Introduction: Many epidemiological studies have shown a connection between vitamin D deficiency and increased incidence of type 1 diabetes. Objective: The aim of this study is to determine the impact of vitamin D levels in children with newly diagnosed type 1 diabetes, taking into account the following parameters: gender, place of residence, positive/negative family history, comorbidities. Respondents and methods: The research was conducted through a retrospective analysis of the medical records of the Children's Disease Clinic of the University Clinical Hospital Mostar. The research included a sample of 30 children diagnosed with type 1 diabetes, treated at the Department of Endocrinology and Metabolic Diseases, Clinic for Children's Diseases, University Clinical Hospital Mostar. Results: The research consisted of 30 participants treated at the Department of Endocrinology and Metabolic Diseases, Clinic fo Children's Disease. The sample consists of 40% (n=12) male respondents and 60% (n=18) female respondents. Slightly more than half of the respondnents, 53.3% (n=16) lived in the city, while the remaining 46.7% (n=14) lived in the countryside. Statistical analysis of the patients with newly diagnosed type 1 diabetes, showed that there were significantly more patients (70%) with positive family history of diabetes mellitus than those with negative. In this study, 26.7% (n=8) patients with newly diagnosed type 1 diabetes had comorbidities, compared to 73.3% patients without comorbidities (n=22). Patients living in rural areas had significantly higher values of vitamin D3 concentration compared do those who lived in urban areas. Conclusion: 83.3% of subjects with newly diagnosed type 1 diabetes have a reduced level of vitamin D at the time of diagnosis. Numerous studies have shown a link between vitamin D deficiency and an increased risk of developing diabetes. Due to all of the above, supplementation and control of vitamin D is recommended, especially in children who have a risk in the form of positive family history and comorbidities such as Hashimoto's thyroiditis, and celiac disease from an early age for the purpose of prevention.

SUMMARY Introduction: Due to the consequences of the COVID-19 pandemic, experts have expressed concern for psychological functioning and well-being globally, with a particular reference to life quality disorder. Aim: To determine the connectin of recovery and the degree of life quality. Respondents and methods: A cross-sectional survey is carried out. The sample in the research consist of persons of both sexes at the age of 18, who have recovered from the infection, reviewing more than a year since the beginning of this research. The test survey was done by 384 respondents, which was carried out from October to December 2022. It was used a questionare survey, designed for research purpose, consisting of socio-demographich characteristics, characteristics of COVID-19 infection and consequences of COVID-19 infection. Results: By the comparison of established frequencies of response, confirmations of agreement and disagreement of the claims examinated is established that significantly higher percentage of respondents have noticed, in their functioning after COVID-19 infection, the appearance of fatigue and muscles weakness (65,9%), significant hair loss (57,8) and higher level of symptoms of depression and anxiety (43,8%). Conclusion: The COVID-19 pandemic has markedly influenced life quality and has affected all aspects of life and health.

Introduction: Vaccination against infectious diseases is the most effective, cost-effective, often unavoidable, or the only possible way to protect individuals and the population from infectious diseases. In the last ten years, a lack of understanding and knowledge about the benefits of vaccination has led to a decline in the number of vaccinated children and the danger of the reappearance of already eradicated infectious diseases. Objective: To examine the knowledge and attitudes about mandatory vaccination of children among students of the Faculty of Health Studies and the Faculty of Medicine of the University of Mostar. Respondents and methods: A cross-sectional survey was conducted, which included 150 respondents in the third and fourth year of study, 50 respondents from the Faculty of Medicine, and 100 respondents from the Nursing and Sanitary Engineering study tracks at the Faculty of Health Studies. Data were collected through a self-assessment questionnaire. Results: Over 90% of respondents have a positive attitude towards vaccination and would vaccinate their children. The results show that respondents form their attitudes about vaccination based on academic activities. Students with a positive attitude about vaccination also showed greater knowledge about it. Nursing students have the weakest knowledge, followed by showing a greater aversion to vaccines than other respondents. More than a quarter of respondents are convinced of the connection between autism and vaccines, and this is also the case for autoimmune diseases. Conclusion: Although students of biomedical studies have positive attitudes about vaccination, the level of knowledge was more significant among students of the Faculty of Medicine compared to the study tracks of the Faculty of Health Studies.

