Aim To analyse the association of human leukocyte antigen B27 with clinical and laboratory parameters in patients with juvenile idiopathic arthritis (JIA) at the disease onset. Methods A retrospective review of medical records of 25 HLAB27 positive and 25 HLA-B27 negative JIA patients was performed. The diagnosis of JIA was based on the 1997-2001 International League Against Rheumatism (ILAR) criteria. Collected data: age, sex, HLA- B27 antigen presence, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid-factor (RF), antinuclear antibody (ANA), fever, rash, uveitis, enthesitis, inflamed joints and subtype of JIA. Results HLA- B27 positive study group had more boys (p=0.01), higher erythrocyte sedimentation rate (p=0.038), higher presence of fever (p= 0.025) and enthesitis (p=0.024). Any significant difference in age of the disease onset, CRP, ANA, RF, rash, uveitis, inflamed joint and dactylitis was not noticed. The most common subtype of JIA in the HLA-B27 positive patients was ERA (60%). Conclusion This study showed that the presence of HLA- B27 antigen plays a significant role in determining the presenting clinical and laboratory characteristics in JIA patients.

The production of a $W$ boson in association with a single charm quark is studied using 140 $\mathrm{fb}^{-1}$ of $\sqrt{s} = 13\,\mathrm{TeV}$ proton-proton collision data collected with the ATLAS detector at the Large Hadron Collider. The charm quark is tagged by a charmed hadron, reconstructed with a secondary-vertex fit. The $W$ boson is reconstructed from an electron/muon decay and the missing transverse momentum. The mesons reconstructed are $D^{\pm} \to K^\mp \pi^\pm \pi^\pm$ and $D^{*\pm} \to D^{0} \pi^\pm \to (K^\mp \pi^\pm) \pi^\pm$, where $p_{\text{T}}(e, \mu)>30\,\mathrm{GeV}$, $|\eta(e, \mu)|<2.5$, $p_{\text{T}}(D)>8\,\mathrm{GeV}$, and $|\eta(D)|<2.2$. The integrated and normalized differential cross-sections as a function of the pseudorapidity of the lepton from the $W$ boson decay, and of the transverse momentum of the meson, are extracted from the data using a profile likelihood fit. The measured fiducial cross-sections are $\sigma^{\mathrm{OS-SS}}_{\mathrm{fid}}(W^{-}{+}D^{+}) = 50.2\pm0.2\,\mathrm{(stat.)}\,^{+2.4}_{-2.3}\,\mathrm{(syst.)}\,\mathrm{pb}$, $\sigma^{\mathrm{OS-SS}}_{\mathrm{fid}}(W^{+}{+}D^{-}) = 48.5\pm0.2\,\mathrm{(stat.)}\,^{+2.3}_{-2.2}\,\mathrm{(syst.)}\,\mathrm{pb}$, $\sigma^{\mathrm{OS-SS}}_{\mathrm{fid}}(W^{-}{+}D^{*+}) = 51.1\pm0.4\,\mathrm{(stat.)}\,^{+1.9}_{-1.8}\,\mathrm{(syst.)}\,\mathrm{pb}$, and $\sigma^{\mathrm{OS-SS}}_{\mathrm{fid}}(W^{+}{+}D^{*-}) = 50.0\pm0.4\,\mathrm{(stat.)}\,^{+1.9}_{-1.8}\,\mathrm{(syst.)}\,\mathrm{pb}$. Results are compared with the predictions of next-to-leading-order quantum chromodynamics calculations performed using state-of-the-art parton distribution functions. The ratio of charm to anti-charm production cross-sections is studied to probe the $s$-$\bar{s}$ quark asymmetry and is found to be $R_c^\pm = 0.971\pm0.006\,\mathrm{(stat.)}\pm0.011\,\mathrm{(syst.)}$.

This research combines complex systems science, geographical information systems, and environmental noise modelling to analyse effects of future air mobility in urban settings and plan efficient routes for vehicles. The research used the environmental noise maps of an urban agglomeration produced under the Environmental Noise Directive (END) as input to inform the UAV operations. These maps reveal potential routes for the UAV operations where the noise impact of the vehicle can be embedded within a high background noise due to the existing sources modelled under the END. When an agent based model is superimposed on a real-world map simple strategies of the diverse agents in interaction with the environment reveal patterns, such as dominant paths, points of congestion, and suggest positioning of terrestrial infrastructure. We investigate how agents can overcome the conflicts and find trade-off solutions by interacting only with their immediate neighbours-therefore enabling autonomy, decentralization, and putting to use emergent self-organising behaviour. The potential impact of increased drone operations on urban and peri urban regions is significant. Route optimisation which does not consider the noise is likely to impact on quite areas within our residential spaces and should be considered as part of noise action planning.

