Introduction. Bosnia and Herzegovina (B and H) has been recognized for decades as a country with a high risk of diseases caused by hantaviruses.Gap statement. The severe acute respiratory syndrome-associated coronavirus 2 (SARS-CoV-2) pandemic has diverted attention from many pathogens, including hantavirus.Aim. To provide a socio-demographic, temporal, geographical and clinical laboratory overview of the expansion of hantavirus infection cases during the SARS-CoV-2 pandemic in B and H in 2021.Methodology. The RecomLine HantaPlus IgG, IgM immuno-line assay (Mikrogen, Germany) was used to detect IgG and IgM antibodies to hantavirus serotypes in human sera from clinically suspected cases.Results. In 2021 (January-October), the number of confirmed cases of hantavirus infection and tested persons (92/140; 65,71 %) was higher than in the previous 2 years, 2020 (2/20; 10.00 %) and 2019 (10/61; 16.39 %). Most of the infected persons were men (84/92; 91.30 %). Hantavirus infections were recorded from January to October 2021, and the peak was reached in July (25/92; 27.17 %). Six out of 10 cantons in the Federation of Bosnia and Herzegovina (FB and H) were affected, namely Sarajevo Canton, Central Bosnia Canton, Neretva Canton, Zenica-Doboj Canton, Posavina Canton and Bosnian-Podrinje Canton Goražde, in descending order. Of the 38/92 (41.30 %) infected patients with characteristic clinical manifestations of haemorrhagic fever, including renal (mainly) or pulmonary syndrome, 32/92 (34.78 %) were hospitalized in the Clinical Center of the University of Sarajevo. Two cases were detected with dual infection, hantavirus (Puumala) with Leptospira in one and SARS-CoV-2 in another case. The largest number of infections was related to Puumala (PUUV) (83/92; 90.22 %), while the rest of the infections were caused by the hantavirus Dobrava serotype (DOBV).Conclusion. The reported infections were probably caused by exposure of individuals to at-risk areas inhabited by contaminated rodents as natural reservoirs of hantavirus. As a highly endemic area, B and H requires continuous monitoring and increased awareness of this problem.

Abstract The study investigates effectiveness of selected credit related macro prudential instruments in reducing the correlation between economic and credit growth in European emerging countries between 2000 and 2017. Two GMM (Generalized Method of Moments) estimators are used to empirically investigate the validity of tightening policy actions. Although greater attention to MMPs is found in both European regions the study finds some differences as well. On the level of full sample, the findings confirm our expectation about effectiveness of the selected credit related macroprudential instruments in reducing credit growth. More specifically, the European transition countries proved to be more successful in using macroprudential tools in curbing credit growth than European post-transition countries. It is confirmed that all three employed credit related macroprudential instruments play a key role in curbing credit growth in the expansive stage of business cycle in the European transition countries. It means that a lower economic growth leads to lower effects of credit related macroprudential instruments on credit growth. However, empirical evidence from European post-transition countries shows mixed results followed by the lack of robustness of economic results, but with expected theoretical sign. In fact, introduction of CG limits and FC limits reduce the correlation between GDP growth and credit growth only in one step S-GMM estimator, while a variable of caps on debt-to-income ratio (DTI) not.

Soluble-Klotho (sKl) is the shed ectodomain of the transmembrane protein-Klotho (mKl) that exhibits pleiotropic actions, including lifespan extension, mineral metabolism, slowing-down kidney diseases and cardioprotection. The sKl is derived from the kidneys, but what type/s of renal cells secrete it is unknown. Secondly the respective roles of mKl versus sKl in regulating mineral metabolism is unclear due to the lack of appropriate in vivo models. Here, using scRNA-seq of renal distal-convolution (DC) cells, we found an unexpected pattern revealing that Klotho transcripts ( Kl) are moderately expressed in overall distal convoluted tubule (DCT), but highly enriched in the end of DCT and in connecting tubule (CNT). Immunohistochemistry further confirmed this pattern for mKl protein as well. Next, Kl was knocked-out only in renal DC to check if it affects sKl production. Interestingly, deleting Kl in the DCT and late-DCT+CNT in mice showed ~20% and ~80% reduction in sKl levels, respectively. Expectedly, knocking-out Kl along the entire DC in mice (Kl-KODC) abolished sKl levels. Furthermore, we found that compared to control mice, Kl-KODC mice exhibited reduced renal TRPV5-Ca2+ channel expression, profound calciuria, and loss of bone mineral density. The RNA-seq of automated-sorted DC cells from Kl-KODC mice revealed enhanced caveolae-mediated endocytosis of TRPV5. On the other hand, Kl-KODC mice had normal phosphate metabolism as confirmed by unchanged serum FGF23, serum phosphate, urinary phosphate excretion, and renal NaPi-IIa expression. Our findings reveal that a small population of renal DC cells accounts for the sKl levels. The lack of sKl may leads to disturbed Ca2+ homeostasis and bone loss without affecting phosphate balance in mice. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Abstract This paper aims to provide objective quality metrics assessment for cloud gaming using machine learning algorithms. Three classification algorithms (i.e., Random Forest, Random Three and J-48) have been used for the development of models for objective quality assessment of two metrics: blurriness and blockiness. The results indicate that Random Forest has the best performance in this experimental case of objective quality metrics assessment for cloud gaming. Future research activities will cover comparison of a broad range of objective quality metrics and machine learning algorithms while using larger dataset to enhance the results significance.