Objetivo: Apresentar a implantação e desenvolvimento de um processo sistematizado de prescrição de Projeto Terapêutico Singular (PTS) para pacientes internados em um Centro de Reabilitação do Centro-Oeste brasileiro e seus desdobramentos e potencialidades para aplicação em diversos perfis de pacientes hospitalizados. Relato de experiência: A metodologia de prescrição e gerenciamento de PTS nos serviços da instituição conta com o envolvimento do paciente, sua família e equipe multiprofissional, que desempenham diversos papéis durante o processo: desde a avaliação de diagnóstico e prognóstico, até o gerenciamento de dados e desenvolvimento de planos de ação de melhoria. A implantação do PTS conforme a metodologia proposta se mostrou adaptável e funcional para gerenciar a jornada do paciente e auxiliou a organização e manejo da equipe diante dos prognósticos apresentados. A prescrição do PTS trouxe mais agilidade e funcionalidade na avaliação e manejo dos casos, proporcionando condutas mais assertivas voltadas às necessidades e desejos dos pacientes. Considerações finais: O gerenciamento do PTS contribui para o alcance de diversas metas institucionais e proporciona melhores desfechos clínicos aos pacientes, impactando diretamente na qualidade de vida dos mesmos, além da redução de custos e melhoria da performance da gestão sócio-econômica da saúde pública.

To generate oregano essential oil, the leaves and flowering tops of the Origanum vulgare plant go through the process known as steam distillation. This essential oil is known for its antibacterial activity. Bacterial biofilms are microbial communities attached to inert surfaces or tissues and encapsulated in complex matrices. Planktonic bacteria reversibly attach to surfaces, form microcolonies, and generate polymeric matrices around biofilms. Bacteria in biofilms provide bacteria with a safer way to reproduce and survive. This research tests the antibacterial activity and effect on the biofilm formation of Oregano essential oil. The antibacterial activity and effect on biofilm formation were tested against five bacterial strains, including Escherichia coli ATCC 14169, Escherichia coli ATCC 25922, Staphylococcus aureus NCTC 12393, Staphylococcus aureus ATCC 25923, and Staphylococcus aureus ATCC 6538. The concentrations of oil that were used in this research were 100%(v/v), 75%(v/v), 50%(v/v), and 25%(v/v). The best antibacterial effect was achieved against Staphylococcus aureus NCTC 12393 at 25%(v/v) of oil concentration. While performing the experiment, a variety of oregano oil concentrations had significant results for further tests to be performed.

Many large-scale systems are composed of subsystems operated by decentralized controllers, which are fixed in their structure, yet have parameters to tune. Initial tuning or subsequent adjustments dof those parameters ue to varying operating conditions or changes in the network of interconnected systems, while ensuring stability, performance, and security, pose a challenging task due to the overall complexity and size. Subsystems may not be willing or allowed to expose detailed information for safety and privacy reasons. In some cases, a comprehensive system model might not be available for global tuning, or the resulting problem might be computationally infeasible. To enable meaningful global parameter tuning while allowing for data privacy and security, we propose that the subsystems themselves should provide reduced-order models. These models capture the parametric dependency of the subsystem dynamics on the controller parameters. Specifically, we present a method to construct a region in the subsystems’ parameter space in which the deviation of the subsystem and the reduced-order model stays below a specified error bound and in which both systems are stable. A necessary and sufficient condition for such regions is derived using robust control theory. Notably, sufficiency can be expressed in terms of a linear matrix inequality. We demonstrate the approach by considering the temperature control of a large-scale building complex.

