Background: Although the Bhanja bandavirus (BHAV) is widely distributed in some European countries, human infections are rarely reported. This study analyzed the prevalence of BHAV antibodies in patients with neuroinvasive diseases of unsolved etiology. Methods: A total of 254 Croatian patients who developed neurological symptoms during the four consecutive arbovirus transmission seasons (April 2017–October 2021) were tested. Cerebrospinal fluid (CSF) and urine samples were tested using RT-qPCR. In addition, CSF and serum samples were tested using a virus neutralization test. Results: BHAV RNA was not detected in any samples, while neutralizing (NT) antibodies were detected in serum samples of 53/20.8% of patients (95% CI = 16.0–26.3). In two patients, BHAV NT antibodies were detected in the CSF, indicating a recent infection. Both patients were inhabitants of rural areas in continental Croatia, and one reported a tick bite two weeks before symptoms onset. The seropositivity was high in all age groups (15.2–29.1%). The majority of seropositive patients (94.3%) resided at altitudes less than 200 m above sea level. The prevalence rates correlated positively with population density and negatively with certain climate parameters (temperature, number of hot/warm days). Conclusions: The presented results indicate that BHAV is distributed in Croatia. Further studies are needed to determine the clinical significance of this neglected arbovirus.

Limited scientific evidence shows that alpha lipoic acid (ALA) can induce regression rates of low-grade squamous intraepithelial lesions (LSILs), but the mechanisms of these effects have not been elucidated. To gain a broader insight into its therapeutic potential and mechanisms of action, the effects of 3 months of supplementation with 600 mg of ALA on antioxidant and lipid status parameters in 100 patients with LSILs were investigated in a randomized, placebo-controlled study. The obtained results are discussed in terms of patients’ initial metabolic status and diet quality (particularly nutritional intake of antioxidants). The obtained results showed that oxidative status biomarkers were not significantly affected by ALA supplementation. However, serum superoxide dismutase (SOD) activity was positively affected in the subgroup of patients with higher dietary antioxidant intake. Surprisingly, ALA supplementation resulted in a small but statistically significant increase in serum low density lipoprotein (LDL), and the observed effect was significantly affected by the initial lipid status of the participants. Larger studies are necessary to gain additional insights on the clinical significance of ALA as an antioxidant and hypolipemic agent and to optimize its potential application in LSIL treatment.

In the context of sustainable buildings, an ecological study of building and insulating materials is critical since it may assist affirm or shift the path of new technology development. Utilising sustainable material is a part of the sustainable improvement. For this reason, material fabrication is the primary process for the energy usage and release of intense environmental gaseous. The fabrication of the insulation and building materials, as in every fabrication process, comprises an energy consumption of crude materials in addition to the pollutants’ release. In buildings, insulation is a relevant technological resolution for cutting energy usage. This study aims to assess the primary energy consumption and the environmental effects of the fabrication of building and thermal isolation materials by using a new hybrid MCDM model. The proposed new hybrid MCDM model includes Fuzzy FUCOM, CCSD and CRADIS methods. While the subjective weights of the criteria were determined with the fuzzy FUCOM method, the objective weights of the criteria were determined with the CCSD method. Construction materials were listed with the CRADIS method. According to the fuzzy FUCOM method, the most important criterion was determined as the CR3 criterion, while the most important criterion according to the CCSD method was determined as the CR1 criterion. According to the combined weights, the most important criterion was determined as the CR3 criterion. According to the CRADIS method, the material with the best performance was determined as Cement Plaster. The methodology used in this study is a novel approach therefore it has not been used in any study before. In addition, since the CRADIS method is a newly developed MCDM method, the number of articles related to this method is low. Therefore, this research gap will be filled with this study.

