Background The incidence of the signs and symptoms of acute pulmonary embolism (PE) according to mortality risk, age and sex has been partly explored. Patients and methods A total of 1242 patients diagnosed with acute PE and included in the Regional Pulmonary Embolism Registry were enrolled in the study. Patients were classified as low risk, intermediate risk or high risk according to the European Society of Cardiology mortality risk model. The incidence of the signs and symptoms of acute PE at presentation with respect to sex, age, and PE severity was investigated. Results The incidence of haemoptysis was higher in younger men with intermediate-risk (11.7% vs 7.5% vs 5.9% vs 2.3%; p=0.01) and high-risk PE (13.8% vs 2.5% vs 0.0% vs 3.1%; p=0.031) than in older men and women. The frequency of symptomatic deep vein thrombosis was not significantly different between subgroups. Older women with low-risk PE presented with chest pain less commonly (35.8% vs 55.8% vs 48.8% vs 51.9%, respectively; p=0.023) than men and younger women. However, younger women had a higher incidence of chest pain in the lower-risk PE group than in the intermediate-risk and high-risk PE subgroups (51.9%, 31.4% and 27.8%, respectively; p=0.001). The incidence of dyspnoea (except in older men), syncope and tachycardia increased with the risk of PE in all subgroups (p<0.01). In the low-risk PE group, syncope was present more often in older men and women than in younger patients (15.5% vs 11.3% vs 4.5% vs 4.5%; p=0.009). The incidence of pneumonia was higher in younger men with low-risk PE (31.8% vs<16% in the other subgroups, p<0.001). Conclusion Haemoptysis and pneumonia are prominent features of acute PE in younger men, whereas older patients more frequently have syncope with low-risk PE. Dyspnoea, syncope and tachycardia are symptoms of high-risk PE irrespective of sex and age.

This paper deals with safe human-robot collaboration in the context of speed and separation monitoring paradigm. The core of the approach is to continuously track the separation distance between the robot and the human. The robot speed is then adjusted according to the perceived distance so that it will be able to stop before eventually come into contact with the human. We present an approach that aims at maximizing the productivity of the robot, i.e., its speed, while keeping the prescribed safety requirements satisfied. The method is based on explicit representation of danger zones – regions around the robot, where safety requirements are violated. The motion is then generated such that the robot moves as fast as possible, while its danger zone still does not collide with human operators. The approach is validated within an experimental study. Note to Practitioners—This article was motivated by the problem of maximizing productivity of the robotic manipulator while ensuring the safety of human collaborator. The increase in productivity is achieved by a faster traversal of predefined paths without compromising the safety of the human, which is specifically defined by industrial standard. The approach requires limited knowledge on robot’s dynamical properties. More precisely, we only need the braking time as a “lumped” representation of robot’s inertia. The underlying optimization problem is conveniently resolved by introducing danger zones that allow for intuitive visualization and geometrical representation of the regions around the robot that must be avoided. On the other hand, the method assumes the representation of humans via typical geometric primitives, which can be obtained using of-the-shelf depth perception systems. The solution to the problem reduces to a repeated collision checking between danger zones and the human. Such an approach turns out to be suitable for real-time implementation due to availability of fast and efficient collision checking algorithms/libraries.