The polarized massive multiple-input multiple-output (MIMO) technique has been regarded as a promising solution to millimeter wave (mmWave) communication systems, because it experiences more degrees-of-freedom than the scalar configuration, and it represents a significant opportunity for secure communication. To deliver smart service to terminals, it is essential to provide base stations (BS) with the capability of terminal’s direction-of-arrival (DOA) awareness. In this paper, a compressive sampling (CS) framework is proposed for two-dimensional (2D) DOA and polarization estimation in mmWave polarized massive MIMO systems. The proposed approach first reduces the data volume via a reduced-dimension matrix. Then it computes the signal subspace via the eigendecomposition of the compressed array measurement. Thereafter, the rotational invariance characteristic is utilized to form a normalized polarization steering vector. Finally, 2D-DOA and polarization are estimated by incorporating the Poynting vector and the least squares (LS) techniques. The proposed architecture is computationally much more economical than existing algorithms. Besides, it allows a mmWave BS to provide comparable estimation performance with arbitrary sensor geometry, which is more flexible than most of the existing architectures. Furthermore, it is robust to the sensor position error. Numerical simulations verify the advantages of the proposed framework.

Introduction Decompressive craniectomy (DC) can save brain tissue, but unfortunately it has many limitations and complications. Hinge craniotomy (HC), as less aggressive method seems to be adequate alternative not only to DC but also to conservative treatment. Research question Presentation of the results of modified surgical techniques of cranial decompression and comparing with more and less aggressive medical options. Material and methods A prospective clinical study was conducted during 86 months. Comatose patients who suffered refractory intracranial hypertension (RIH) were treated. Altogether, 137 patients have been evaluated. The final outcome of all patients in the study was evaluated after 6 months. Results Both surgical options resulted in adequate control of intracranial pressure (ICP). HC method was shown to have the lowest probability of worsening from a prior state of relative stability. Discussion and conclusion There was no statistically significant difference between methods to treatment of DC or HC, meaning the final outcome of patients treated in any manner. There was similar rate of early and late complications.

The main objective of this review was to investigate whether educational attainment has an impact on the occurrence of atrial fibrillation (AF) as well as the implementation of smart technology to detect this condition. Data on the relationship between education level and the occurrence of AF were collected, as well as data on smart devices for detecting AF. A lower level of education has been linked to an increased risk of AF. With this in mind, it is easy to explain the clear correlation between education level and AF, as well as the adoption of smart device detection and how it may improve illness prognosis. People with a higher level of education understand and embrace the notion of employing smart devices to detect and prevent AF; they also have decreased AF prevalence compared with those with a lower level of education.

(1) Background: This study evaluates the effect of a conventional/low-voltage light-curing protocol (LV protocol) (10 s with 1340 mW/cm2) and high-voltage light-curing protocol (HV protocol) (3 s with 3440 mW/cm2) on the microhardness (MH) of dental resin-based composites (RBCs). Five resin composites were tested: conventional Evetric (EVT), Tetric Prime (TP), Tetric Evo Flow (TEF), bulk-fill Tetric Power Fill (PFL), and Tetric Power Flow (PFW). (2) Materials and Methods: Two tested composites (PFW and PFL) were designed for high-intensity light curing. The samples were made in the laboratory in specially designed cylindrical molds; diameter = 6 mm and height = 2 or 4 mm, depending on the type of composite. Initial MH was measured on the top and bottom surfaces of composite specimens 24 h after light curing using a digital microhardness tester (QNESS 60 M EVO, ATM Qness GmbH, Mammelzen, Germany). The correlation between the filler content (wt%, vol%) and the MH of the RBCs was tested. For the calculation of depth-dependent curing effectiveness, the bottom/top ratio for initial MH was used. (3) Conclusions: MH of RBCs is more dependent on material composition than on light-curing protocol. Filler wt% has a greater influence on MH values compared to filler vol%. The bottom/top ratio showed values over 80% for bulk composites, while for conventional sculptable composites, borderline or suboptimal values were measured for both curing protocols.