OBJECTIVE Excessive crying in infancy has been associated with increased risk of later behavioral problems. To identify individuals at risk for behavioral problems and to understand the mechanisms underlying excessive crying and irritability in infancy, research into the neurobiology of excessive crying is needed. We examined if excessive crying and irritability in infancy are associated with behavioral problems and amygdala volume among children and adolescents. METHOD This study included 4,751 singleton children from the prospective population-based Generation R Study cohort, born in the Netherlands in 2002-2006. Excessive crying (>3h on at least 1 day/week) and irritability (Mother and Baby Scales questionnaire) were parent-rated at 3 months. Amygdala volume was measured at 10 years using magnetic resonance imaging, and internalizing and externalizing were parent-rated at 1.5, 3, 6, 10 and 14 years and self-rated at 14 years. Covariates included child age, sex, national origin, gestational age, and maternal age, psychopathology score, parity, education, relationship status and family income. RESULTS Children who cried excessively in infancy had higher parent-rated internalizing (effect estimate 0.20 SD-units, 95% confidence interval [CI] 0.14, 0.27) and externalizing (0.17 SD-units, 95% CI 0.10, 0.24) throughout childhood (linear mixed models), and smaller amygdala volume at 10 years (-0.19 SD-units, 95% CI -0.32, -0.06) (linear regression model). The pattern of associations for both behavioral problems and amygdala volume was similar for irritability. CONCLUSION Excessive crying and irritability in infancy may reflect an early vulnerability to behavioral problems and be linked with neurobiological differences in the development of the amygdala.

Aim To identify clinical and laboratory parameters on admission and/or during a hospital stay that would predict prolonged hospital stay in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A retrospective cross-sectional study was conducted at the Clinic for Pulmonary Diseases and Tuberculosis, Clinical Centre University of Sarajevo for the period 2019-2021 accounting patients admitted due to AECOPD. The need for hospitalization was evaluated according to the current GOLD criteria and certain clinical parameters. Spirometry testing and laboratory analysis were performed for all patients on the day of admission and on the 10th day of hospital stay. Linear regression was used to show the relationship between multiple independent predictor variables and LOS. Results A total of 50 patients were evaluated during their hospital stay due to AECOPD. Median of LOS was 22.02±1.06, with 90% hospital survival rate. Due to AECOPD the median of LOS in the intensive care unit (ICU) was 4±0.68 days with pH<7.35 in 34% of hospitalized patients. According to spirometry classification on the day of admission, 56% of patients were assigned to group 3 and 16% to group 4 with significant improvement identified on spirometry findings on discharge. Platelets on the day of admission were the only statistically significant positive predictors of the length of hospital stay. Conclusion Identifying chronic obstructive pulmonary disease patients at risk of frequent exacerbations and appropriate disease management could reduce the disease burden.

Background: Deep Acute pancreatitis (AP) is an urging cause of hospitalization in the gastroenterology due to different causes and an unpredictable outcome. Known causes are grouped into four main groups: metabolic, mechanical, vascular and infectious. Objective: To determine the role of certain biochemical or radiological parameters as predictors of an involvement of other organs in AP different pathological staging and the surgical outcome in the treatment of AP. Methods: Ninety-seven AP patients hospitalized in General Hospital “Prim.dr Abdulah Nakaš” Sarajevo, in a period between 2016 and 2021 for both sexes, were divided according to the etiological factors of AP into four groups: nutritional factors, biliary concernments, alcohol and morphological changes of the pancreas. Beside laboratory tests, the imaging methods of abdomen (transabdominal ultrasound, abdominal computed tomography) used in determining morphological changes in the pancreas and other organs were analyzed in relation to parameters that predict the need for surgical outcomes. Results: AP etiological factors of patients differ significantly by gender and showed the dominance of dietary factors in female subjects (51%), followed by the presence of concernments in the biliary tract in 36% of cases, and alcohol consumption in male subjects in 28% of cases. The only variable correlated with the indicator of necessity for surgery is the existence of pleural effusion (coefficient of correlation was 0.38; risk ratio was 5.5) resulting that patients with pleural effusion have a 5.5 times higher chance of surgery indication than other patients. Conclusion: The application of simple parameters such as creatinine value with the values of amylases in serum and urine and the presence of pleural effusion confirmed by radiological imaging of the lungs opens the possibility of a simple and effective selection of patients for surgical treatment with a more severe form of AP.

