Percolation model with nucleation and object growth is studied by Monte Carlo simulations on a triangular lattice with point-like impurities. Growing objects are needle-like objects and self-avoiding random walk chains. In each run through the system the lattice is initially randomly occupied by point-like impurities at given concentration ρimp . Then the seeds for the object growth are randomly distributed at given concentration ρ. The percolation properties and the jamming densities are compared for the two classes of growing objects on the basis of the results obtained for a wide range of densities ρ and ρimp up to the percolation threshold for the monomer deposition on a triangular lattice. Values of the percolation thresholds θp∗ have lower values for the needle-like objects than for the self-avoiding random walk chains. The difference is largest for the lowest values of ρ and ρimp , and ceases near the values of the site percolation threshold for monomers on the triangular lattice, ρp∗≃0.5 . Values of the jamming coverage θJ decrease with ρimp for given ρ. This effect is more prominent for the growing random walk chains.

Aim To determine an outcome of acute kidney injury (AKI) in critically ill children (CIC) who needed renal replacement therapy (RRT) and were admitted to the Paediatric and Neonatal Intensive Care Unit (PICU and NICU) at the Paediatric Clinic, University Clinical Centre Sarajevo (UCCS). Methods The research included 81 children with AKI. The Kidney Disease: Improving Global Outcomes (KDIGO) criteria to define AKI was used. Other laboratory findings and imaging tests were made depending on children's primary disease that led to the AKI. Results Among 81 children with AKI, 38 were girls and 43 boys. A total of 39 (48.1%) patients died; the death was due to the nature of the primary disease and multiple organ failure syndromes. Out of the total of 81 patients the highest mortality rate was found in children in the first year of life, 22 (56.4%), while 17 (43.6%) patients died after the first year of life. Conclusion Without an accurate diagnosis at the right time, due to the lack of adequate biomarkers for AKI screening, the heterogeneity of AKI, comorbidities often lead to unfavourable outcomes of the disease, among CIC, especially in infants with low birth weight and extreme immaturity. Some causes of AKI are preventable and can be reduced by a better organization of primary and secondary health care.

The aims of this study were to analyze the utilization of antibiotics before (2018, 2019) and during the COVID-19 pandemic (2020) and the practice of prescribing antibiotics in outpatient settings for COVID-19 patients during the 2020–2022 period. The Anatomical Therapeutic Chemical Classification/Defined Daily Dose methodology was used for the analysis of outpatient antibiotic utilization in the Republic of Srpska. The data was expressed in DDD/1000 inhabitants/day. The rate of antibiotics prescribed to COVID-19 outpatients was analyzed using medical record data from 16,565 patients registered with B34.2, U07.1, and U07.2 World Health Organization International Classification of Diseases 10th revision codes. During 2020, outpatient antibiotic utilization increased by 53.80% compared to 2019. At least one antibiotic was prescribed for 91.04%, 83.05%, and 73.52% of COVID-19 outpatients during 2020, 2021, and the first half of 2022, respectively. On a monthly basis, at least one antibiotic was prescribed for more than 55% of COVID-19 outpatients. The three most commonly prescribed antibiotics were azithromycin, amoxicillin/clavulanic acid, and doxycycline. The trend of repurposing antibiotics for COVID-19 and other diseases treatment might be a double-edged sword. The long-term effect of this practice might be an increase in antimicrobial resistance and a loss of antibiotic effectiveness.

We aimed to investigate expression of the novel susceptibility genes for CAKUT, DLG1 and KIF12, proposed by a systematic in silico approach, in developing and postnatal healthy human kidneys to provide information about their spatiotemporal expression pattern. We analyzed expression of their protein products by immunohistochemistry and immunofluorescence and quantified relative mRNA levels by RT-qPCR. Statistically significant differences in expression patterns were observed between certain developmental stages. Strong expression of DLG1 was observed in the developing kidney, with a gradual decrease from the first phase of kidney development (Ph1) until the third phase (Ph3), when most nephrons are formed; at later stages, the highest expression was observed in the tubules. KIF12 was highly expressed in the developing structures, especially in Ph1, with a gradual decrease until the postnatal phase, which would indicate a significant role in nephrogenesis. Co-localization of DLG1 and KIF12 was pronounced in Ph1, especially on the apical side of the tubular epithelial cells. Thereafter, their expression gradually became weaker and was only visible as punctate staining in Ph4. The direct association of DLG1 with KIF12 as control genes of normal kidney development may reveal their new functional aspect in renal tubular epithelial cells.