This paper explores the use of semantic knowledge inherent in the cyber-physical system (CPS) being studied in order to minimize the use of explicit communication, which refers to the use of physical radio resources to transmit potentially informative data. It is assumed that the acquired data have a function in the system, usually related to its state estimation, which may trigger control actions. We propose a semantic-functional approach that can leverage semantic-enabled implicit communication while ensuring the system maintains its required functionality and performance. We illustrate the potential of this proposal through simulations of a swarm of drones jointly performing remote sensing in a given area. Our numerical results demonstrate that the proposed method offers the best design option regarding the ability to accomplish a previously established task—remote sensing in the addressed case—while minimizing the use of explicit communication by controlling the trade-offs that jointly determine the performance and effectiveness of the CPS in terms of resource utilization. In this sense, we establish a fundamental relationship among energy, communication, and functionality, considering a specific end application.

Driven by co‐evolution with pathogens, host immunity continuously adapts to optimize defence against pathogens within a given environment. Recent advances in genetics, genomics and transcriptomics have enabled a more detailed investigation into how immunogenetic variation shapes the diversity of immune responses seen across domestic and wild animal species. However, a deeper understanding of the diverse molecular mechanisms that shape immunity within and among species is still needed to gain insight into—and generate evolutionary hypotheses on—the ultimate drivers of immunological differences. Here, we discuss current advances in our understanding of molecular evolution underpinning jawed vertebrate immunity. First, we introduce the immunome concept, a framework for characterizing genes involved in immune defence from a comparative perspective, then we outline how immune genes of interest can be identified. Second, we focus on how different selection modes are observed acting across groups of immune genes and propose hypotheses to explain these differences. We then provide an overview of the approaches used so far to study the evolutionary heterogeneity of immune genes on macro and microevolutionary scales. Finally, we discuss some of the current evidence as to how specific pathogens affect the evolution of different groups of immune genes. This review results from the collective discussion on the current key challenges in evolutionary immunology conducted at the ESEB 2021 Online Satellite Symposium: Molecular evolution of the vertebrate immune system, from the lab to natural populations.

The purpose of this study was to compare the effects of reviparin, dalteparin and enoxaparin on intraoperative blood loss in patients with trochanteric fracture treated with intramedullary nailing. This retrospective multicenter study included 100 patients with trochanteric fracture who were divided into three groups according to the low-molecular-weight heparin administered. In all cases, a short third generation Gamma nail was used for osteosynthesis. Complete blood count and number of red blood cell transfusions (RBC) were evaluated. The mean value of postoperative haemoglobin level was lower in the enoxaparin group compared to the reviparin group, with significant difference (p = 0.001; 95% CI 4.1–18.87). Patients in the dalteparin group received more RBC transfusions compared to the reviparin and enoxaparin group (p = 0.048). The use of enoxaparin and dalteparin in hip fracture patients can result in lower postoperative haemoglobin levels and more RBC transfusions compared to reviparin.

The goal in the present paper was to examine the combined and relative impact of fine motor ability, auditory working memory, and processing speed on fluid intelligence in a sample of early elementary school students. Our participant sample was 145 children (Mage = 9.1 years, SD = 1.1; 80 boys, 65 girls). We used the Raven’s Colored Progressive Matrices Test as a measure of fluid intelligence and five other measures to represent the three predictor variables: the Grooved Pegboard Test as a measure of fine motor skills, Digit Span Forwards and Digit Span Backwards tests as measures of working memory, and Rapid Automatized Naming and Letter-Digit Substitution tasks as measures of processing speed. Regression analyses indicated that only two of these measures had a statistically significant association with the fluid intelligence test scores, namely, scores on the Grooved Pegboard (fine motor skills) and Digit Span Backwards (working memory) tests, with these two measures explaining 35% of the variance in the fluid intelligence test scores. Thus, fine motor skills and working memory were correlated with fluid intelligence in early elementary-grade students. Until the directions of these relationships are better understood, we might assume that interventions aiming to increase young children’s fluid intelligence, or at least their intelligence scores, might partly target working memory and fine motor skills.

