patients, a change in heart rhythm was observed in the postoperative period in the group of operated ON pump techniques, while in the case of the application of Off pump technique only 5 patients were present, which was statistically significant (p <0.05). Conclusion Preoperative patient preparation and prophylaxis with good anesthesia monitoring and minimal trauma during surgery are the main preconditions for reducing the incidence of postoperative heart rhythm disorders.

Colorectal cancer is the second leading cause of mortality in the West, and rectal cancer accounts for about 25% of the colon cancers. The concept of total mesothelial excision (TME) was the most important event in surgery for rectal cancer of the last two decades, because even without a curative approach, it reduced local recurrence and extended 5-year survival.

Objectives Endemic nephropathy (EN) is a chronic tubulointerstitial renal disease associated with increased incidence of upper urinary tract urothelial cancer (UTUC) occurring predominantly in geographically limited areas in villages along big Danube river. Based on results obtained by the research it is confirmed that aristolochic acid is causative agent of endemic nephropathy (EN). Aim The aim of this study was to determine characteristics of UTUC in two endemic areas and analyze trends in 5-year period. Methods This study included all patients with UTUC with or without synchronous/metachronous urothelial cancer in urinary bladder, from Croatian and Bosnian EN and non-EN regions. We analyzed archival data bases from all patients with UTUC who were admitted and operated in Department for surgery and urology, General Hospital Josip Bencevic Slavonski Brod in the time period between 2005 and 2010. Analyzed groups of patients were divided and compared as EN group (that includes patients from Croatian and Bosnian EN region) and non-EN group (that includes patients from Croatian and Bosnian non-EN region). All surgical specimens were processed according to standardized pathological procedures. Results Comparing patients basic characteristics from Croatian and Bosnian EN region there was no significant difference in gender (females were more frequently affected in both EN regions, p=0.99) or age (p=0.43) of patients. We found higher blood levels of urea and creatinine in group of patients from Croatian EN region when compared with group of patients from Bosnian EN region but the difference was not statistically significant (p=0.79 and p=0.44, respectively). In patients from Croatian EN group Hemoglobin levels were significantly lower than levels from Bosnian EN region patients, p=0.0049. In group of patients from Bosnian EN region ureteral tumors were more frequently observed than in Croatian group of patients, when compared with renal pelvis tumors but the difference was not statistically significant (p=0.258). Conclusion Our data showed some differences in tumor localization between to investigated, relatively nearly situated, EN regions in Croatia and Bosnia. Statistically significant difference in hemoglobin levels between Croatian and Bosnian EN regions that should be further analyzed to give some reasonable explanation.

Porphyromonas gingivalis, an asaccharolytic Gram-negative oral anaerobe, is a major pathogen associated with adult periodontitis, a chronic infective disease that a significant percentage of the human population suffers from. It preferentially utilizes dipeptides as its carbon source, suggesting the importance of dipeptidyl peptidase (DPP) types of enzyme for its growth. Until now DPP IV, DPP5, 7 and 11 have been extensively investigated. Here, we report the characterization of DPP III using molecular biology, biochemical, biophysical and computational chemistry methods. In addition to the expected evolutionarily conserved regions of all DPP III family members, PgDPP III possesses a C-terminal extension containing an Armadillo (ARM) type fold similar to the AlkD family of bacterial DNA glycosylases, implicating it in alkylation repair functions. However, complementation assays in a DNA repair-deficient Escherichia coli strain indicated the absence of alkylation repair function for PgDPP III. Biochemical analyses of recombinant PgDPP III revealed activity similar to that of DPP III from Bacteroides thetaiotaomicron, and in the range between activities of human and yeast counterparts. However, the catalytic efficiency of the separately expressed DPP III domain is ~1000-fold weaker. The structure and dynamics of the ligand-free enzyme and its complex with two different diarginyl arylamide substrates was investigated using small angle X-ray scattering, homology modeling, MD simulations and hydrogen/deuterium exchange (HDX). The correlation between the experimental HDX and MD data improved with simulation time, suggesting that the DPP III domain adopts a semi-closed or closed form in solution, similar to that reported for human DPP III. The obtained results reveal an atypical DPP III with increased structural complexity: its superhelical C-terminal domain contributes to peptidase activity and influences DPP III interdomain dynamics. Overall, this research reveals multifunctionality of PgDPP III and opens direction for future research of DPP III family proteins.

The objective of our study is to uncover the micro-processes of managing repeated episodes of tensions occurrence between product and service business model. By contrasting 10 national subsidiaries, we find that whereas the unsuccessful subsidiaries pursue a bargaining process to tension management that preserves the dualism between the two business models, the successful subsidiaries upgrade from an initial synergistic process to a subsequent routinized process of tension management, which allows them to move towards a duality. Rather than bargaining for compromises between diverging interests, the successful subsidiaries engaged in promoting common overarching goals, resolving the conflict of interest, and promoting the identification of synergies. As trust in the success of the synergistic process grows, organizational members begin to learn how to resolve conflicts without their leader’s active mediation. They jointly generate and implement routines for the proactive identification of latent tensions,...

Product providers have increasingly embraced services alongside their product offerings in order to improve performance. Yet, it remains unclear how this change in the market strategy and the underpinning innovation in the business model – the activity system design –jointly create value. Relying on 12 case studies of product providers that shifted to providing highly sophisticated service offerings – outcome-based contracts – we derive theoretical propositions regarding the interplay of service market strategy and business model innovation on value creation. The product providers we studied report two interdependent changes that they pursue to secure the required fit; they evolve the market strategy from pure products to outcomes so as to achieve a better fit with the client’s needs and to grow the service business. In parallel, they ‘open up’ their business models to maintain the internal activity system’s fit with their core competencies while relying on ecosystem partners for activities outside the pr...

Manufacturing companies increasingly search to improve their competitiveness through service growth opportunities. However, the service transition strategy brings additional risks as complementary ...