Homocysteine is known to be associated with adverse vascular and metabolic effects, as well as pregnancy complications. Its serum levels are influenced by the function of the enzyme methylenetetrahydrofolate reductase (MTHFR) and the dietary intake of folic acid, vitamin B12, and methionine. In this cross-sectional study, we investigated the association of genetic polymorphisms of the MTHFR gene with vitamin status in pregnant women during mandatory folic acid supplementation. The study included 102 pregnant women between 24 and 28 weeks of gestation who were attending regular outpatient examinations at the maternity clinic. Homocysteine, folic acid, vitamin B12 levels, and MTHFR gene polymorphisms (C677T and A1298C) were analyzed. Significant associations were found between vitamin B12 and folic acid levels with homocysteine (P< 0.001), with lower serum levels of these vitamins being associated with higher homocysteine levels. Surprisingly, there was no significant association between MTHFR genetic polymorphisms and serum homocysteine levels, likely attributed to the supplementation of folic acid and vitamin B12 in vitamin supplements for pregnant women, which counteracts the effect of the mutation. Remarkably, a high prevalence of MTHFR gene mutations was found, with the C677T polymorphism present in 56.9% and the A1298C polymorphism in 87.2% of pregnant women. These findings emphasize the importance of adequate folic acid and vitamin B12 intake during pregnancy to regulate homocysteine levels. Although the MTHFR gene mutations were highly prevalent, their influence on homocysteine levels in this population appears to be mitigated by vitamin supplementation. Further research is warranted to explore the impact of these mutations on other aspects of pregnancy outcomes. The trial is registered at Clinicaltrail.gov (NCT04952324).

This paper provides an insight into measuring financial inclusion through a multidimensional index of financial inclusion in Southeast European countries (SEE). We used a two-stage principal component analysis to extract dimensions of financial inclusion. Data were obtained from two sources, the World Bank Global Findex Survey (WB-GFS) data base and the International Monetary Fund Financial Access Survey data (IMF-FAS), for twelve SEE countries for the years 2011, 2014, 2017, and 2021. The research confirms that financial inclusion can be measured using two dimensions in terms of access as one factor and usage and availability as the second factor. Practical implications of this research are in ensuring an adequate measure of the level of financial inclusion for SEE countries that can be used for further research related to understanding the underlying factors contributing to financial inclusion, barriers to financial inclusion as well as the impact of financial inclusion on economic growth and poverty alleviation.

Background: Chest pain represents a prevalent complaint in emergency departments (EDs), where the precise differentiation between acute coronary syndrome and alternative conditions assumes paramount significance. This pilot study aimed to assess the HEART score’s implementation in West Balkan EDs. Methods: A retrospective analysis was performed on a prospective cohort comprising patients presenting with chest pain admitted to EDs in Sarajevo, Zenica, and Belgrade between July and December 2022. Results: A total of 303 patients were included, with 128 classified as low-risk based on the HEART score and 175 classified as moderate-to-high-risk. The low-risk patients exhibited younger age and a lower prevalence of cardiovascular risk factors. Laboratory and anamnestic findings revealed higher levels of C-reactive protein, ALT, and creatinine, higher rates of moderately to highly suspicious chest pain history, a greater number of cardiovascular risk factors, and elevated troponin levels in moderate-to-high-risk patients. Comparatively, among patients with a low HEART score, 2.3% experienced MACE, whereas those with a moderate-to high-risk HEART score had a MACE rate of 10.2%. A moderate-to-high-risk HEART score demonstrated a sensitivity of 91.2% (95%CI 90.2–93.4%) and specificity of 46.5% (95%CI 39.9–48.3%) for predicting MACE. Conclusion: This pilot study offers preliminary insights into the integration of the HEART score within the emergency departments of the West Balkan region.

The Analytic Hierarchy Process (AHP) method is one of the oldest and mostly used multi-criteria decision-making methods. In addition to the development of a large number of other methods, the AHP method is still widely applied. More and more often, this method is being modified by the application of various mathematical tools dealing with the consideration of uncertainty and indeterminacy. This paper presents an approach to the modification of the AHP method using triangular interval fuzzy numbers. In this approach, the confidence interval of the fuzzy number describing the comparison of criteria differs from one comparison to another. It depends on the opinion of the decision makers/experts, respectively, on their certainty in the comparison they make. The modification of the method is presented on the problem of selecting the course of navigation of vessels in flooded areas, based on the risk assessment of each predicted course.