Juvenile systemic sclerosis (jSSc) is an orphan disease with a prevalence of 3 in 1 000 000 children. In adult patients there are significant differences between the clinical presentation of diffuse and limited subtypes. We reviewed clinical differences in presentation of subtypes in patients in the juvenile systemic scleroderma inception cohort (jSScC).To study the clinical presentation of jSSc patients with diffuse (djSSc) and limited (ljSSc) subtypes.We reviewed the baseline clinical characteristics of the patients, who were recruited to the jSScC till December 2022. jSScC is a prospective cohort of jSSc patients, who developed the first non-Raynaud´s symptom before the age of 16 years and are under the age of 18 years at the time of inclusion.The JSScC included 232 patients, 68% (n=159) had diffuse subtype. The median age at onset of Raynaud phenomenon was 10.4 years (7.3-12.9), at the first non-Raynaud symptom 10.9 years (7.3-13.0) and median disease duration 2.5 years (1.0-4.6). The female/male ratio was significantly lower in the djSSc subtype (3:1 versus 5:1, p<0.001). Antibody profile was similar, with the exception of a significantly higher number of anticentromere positive patients in the ljSSc. Decreased FVC<80% was found in approximately 30% and decreased DLCO<80% was found in around 40% in both subtypes. Abnormal HRCT findings were found in 44% of patients. Pulmonary hypertension assessed by ultrasound occurred in approximately 5% in both groups and gastrointestinal involvement in 43% of djSSc and 36% in ljSSc (p=0.303). Patients with djSSc had significantly higher modified Rodnan Skin Score, more frequently sclerodactyly, a history of digital ulceration active ulceration, telangiectasia, a decreased Body Mass Index z score ≤ -2 and decreased joint range of motion. Patients with ljSSc had significantly higher rate of cardiac involvement. Regarding patient related outcomes assessed by VAS 0-100 djSSc patients had more severe disease also physician related outcome assessed by VAS 0-100 were significantly higher in djSSc (see Table 1).Table 1.Comparison of subtypes at time of inclusion in the cohortWhole Group N=232Diffuse Subtype N=159Limited Subtype N=73P value Anticentromere5% (7/156)2% (2/106)10% (5/50)0.022 MRSS, median (IQR)10 (4 – 20)16 (8 - 27)4 (0 – 8)0.001 Gottron Papules26% (59/228)31% (48/155)15% (11/73)0.011 Sclerodactyly75% (165/219)85% (127/150)55% (38/69)<0.001 Telangiectasia37% (77/209)44%(62/141)22% (15/68)0.002 History of ulceration52% (119/229)62% (98/158)30% (21/71)<0.001 Active ulceration17% (39/229)21% (33/158)8% (6/71)0.021 Only Cardiac involvement5% (12/232)3% (4/159)11% (8/73)0.007 BMI<- 2 z score15% (33/217)20% (29/148)6% (4/69)0.008 Joints with decreased range59% (136/231)64% (101/158)48% (35/73)0.022Physician Reported (Median, IQR) Physician global disease activity30 (20 – 45)n=19735 (20– 50)n=13820 (10 – 30)n=590.001 Physician global disease damage30 (15 – 40)n=19530 (20 – 45)n=13820 (5 – 30)n=570.004 Physician ulceration activity0 (0 – 16)n=2165 (0 – 20)n=1540 (0 – 0)n=620.018Patient Reported (Median, IQR) Patient global disease activity40 (20 – 50)n=17840 (20 – 50)n=12930 (15 – 55)n=490.024 Patient global disease damage30 (15 – 60)n=17740 (20 – 60)n=12825 (5 – 55)n=490.001 Patient Raynaud activity30 (10 – 60)n=20230 (10 – 60)n=14515 (0 – 55)n=570.001 Patient ulceration activity0 (0 – 30)n=20310 (0 – 30)n=1450 (0 – 20)n=580.001In the largest jSSc cohort in the world, djSSc patients have a significantly more severe disease. Patients and physician related outcomes were significantly more severe in djSSc group. Interestingly, we found no differences regarding interstitial lung disease, pulmonary hypertension or gastrointestinal involvement, although the number of patients with decreased BMI ≤ -2 z score was significantly higher in the djSSc patients.NIL.NIL.None Declared.