Background: After successful reperfusion is achieved (extended Thrombolysis in Cerebral Infarction (eTICI) ≥2b50), decision on pursuing additional treatment strategies in order to achieve complete reperfusion (eTICI=2c/3), is multifactorial and depends on patient’s clinical and imaging characteristics. We have developed and validated a clinical decision tool to provide individualized predictions on achieving delayed reperfusion based on individual patient data. Methods: Single-center registry analysis for all consecutive patients admitted between 02/2015 - 12/2020. Primary variable of interest was perfusion imaging outcome in patients with incomplete reperfusion (eTICI 2a-2c), evaluated on the 24-hour follow-up imaging. This variable was dichotomized into delayed reperfusion, in case of non-observable perfusion deficit, and persistent perfusion deficit, in case of perfusion deficit captured on the final angiography imaging. Final model variable selection was performed via bootstrapped (n=200) stepwise backwards regression. Model was split into a training and testing set (80:20 ratio), with 10-fold cross validation resampling. Results: 372 patients (50.8% female, mean age 74) were included, with 228 (61.2%) of them having delayed reperfusion. Final model identified seven variables of importance including: age, sex, atrial fibrillation, Intervention-to-Follow-Up time, maneuver count, eTICI and collateral status. Model’s discriminative ability for predicting delayed reperfusion was adequate (AUC 0.83, 95% CI 0.74 -0.92), with an overall adjusted calibration (Brier score 0.17, 95% CI 0.15-0.18). Conclusions: Current model presents a tool that may aid clinical decision-making process in selection of patients for pursuing additional treatment strategies after incomplete reperfusion has been achieved. This is an important next step towards personalized treatment of stroke patients undergoing mechanical thrombectomy.

Background: One potential benefit of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT) is pre-interventional reperfusion. Currently, there is a paucity of data regarding the occurrence of pre-interventional reperfusion in patients randomized to IVT or no-IVT before MT. Methods: SWIFT DIRECT was a randomized controlled trial including acute ischemic stroke IVT-eligible patients being directly admitted to a comprehensive stroke center, with allocation to either MT alone or IVT + MT. Primary endpoint of this analysis was the occurrence of pre-interventional reperfusion defined as pre-interventional expanded Thrombolysis in Cerebral Infarction score ≥2a. The effect of IVT and potential treatment effect heterogeneity were analyzed using logistic regression analyses. Results: Out of the 396 patients analyzed, pre-interventional reperfusion occurred in 20 (10.0%) of patients randomized to IVT+MT, and 7 (3.6%) of patients randomized to MT alone. Receiving IVT favored the occurrence of pre-interventional reperfusion (aOR 2.91 [95% CI 1.23 - 6.87]). There was no IVT treatment effect heterogeneity on the occurrence of pre-interventional reperfusion with different strata of Randomization-to-Groin-Puncture (p for interaction=0.33), although the effect tended to be stronger in patients with Randomization-to-Groin-Puncture >28 minutes (aOR 4.65 [95% CI 1.16 - 18.68]). There were no significant difference in rates of functional outcomes between patients with and without pre-interventional reperfusion. Conclusion: Even for patients with proximal large vessel occlusions and direct access to MT, IVT leads towards an absolute increase of 6.9% (95% CI 1.7-12.2%) in the rates of pre-interventional reperfusion. The effect of IVT tended to be more pronounced when Randomization-to-Groin-Puncture intervals were longer, but this heterogeneity did not reach statistical significance.