We present eight cases of the homozygous MCPggaac haplotype, which is considered to increase the likelihood and severity of atypical hemolytic uremic syndrome (aHUS), especially in combination with additional risk aHUS mutations. Complement blockade (CBT) was applied at a median age of 92 months (IQR 36–252 months). The median number of relapses before CBT initiation (Eculizumab) was two. Relapses occurred within an average of 22.16 months (median 17.5, minimum 8 months, and maximum 48 months) from the first subsequent onset of the disease (6/8 patients). All cases were treated with PI/PEX, and rarely with renal replacement therapy (RRT). When complement blockade was applied, children had no further disease relapses. Children with MCPggaac haplotype with/without additional gene mutations can achieve remission through renal replacement therapy without an immediate need for complement blockade. If relapse of aHUS occurs soon after disease onset or relapses are repeated frequently, a permanent complement blockade is required. However, the duration of such a blockade remains uncertain. If complement inhibition is not applied within 4–5 relapses, proteinuria and chronic renal failure will eventually occur.

This study investigates the effectiveness of collaborative governance in the context of state and local government responses to the COVID‐19 pandemic in Florida. Our analysis uncovers how local authorities have successfully adapted to implement policies to increase resilience and address the crisis, despite facing challenges, constraints, and limitations. Our findings underscore the significance of considering unique local characteristics when addressing pandemics and shed light on the potential influences of state‐level actors on Home Rule. Notably, research examining the interplay between state decisions and Home Rule during a pandemic is scarce. We utilize Florida as a case study to examine local government responses to COVID‐19, employing a qualitative analysis of data from webinars hosted by the Florida League of Cities and media reports on local government actions. To substantiate our findings and encourage further research, we apply the collaborative governance framework in the context of local government administrative responsibilities.

Arachnoid cysts (AC) are benign, non-neoplastic fluid-filled malformations of the arachnoid tissue. Approximately 50-65% occur in the middle cranial fossa and predominantly on the left side, followed by retrocerebellar and convexity locations. Tremendous development and usage of cross-sectional imaging modalities suggest a higher prevalence of AC than previously thought. Since large arachnoid cysts express mass effect on surrounding neurovascular structures, a surgical approach is preferred to passive observation. Nevertheless, the symptomatology is frequently subjective and difficult to validate, and the causal link between symptoms and an arachnoid cyst is often dubious. Therefore, the operative indication and the best surgical modality for patients with AC remain controversial. Surgical options include opencraniotomy or endoscopic cyst fenestration, cystoperitoneal, cystosubdural, ventriculoperitoneal shunt insertion, or marsupialization via a craniotomy. The complications of these procedures include subdural hematomas, hygromas, hydrocephalus, cerebral edema, postoperative secondary arachnoid cyst, and, more rarely, remote intraparenchymal or subarachnoidal hemorrhage.

On 4 May 2022 the InSight seismometer SEIS‐VBB recorded the largest marsquake ever observed, S1222a, with an initial magnitude estimate of MWMa ${M}_{W}^{\mathrm{M}\mathrm{a}}$ 4.6. Understanding the depth and source properties of this event has important implications for the nature of tectonic activity on Mars. Located ∼37° to the southeast of InSight, S1222a is one of the few non‐impact marsquakes that exhibits prominent surface waves. We use waveform modeling of body waves (P and S) and surface waves (Rayleigh and Love) to constrain the focal mechanism, assuming a double‐couple source, and find that S1222a likely resulted from reverse faulting in the crust (source depth near 22 km). We estimate the scalar moment to be 2.5 × 1015–3.5 × 1015 Nm (magnitude MW 4.2–4.3). Our results suggest active compressional tectonics near the dichotomy boundary on Mars, likely due to thermal contraction from planetary cooling.

Coherence estimation between speech envelope and electroencephalography (EEG) is a proven method in neural speech tracking. This paper proposes an improved coherence estimation algorithm which utilises phase sensitive multitaper cross-spectral estimation. Estimated EEG coherence differences be-tween attended and ignored speech envelopes for a hearing impaired (HI) population are evaluated and compared. Testing was made on 31 HI subjects and showed significant coherence differences for grand averages over the delta, theta, and alpha EEG bands. Significance of increased coherence for attended speech was stronger for the new method compared to the traditional method. The new method of estimating EEG coherence, improves statistical detection performance and enables more rigorous data-based hypothesis-testing results.