Children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) usually present minimal symptoms or are asymptomatic. Nevertheless, a subset of children 2-6 weeks after the initial SARS-CoV-2 infection develops a postinfectious SARS-CoV-2-related multisystem inflammatory syndrome in (MIS-C). Recently, transient expansion of TRBV11-2 T cell clonotypes in MIS-C was associated with signatures of inflammation and T cell activation, however, the underlying pathophysiology of MIS-C is not fully understood [1].The purpose of our project is to characterize the complexity of cell populations and capture cellular heterogeneity to uncover the regulatory networks and interactions that are disrupted during MIS-C flare with simultaneous profiling of gene expression and open chromatin regions from the same nuclei.Samples of peripheral blood mononuclear cells from patients with MIS-C diagnosed at the University Children’s Hospital, University Medical Center Ljubljana, were collected during the initial presentation before any treatment and at 6-12 months in remission. The primary aim is to identify which regulatory networks are driving inflammation in MIS-C flare, for which we are performing single cell Multiome ATAC + Gene Expression Sequencing. To enable simultaneous profiling of epigenomic landscape and gene expression from the same nuclei, we are using Chromium Next GEM Single Cell Multiome ATAC + Gene Expression kit from 10X Genomics.We included 32 patients with MIS-C from whom we collected paired blood samples during the initial presentation before treatment and at 6-12 months in remission. In single cell multiomic experiment we included 10 patients with paired samples, with the most viable cell count prior cryopreservation. All samples that are included into multiomic single cell analysis have 75% - 99% viability prior cryopreservation. In the protocol the key is to remove remaining granulocytes causing high mitochondrial RNA burden and extensively optimize the dilution factor of lysis buffer and the length of cell lysis step in order to get intact nuclei with no significant blebbing. Afterward, the single cell ATAC libraries as well as single-cell gene expression libraries are constructed and sequenced. Data are undergoing pairwise analysis to compare the cell population heterogeneity, expression profile and open chromatin landscape in the time of the initial presentation of MIS-C and in the remission, with Cell ranger software as well as with R package scREG [2], and custom scripting. In the second step we will inspect if the resulting altered transcriptomic signature from single-cell experiment is present on larger cohort. In that regard, we will perform bulk transcriptomic profiling on all paired collected samples during the initial presentation of MIS-C before treatment and at 6-12 months in remission.The results of this project are expected to enlighten the underlying pathophysiology of MIS-C flare and thus support clinical decision on more targeted treatment. The identified disrupted networks during MIS-C flare could lead the way to establish an early diagnosis and improve long-term outcome, including prevention of myocardial and neuropsychological impairment. Moreover, a better understanding of the disrupted regulatory networks that are driving inflammation in MIS-C, could lead to new insights into diseases with similar clinical presentations as is Kawasaki Disease.[1]Sacco, K., Castagnoli, R., Vakkilainen, S.et al.Immunopathological signatures in multisystem inflammatory syndrome in children and pediatric COVID-19.Nat Med28, 1050–1062 (2022).[2]Duren, Z., Chang, F., Naqing, F.et al.Regulatory analysis of single cell multiome gene expression and chromatin accessibility data with scREG.Genome Biol23, 114 (2022).This research was supported by Slovenian research agency grant J3-3061 and Interreg ITA-SLO project Cattedra.None Declared.