Production enterprises are enterprises that produce goods or services that aim to meet human needs such as machinery-equipment materials and labour. In order for a manufacturing enterprise to carry out its activities successfully, it must make the right choice when choosing its inputs. The correct execution of production activities and the selection of machinery, which requires high capital investments, also affect the efficiency of the enterprises, the correct use of materials and their costs. Therefore, it is an important decision for business managers to choose the right machine. At this stage, multi-criteria decision making (MCDM) methods are used for choosing the right machine. MCDM methods are methods used in the evaluation of alternatives using more than one criterion. In addition, the MCDM method is used in machine selection as well as in many areas. In this study, PSI, SV and MARCOS methods, which are among the MCDM methods, were used for peanut butter machine selection. First, the criteria and alternatives to be used for the peanut butter machine selection were determined by interviewing a peanut butter factory manager. In the study, while the criteria weights were determined, PSI and SV methods were used, while the machines were ranked with the MARCOS method. In addition, the MARCOS method was compared with other MCDM methods such as PIV, CODAS and WEDBA methods. After the rankings were found according to the methods, the relations between the rankings were examined using the Spearman Correlation method. The main purpose of the study is to determine the suitable butter machine for a peanut paste production factory. Contribution of this study to the literature PSI, SV and MARCOS methods were used together for the first time. In addition, no study has been found in the literature related to peanut butter machine. Therefore, this study is original and contributes to the literature.

Advances in respiratory medicine have presented a clear need for the continuous training and accreditation of health professionals, as well as of institutions providing and delivering care to respiratory patients. EBAP holds a central overarching position across Europe and overseas as an independent accreditor of training centres and educational activities with transferable and recognised CME/CPD points across countries https://bit.ly/3uZb5WT

Aim To determine radiologic, clinic and laboratory characteristics of COVID-19 positive patients with acute arterial occlusion and compare them with post COVID-19 and non-COVID-19 patients. Methods In this retrospective study, 53 patients with acute occlusion of peripheral arteries admitted to the University Clinical Hospital Mostar in the period between 29 February 2020 and 30 September 2021 were involved. The first group was made of COVID-19 positive patients, the second group were post COVID-19 patients and a control group were non-COVID-19 patients. Results Most patients were males, 37 (69.8%). The average age of COVID positive patients was 66.09±11.25 years, post COVID-19 patients 71.33±5.22 years and COVID-19 negative patients 69.82±1.99 years. Lower extremities were most affected, 38 (71.6%), without significant alteration in the coagulogram. Acute arterial occlusion occurred about 2 weeks after the beginning of COVID-19 or at the time of the first appearance of symptoms. Conclusion We have to take special care about patients with risk factors for developing acute arterial occlusion due to thromboembolism or thrombosis 10 days after the beginning of the disease. We also recommend the use of low molecular weight heparin (LMWH) and monitoring coagulation state due to anti Xa and thromboelastometry.

Aim To examine a relation of thyroid function, neutrophil-lymphocyte ratio (NLR) with left ventricular function measured through the left ventricular ejection fraction (LVEF) in patients with acute myocardial infarction treated with percutaneous coronary intervention (PCI). Methods This prospective research involved 160 consecutive patients with acute myocardial infarction. Patients were divided into those with normal thyroid hormone status (n=80) and those with hypothyroidism (newly diagnosed) (n=80). Inflammatory parameters and parameters of hormonal status were taken for analysis: thyroid-stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroxine (FT4), and free triiodothyronine (FT3). All patients underwent transthoracic echocardiographic examination (TTE) five days upon admission, and left ventricular ejection fraction (LVEF) was analysed. Results Significant difference between the two groups was verified in values of T3, T4, erythrocytes, haemoglobin, haematocrit, neutrophil, lymphocytes, NLR, C-reactive protein (CRP) and sedimentation rate. Patients with euthyroidism had a higher frequency of coronary single-vessel disease (p=0.035) and a significantly lower frequency of triple vessel disease (p=0.046), as well as a higher median value of LVEF (p=0.003). There was a significant correlation between LVEF with haemoglobin values (p=0.002), NLR (p=0.001), and CRP (p=001). Conclusion The altered status of the thyroid gland in acute myocardial infarction is associated with the severity of the coronary blood vessel lesion, LVEF and correlates with inflammatory response.