Nearby lightning strokes are often considered as a prime source of transient overvoltages in the substations. Lightning overvoltages can cause unreliable operation of power system and power supply interruptions. Calculation of expected lightning overvoltages is necessary to design appropriate protection system. This paper presents the analysis of the lightning overvoltage performance of real 400 kV overhead transmission line and gas insulated substation (GIS), considering various factors, such as lightning stroke locations, peak currents, front rise times, etc. EMTP-RV software was used to model transmission line and substation elements and conduct simulations, while transmission line lightning performance was determined using Sigma Slp software. The expected overvoltages and surge arrester currents are calculated and used to design lightning protection system of the considered substation. Obtained results also indicate the importance of proper modelling of power system elements and lightning strokes.

(1) Background: Viral hepatitis C (HCV) and viral hepatitis B (HBV) are common co-infections in people living with HIV (PLWH). All PLWH should be vaccinated against HBV and hepatitis A (HAV) and treated for HBV and HCV. We aimed to compare testing, prophylaxis and treatment of viral hepatitis in PLWH in Central and Eastern Europe (CEE) in 2019 and 2022. (2) Methods: Data was collected through two on-line surveys conducted in 2019 and 2022 among 18 countries of the Euroguidelines in CEE (ECEE) Network Group. (3) Results: In all 18 countries the standard of care was to screen all PLWH for HBV and HCV both years; screening of HAV was routine in 2019 in 54.5% and in 2022 47.4% of clinics. Vaccination of PLWH against HAV was available in 2019 in 16.7%, in 2022 in 22.2% countries. Vaccination against HBV was available routinely and free of charge in 50% of clinics both in 2019 and 2022. In HIV/HBV co-infected the choice of NRTI was tenofovir-based in 94.4% of countries in both years. All clinics that responded had access to direct-acting antivirals (DAAs) but 50% still had limitations for treatment. (4) Conclusions: Although testing for HBV and HCV was good, testing for HAV is insufficient. Vaccination against HBV and especially against HAV has room for improvement; furthermore, HCV treatment access needs to overcome restrictions.

Introduction The World Health Organization (WHO) Surgical Safety Checklist is a tool developed by the WHO to promote safer surgical practices and reduce the incidence of surgical errors and complications. This study aims to describe the role of assistant nurses in the implementation of this checklist by surgical teams. Materials and methods This descriptive study utilized a questionnaire-based survey conducted between September 2018 and March 2019 among 196 healthcare professionals at two surgical units in a university hospital in Sweden. The questionnaire covered demographic information such as age, gender, and occupation, as well as details about their workplace, experience, education/training on using the WHO checklist, the adaptation of the checklist to their department, their responsibilities in implementing and using the checklist, the frequency of use in emergency situations, and the impact on patient safety. Results The results of the study showed that assistant nurses, despite having the lowest level of education among healthcare professionals, were highly trusted and valued by other members of the surgical team. Most healthcare professionals were unsure who was responsible for using the WHO checklist but believed it was the assistant nurse's responsibility to ensure its implementation. Assistant nurses reported little to no training on using the checklist but noted that it had been adapted to the department's needs. Almost half (48.8%) of assistant nurses believed that the checklist was often used in emergency surgery, and most believed that it improved patient safety. Conclusions Improved understanding of the significance of assistant nurses in implementing the WHO Surgical Safety Checklist may enhance adherence to the checklist and potentially improve patient safety, as they were the most valued and trusted healthcare professionals in the surgical team according to the study's findings.

INTRODUCTION Sodium-glucose cotransporter-2 (SGLT2) inhibitors are integral in treating patients with heart failure, regardless of the existence of diabetes mellitus. In light of their benefits on the heart muscle, the question of their effect on acute coronary syndrome is raised, and a hypothesis as to whether they can be implemented in its treatment is proposed. The aim of the article was to indicate the potential of using SGLT2 inhibitors in the treatment of myocardial infarction (MI). EVIDENCE ACQUISITION A PubMed search for articles published between October 2017 and May 2022 was conducted using the following keywords: "SGLT2 inhibitors," "Acute Coronary Syndrome," "Treatment," "Prognosis." Reference lists of identified articles were searched for further articles. EVIDENCE SYNTHESIS Reports from clinical trials and animal studies thus far investigating mechanistic pathways of SGLT2 inhibitors' effect in relation to acute myocardial infarction were interplayed to extract relevant findings and analyze the safety of this therapy in acute coronary syndrome (ACS) patients. CONCLUSIONS SGLT2 inhibitors indicate beneficial effects in acute cardiovascular incident by various mechanisms, and early initiation of therapy may improve outcomes for AMI survivors.