Background Monitoring of trough levels and anti-drug antibodies is important when patients with inflammatory bowel disease (IBD) are treated with anti-TNF biologics due to guided therapeutic decisions. The comparability of 3 ELISA tests for detection of the lowest serum concentration of infliximab (IFX) or antibodies to IFX (ATIs) was evaluated. Material/Methods Two commercial assays for measuring IFX levels were compared with the in-house (UHL) test. ATIs were measured with 1 commercial test and compared to the in-house test. According to the guidelines, IFX levels were within the range of 3 to 7 μg/mL. Results The decision to continue therapy would be the same for 11 out of 16 patients when comparing the apDia Infliximab ELISA and UHL test, and for 12 out of 18 patients when comparing the Lisa-Tracker and in-house UHL test. Linear correlations between the tests were R=0.92 (UHL and apDia), R=0.91 (apDia and Lisa-Tracker), and R=0.89 (UHL and Lisa-Tracker) with P<0.001, respectively. Conclusions As the IFX levels are important for decisions on further therapy, detectable IFX levels realistically reflect the presence of the drug in the patients’ blood and thus control inflammatory activity. The tests were found as comparable and performed well in this aspect and might be used in everyday clinical practice.

PURPOSE We undertook a study to evaluate the current state of pedagogy on antiracism, including barriers to implementation and strengths of existing curricula, in undergraduate medical education (UME) and graduate medical education (GME) programs in US academic health centers. METHODS We conducted a cross-sectional study with an exploratory qualitative approach using semistructured interviews. Participants were leaders of UME and GME programs at 5 institutions participating in the Academic Units for Primary Care Training and Enhancement program and 6 affiliated sites from November 2021 to April 2022. RESULTS A total of 29 program leaders from the 11 academic health centers participated in this study. Three participants from 2 institutions reported the implementation of robust, intentional, and longitudinal antiracism curricula. Nine participants from 7 institutions described race and antiracism-related topics integrated into health equity curricula. Only 9 participants reported having "adequately trained" faculty. Participants mentioned individual, systemic, and structural barriers to implementing antiracism-related training in medical education such as institutional inertia and insufficient resources. Fear related to introducing an antiracism curriculum and undervaluing of this curriculum relative to other content were identified. Through learners and faculty feedback, antiracism content was evaluated and included in UME and GME curricula. Most participants identified learners as a stronger voice for transformation than faculty; antiracism content was mainly included in health equity curricula. CONCLUSIONS Inclusion of antiracism in medical education requires intentional training, focused institutional policies, enhanced foundational awareness of the impact of racism on patients and communities, and changes at the level of institutions and accreditation bodies.

Aim Clips in neurosurgery are made of titanium alloys, which reduce artifacts on computed tomography (CT). The radiological advantage of plastic clips on the CT image was demonstrated when they were placed in an inter-hemispherical position at an angle of 90º. The aim of this study was to investigate the behaviour of the clip placed at different angles. Methods Sixty heads of domestic pigs were divided into two groups, in group 1 a titanium clip was placed to the interhemispheric position at an angle of 90º, 45º, 0º, ten heads for each angle. In group 2 a plastic clip was placed in the same way. CT scan of the brain was performed for each angle. The size of the density and possible artifact were measured on CT. Results The size of the titanium clip ranged from 17.05 mm at an angle of 0º in the axial plane to 91.47 mm at an angle of 0º in the sagittal plane. The average size of the plastic clip ranged from 6.4 mm at an angle of 0º in the axial plane to 23.22 mm in an angle of 90º in the sagittal plane. Artifacts were observed only in the titanium clip. Conclusion Plastic clips have shown radiological advantages over titanium clips in the CT image. The average density size of the plastic clip in all planes and all angles was smaller than the titanium clip.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a global pandemic and one group of patients has developed a severe form of COVID-19 pneumonia with an urgent need for hospitalization and intensive care unit (ICU) admission. The aim of our study was to evaluate the prognostic role of MDW, CRP, procalcitonin (PCT), and lactate in critically ill COVID-19 patients. The primary outcome of interest is the 28 day mortality of ICU patients with confirmed SARS-CoV-2 infection and sepsis (according to Sepsis 3 criteria with acute change in SOFA score ≥ 2 points). Patients were divided into two groups according to survival on the 28th day after admission to the ICU. Every group was divided into two subgroups (women and men). Nonparametric tests (Mann–Whitney) for variables age, PCT, lactate, and MDW were lower than alpha p < 0.05, so there was a significant difference between survived and deceased patients. The Chi-square test confirmed statistically significant higher values of MDW and lactate in the non-survivor group. We found a significant association between MDW, lactate, procalcitonin, and fatal outcome, higher values were reported in the deceased group.