Introduction. Although inguinal hernia surgery is the most common surgical procedure worldwide, the best surgical method is still not universally accepted. The Lichtenstein technique is considered the gold standard, although it also has its limitations. Therefore, there is still a need for new techniques, such as the Desarda technique. The aim of this article is to evaluate and compare the postoperative morbidity of two tension-free techniques for inguinal canal pla-stic surgery with and without the use of mesh. Methods. This prospective randomized clinical study was conducted at the Clinic for General and Abdominal Surgery of the Clinical Center of the University of Sarajevo from January 2017 to December 2022. The study included 60 patients with primary inguinal hernia who met the predefi ned inclusion and exclusion criteria and were randomly allocated into two equal groups: 30 patients operated on by the Desarda technique and 30 patients operated on by the Lichten-stein technique. Results: The following parameters showed a statistically signifi cant diff erence in favor of the Desarda operative technique: shorter hospitalization, lower level of postoperative pain, faster achievement of early physical activity, lesser amount of analgesic consumption, earlier return to regular daily and work activities, and absence of chronic inguinal pain. Postoperative morbidity was more frequent in the Lichtenstein group, but likely due to the small sample size, this diff e-rence remained statistically insignifi cant. Conclusion: Patients operated on by the Desarda method exhibited signifi cantly lower levels and frequencies of postoperative pain, faster postoperative recovery, and return to usual daily and work activities.

Prostate cancer (PC) is one of the most commonly diagnosed malignancies worldwide and the second leading cause of mortality among men (1). Nowadays, radical prostatectomy is considered the primary therapeutic modality for treating patients with localized PC (stage pT2), providing a five-year survival rate of nearly 100% (2). Sexual dysfunction in men associated with PC treatment encompasses three distinct entities: erectile dysfunction (ED) and penile shortening; ejaculatory and orgasmic dysfunction; and psychosexual dysfunction, which pertains to sexual desire, intimacy, and mental health (3). Penile rehabilitation (PR) is defined as the use of any intervention or combination of procedures aimed not only at achieving an erection sufficient for satisfactory sexual intercourse but also at restoring erectile function to its preoperative level (4). Despite eff orts to preserve the neurovascular bundle during radical prostatectomy, ED remains a common outcome. Although prevalence rates of ED after the procedure vary widely, recent studies report rates as high as 85% (5). This is primarily due to the lack of control over factors that significantly influence the erection recovery, such as the patient’s age, preoperative erectile function, comorbidities, surgical approach (open, laparoscopic, or robot-assisted), surgical technique (non-, uni-, or bilateral nerve-sparing), and the surgeon’s skills and experience. The pathophysiology of postoperative ED is multifactorial. The primary mechanisms are believed to be damage to the cavernous nerves, whether through dis-section or neuropraxia, and vascular injury, which includes damage to the accessory pudendal arteries, hypoxia and fibrosis of the endothelium and smooth muscle, resulting in penile shortening (6-8). Although there is no consensus on the optimal approach to PR, accepted modalities include the use of phosphodiesterase type 5 inhibitors (PDE-5i; such as sildenafil, vardenafil, tadalafil) and vacuum erection de-vices (VED) or vacuum constriction devices (VCD) as first-line therapies. Second-line treatments involve prostaglandin E1 preparations for intracavernous, or intraurethral (MUSE – “Medicated Urethral System for Erection”) administration. The final therapeutic option is the implantation of penile prostheses (3-10).

The tendency to abolish, to obtain heat from coal in order to reduce atmospheric pollution, leads to the closure of coal deposits. The alternative for obtaining heat, especially in the category of heating smaller residential buildings, with wood pellets, although acceptable from an ecological point of view, has its drawbacks, if one takes into account the scale of the required amount of energy and the role of the forest in purifying the air. Wood pulp and coal as basic energy carriers have hydrocarbon compounds. So, in both cases COx and NOx gases appear as gaseous products. The difference is in their scale. Unlike wood, coal also contains sulfur compounds, which makes it an environmentally unacceptable fuel. By adding a certain amount of wood pulp and additives to the coal mass, in this work, pyrophyllite shale, the impact on the energy and ecological aspects of heat release of such a complex fuel mixture was investigated. The ecological aspect is accentuated through the release of sulfur from coal. The mixture was subjected to the briquetting process, and the obtained samples were tested with relevant parameters, primarily the obtained lower heat value and sulfur content (SOx) in these products. The obtained results are very optimistic with both parameters mentioned above and can be a guide for further research for this idea. Key words: coal, wood sawdust, briquette, calorific value, sulfur, ecology.