Background: Heart failure remains one of the most prevalent clinical syndromes associated with significant morbidity and mortality. According to current guidelines, the prescription of a MRA is recommended to reduce the risk of HF hospitalization and death in all patients with symptomatic heart failure and no contraindications for this therapy. Objective: The aim of our study was to determine the efficacy of eplerenone vs. spironolactone on left ventricular systolic function by measuring left ventricle ejection fraction (LVEF) in patients with chronic heart failure, especially their effect on preventing hospitalization, reducing mortality, and improving clinical status among patients with chronic HF. Methods: From June 2021 to June 2022, the study was a randomized, prospective clinical trial single blind study. A total of 142 patients of chronic heart failure with reduced ejection fraction were selected by random sampling. Each patient was randomly allocated into either of the two groups and was continued receiving treatment with either spironolactone (Spiron-HF group) or eplerenone (Epler-HF group). Patients in Epler-HF group were compared with an arm of the same size and matched by age and gender patients in Spiron-HF group for management of chronic HFrEF. Each patient was evaluated clinically, biochemically, and echocardiographically at the beginning of treatment (baseline) after 6 months and at the end of 12th month. Echocardiography was performed to find out change in left ventricular systolic function. Results: After 12 months of treatment, significant improvement of left ventricular ejection fraction was observed in eplerenone treated arm (37.9 ± 3.8 ± 4.6 in Spiron-HF group versus 40.1 ± 5.7 in Epler-HF group; P < 0.05). A significant reduction in left ventricular end-systolic volume (6.3 ± 2.5ml in Spiron-HF versus 17.8± 4.4ml in Epler-HF group; P < 0.05) and left ventricular systolic diameter volume (2.7 ± 0.5ml in Spiron-HF versus 6.7 ± 0.2ml in Epler-HF group; P < 0.05), occurred after 12 months of treatment. Left ventricular global longitudinal strain (LV GLS) was significantly improved in Epler-HF group compared with Spiron-HF group (0.6 ± 0.4 versus 3.4 ± 0.9; P < 0.05). There were no significant differences observed in reduction of left ventricular end-diastolic volume (2.2 ± 0.5 ml versus 4.7 ± 1.1ml; P =0.103) and left ventricular diastolic diameter (1.2 ± 0.6 versus 1.7 ± 0.3; P=0.082) in both arms. The effects of both MRA agents spironolactone and eplerenone on the primary composite outcome, each of the individual mortality and hospital admission outcomes are shown in Figure 1 and 2. Patients of the Epler-HF group showed statistically significant lower cardiovascular mortality (HR 0.53; 95% CI 0.34–0.82; p= 0.007) and all-cause mortality (HR 0.64; 95% CI 0.44–0.93; p= 0.022) than patients of the Spiron-HF group. The statistical analysis did not show a statistically significant difference between Epler -HF and Spiron-HF study groups regarding the risk of the primary composite outcome; cardiovascular death or hospitalization due to HF (Hazard Ratio (HR) eplerenone vs. spironolactone = 0.95; 95% Confidence Interval (CI) 0.73– 1.27; p= 0.675). Conclusion: Our study has demonstrated favorable effects of eplerenone on cardiac remodeling parameters and reduction of cardiovascular mortality and all-cause mortality compared with spironolactone in the treatment of HFrEF. The ability of eplerenone to effectively block the mineralocorticoid receptor while minimizing side effects and a significant reduction in the risk of hospitalization and cardiovascular death confirms its key role in the treatment of patients with chronic HFrEF.

Background: Schizophrenia is chronic and debilitating psychiatric disorder, characterized by a constellation of clinical signs and symptoms that are categorized into distinct positive, negative, disorganization and cognitive symptom domains. The outcome of the disease is better in female patients compared to male patients who have a higher risk of rehospitalization and twice as long duration of hospital treatment. In male patients with schizophrenia an earlier onset of the disease, negative symptoms and a more severe clinical picture are noted, with a less promising therapeutic response to neuroleptics. The onset of negative symptoms is more variable. Objective: The aim of the study was to determine the correlation of positive and negative symptoms (PANSS scores) in patients with schizophrenia according to gender. Methods: The sample included 40 subjects with schizophrenia (21 males; 19 females). The study was conducted at the Department of Psychiatry Clinical Center University of Sarajevo. Results: All male subjects have a PANSS negative symptoms score of 17 or higher, while all female subjects have a PANSS negative symptoms score of less than 17. While the difference in the variances is not statistically significant, the results show that the difference in the average values of the PANSS symptom score between male and female subjects is statistically significant for both positive and negative symptoms (p=0.026). Conclusion: Diminished sociality, emotional responsiveness, and drive during childhood have been reported in a substantial minority of patients with schizophrenia. This aspect of the illness may account for the low level of emotional expression and neuromotor dysfunction in infants who subsequently have schizophrenia. In other patients, the negative symptoms first occur after the onset of psychosis.

the milk of control and α-linolenic (1.90%) of milk experimental group of sheep were the most prevalent in the winter. The lowest ratio of omega-6/omega-3 fatty acids in sheep's milk was achieved in the period of feeding sheep with old grass (July), 1.46% in the milk of the experimental group of sheep that were fed with concentrates in which omega-3 preparations were added.