Background: After introducing interleukin(IL)-1/IL-6 inhibitors, some Still and Still-like patients developed unusual often fatal pulmonary disease. This complication was associated with scoring as DReSS (drug reaction with eosinophilia and systemic symptoms) implicating these inhibitors, although DReSS can be difficult to recognize in the setting of systemic inflammatory disease. Objective: We sought to facilitate recognition of IL-1/IL-6 inhibitor-DReSS in systemic inflammatory illnesses (Still/Still-like) by looking at timing and reaction-associated features. We evaluated outcomes of stopping or not-stopping IL-1/IL-6-inhibitors after DReSS reaction began. Methods: In an international study collaborating primarily with pediatric specialists, we characterized features of 89 drug-reaction cases versus 773 drug-exposed controls and compared outcomes of 52 cases stopping IL-1/IL-6-inhibitors to 37 cases not-stopping these drugs. Results: Before reaction began, drug-reaction cases and controls were clinically comparable, except for younger disease onset age for reaction cases with pre-existing cardiothoracic comorbidities. After reaction began, increased rates of pulmonary complications and macrophage activation syndrome (MAS), differentiated drug-reaction cases from drug-tolerant controls (p=4.7×10−35; p=1.1×10−24, respectively). Initial DReSS feature was typically reported 2–8 weeks after initiating IL-1/IL-6-inhibition. In drug-reaction cases stopping versus not-stopping IL-1/IL-6-inhibitor treatment, reaction related features were indistinguishable, including pulmonary complication rates [75%(39/52] versus [76%(28/37)]. Those stopping subsequently required fewer medications for treatment of systemic inflammation, had decreased rates of MAS, and improved survival (p=0.005, multivariate regression). Resolution of pulmonary complications occurred in 67%(26/39) of drug-reaction cases who stopped and in none who continued inhibitors. Conclusions: In systemic inflammatory illnesses, recognition of IL-1/IL-6-inhibitor-associated reactions followed by avoidance of IL-1/IL-6-inhibitors significantly improved outcomes.

In this paper, we find out the cosine operator functions \begin{equation*}C(t)=\begin{bmatrix}a(t) & b(t) & c(t) \\0 & d(t) & e(t) \\0 & 0 & f(t)\end{bmatrix}\end{equation*}in a real vector space \(\mathbb{R}^3 \, ( t\in \mathbb{R})\), as the solutions of the second order Cauchy problem\begin{equation*}C''(t)=\mathcal{A}\cdot C(t),\, C(0)=I, \, C'(0)=0.\end{equation*} We find the solutions for the various cases of a given real matrix \begin{equation*}\mathcal{A}=\begin{bmatrix}A & B & C \\0 & D & E \\0 & 0 & F\end{bmatrix},\end{equation*} which is a generator of these cosine operator functions \(C(t), \, t\in \mathbb{R}\).

Detection of extranodal extension on histopathology in surgically treated head and neck squamous cell carcinoma indicates poor prognosis. However, there is no consensus on the diagnostic criteria, interpretation, and reporting of histology detected extranodal extension, which has contributed to conflicting evidence in the literature, and likely clinical inconsistency. The Head and Neck Cancer International Group conducted a three-round modified Delphi process with a group of 19 international pathology experts representing 15 national clinical research groups to generate consensus recommendations for histology detected extranodal extension diagnostic criteria. The expert panel strongly agreed on terminology and diagnostic features for histology detected extranodal extension and soft tissue metastasis. Moreover, the panel reached consensus on reporting of histology detected extranodal extension and on nodal sampling. These consensus recommendations, endorsed by 19 organisations representing 34 countries, are a crucial development towards standardised diagnosis and reporting of histology detected extranodal extension, and more accurate data collection and analysis.

This paper presents a full degrees-of-freedom (DOFs) robust control design for a nonlinear quadrotor unmanned aerial vehicle (UAV) operating under bounded disturbances. Second-order sliding modes controllers (SOSMCs) are designed so that the quadrotor UAV can follow a 3D trajectory in the presence of model uncertainties, underactuation, as well as external disturbances that may be matched or mismatched, and vanishing or nonvanishing. The stability analysis of the closed-loop system is presented via the Lyapunov method, showing the finite-time convergence of the system trajectories to the sliding surfaces, as well as the finite-time convergence of the quadrotor position and attitude to their reference values. The high-gain adaptation (HGA) method is adopted in the SOSMC technique, called SOSMC-HGA, to alleviate the chattering phenomenon. Simulation studies in different scenarios demonstrate that the SOSMC technique exhibits superior tracking performance and robustness properties compared to concurrent control methods for tracking reference trajectories of quadrotor UAVs. The simulation results confirm that SOSMC-HGA significantly attenuates the chattering phenomenon in control signals and system states, which is an important improvement, as it increases the safety of UAVs and reduces power consumption.

Quantum Key Distribution (QKD), a novel secret key agreement primitive, enables long-awaited practical Information-Theoretical Security (ITS). Over the last two decades, academic and industrial communities have devoted their time and resources to developing QKD- based networks that distribute ITS keys to remote parties. However, because of the limited availability of QKD network testbeds to the larger research community and the difficulty and cost of their deployment, progress in this area has been noticeably slow. To that end, we provide an analysis of selected simulated use-cases from the EU H2020 OPENQKD project using the QKDNetSim network simulator. The tool has been extensively upgraded to test novel network management methodologies applied to large-scale QKD networks.

In this case report, we describe the diagnostic modality of sinus of Valsalva aneurysm (SOVA) in combination with congenital cardiac defect, aortic valve involvement, and conduction abnormality in a 19-year-old patient. Aim of article was to understand the importance of clinicians being cautious about SOVA presenting in young patients, despite cases being rare, and that SOVA requires a thorough SOVA diagnostic approach. We further provide a review of literature highlighting and comparing the treatment options for both unruptured and ruptured SOVAs. The patient presented for examination due to tachycardia and palpitations. A murmur was heard, and the patient was found to have an atrioventricular nodal reentry tachycardia. Echocardiographic evaluation, magnetic resonance imaging, and computed tomography angiography confirmed an aneurysmally dilated aortic root, aortic regurgitation, and ventricular septal defect. Surgical intervention was indicated; however, the patient refused to undergo surgery.