We present a singular perturbation theory applicable to systems with hybrid boundary layer systems and hybrid reduced systems {with} jumps from the boundary layer manifold. First, we prove practical attractivity of an adequate attractor set for small enough tuning parameters and sufficiently long time between almost all jumps. Second, under mild conditions on the jump mapping, we prove semi-global practical asymptotic stability of a restricted attractor set. Finally, for certain classes of dynamics, we prove semi-global practical asymptotic stability of the restricted attractor set for small enough tuning parameters and sufficiently long period between almost all jumps of the slow states only.

Encouraged by increasing public and scientific attention, research has made great strides in recent years to improve our understanding of sexting. However, despite these advances, scientifically based and evaluated prevention strategies are not available and are still in development. There is a need to design sexting prevention strategies in order to implement and evaluate them. For this reason, we have developed a comprehensive sexting prevention program, the background, structure, content, and future evaluation of which are presented in this paper. We have proposed a program that needs to be evaluated to train psychologists, parents, and students in order to prevent the negative consequences of sexting and to develop resources for dealing with it.

Introduction. Despite the fact that error correction has significant and long-term effects on facilitating language learning and development, there has not been any research that investigates its influence on learners' motivation within the classroom context of Bosnia and Herzegovina. Purpose. This research aims to examine the impact of written and oral corrective feedback on students' motivation and achievement within this EFL context. Method. For this quantitative study, the questionnaire has been used to collect the data from 160 middle and high school students in central Bosnia and Herzegovina. Results. The findings indicated that the respondents generally like to be corrected and they are moderately to highly motivated to speak and write in English as a foreign language. Furthermore, learners with positive attitudes towards the received feedback feel significantly more motivated to keep learning than those with negative attitudes. Conclusion. The study is expected to provide teachers with suggestions on how to transform their classrooms into an environment conducive to the development of higher levels of writing and speaking motivation and how to provide corrective feedback that will positively influence students' EFL achievement.

An investigation using various methods reports an association between adeno-associated virus 2 and paediatric hepatitis of unknown aetiology. Since its first identification in Scotland, over 1,000 cases of unexplained paediatric hepatitis in children have been reported worldwide, including 278 cases in the UK^ 1 . Here we report an investigation of 38 cases, 66 age-matched immunocompetent controls and 21 immunocompromised comparator participants, using a combination of genomic, transcriptomic, proteomic and immunohistochemical methods. We detected high levels of adeno-associated virus 2 (AAV2) DNA in the liver, blood, plasma or stool from 27 of 28 cases. We found low levels of adenovirus (HAdV) and human herpesvirus 6B (HHV-6B) in 23 of 31 and 16 of 23, respectively, of the cases tested. By contrast, AAV2 was infrequently detected and at low titre in the blood or the liver from control children with HAdV, even when profoundly immunosuppressed. AAV2, HAdV and HHV-6 phylogeny excluded the emergence of novel strains in cases. Histological analyses of explanted livers showed enrichment for T cells and B lineage cells. Proteomic comparison of liver tissue from cases and healthy controls identified increased expression of HLA class 2, immunoglobulin variable regions and complement proteins. HAdV and AAV2 proteins were not detected in the livers. Instead, we identified AAV2 DNA complexes reflecting both HAdV-mediated and HHV-6B-mediated replication. We hypothesize that high levels of abnormal AAV2 replication products aided by HAdV and, in severe cases, HHV-6B may have triggered immune-mediated hepatic disease in genetically and immunologically predisposed children.