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Evangelia Eirini Tsermpini, U. Glamočlija, Fulden Ulucan‐Karnak, Sara Redenšek Trampuž, V. Dolžan

The coronavirus disease (COVID-19) pandemic is a leading global health and economic challenge. What defines the disease’s progression is not entirely understood, but there are strong indications that oxidative stress and the defense against reactive oxygen species are crucial players. A big influx of immune cells to the site of infection is marked by the increase in reactive oxygen and nitrogen species. Our article aims to highlight the critical role of oxidative stress in the emergence and severity of COVID-19 and, more importantly, to shed light on the underlying molecular and genetic mechanisms. We have reviewed the available literature and clinical trials to extract the relevant genetic variants within the oxidative stress pathway associated with COVID-19 and the anti-oxidative therapies currently evaluated in the clinical trials for COVID-19 treatment, in particular clinical trials on glutathione and N-acetylcysteine.

Nadja Gruber, Malik Galijašević, Milovan Regodić, A. Grams, C. Siedentopf, R. Steiger, Marlene Hammerl, M. Haltmeier et al.

Caused by the new SARS-CoV-2 coronavirus, COVID-19 (coronavirus disease 2019) evolves with clinical symptoms that vary widely in severity, from mild symptoms to critical conditions, which can even result in the patient's death. A critical aspect related to an individual response to SARS-CoV-2 infection is the competence of the immune system, and it is well known that several trace elements are essential for an adequate immune response and have anti-inflammatory and antioxidant properties that are of particular importance in fighting infection. Thus, it is widely accepted that adequate trace element status can reduce the risk of SARS-CoV-2 infection and disease severity. In this study, we evaluated the serum levels of Cu, Zn, Se, Fe, I and Mg in patients (n = 210) with clinical conditions of different severity (“mild”, “moderate”, “severe” and “exitus letalis”, i.e., patients who eventually died). The results showed significant differences between the four groups for Cu, Zn, Se and Fe, in particular a significant trend of Zn and Se serum levels to be decreased and Cu to be increased with the severity of symptoms. For Mg and I, no differences were observed, but I levels were shown to be increased in all groups.

Xiaohu Xu, Yifei Liang, Xixi Zhang, Yu Wang, Yun Lin, B. Adebisi, H. Gačanin, Guan Gui

Malware detection is an important step in network security. Traditional malware detection methods suffer from the ability to learn, understand, process, and apply characteristics of network traffic data accurately, and in a relatively short space of time. It also cannot learn new tasks without forgetting the old tasks. In this paper, we propose a self-evolving malware detection (SEMD) method using network traffic and incremental learning. Incremental learning (IL) method is one of the important methods in deep learning, which can learn new tasks without forgetting the old tasks. Its loss function draws lessons from the idea of knowledge distillation. Experimental results show that the proposed method can recognize both old tasks and new tasks (overcoming the problem of catastrophic network forgetting). The performance of the proposed SEMD method is also better than the general method of incremental learning without self-evolving.

Xiaoyi Hu, Jin Ning, Jie Yin, Jie Yang, B. Adebisi, H. Gačanin

The proliferation of mobile communication systems, arrival of high-speed broadband networks and more complex network topologies have exacerbated cyber-threats. Cyber-warfare has become an aspect of modern war-fare that can no longer be overlooked. In recent years, network intrusions launched using the Internet have seriously undermined the security systems of many nations. Classifying malicious network traffic is the first step in network intrusion detection. In this paper, we propose three models using semi-supervised learning-based malicious traffic classification (MTC) methods that effectively improve the classification of traffic using a small proportion of labeled traffic data. Employing three different deep neural networks as feature extraction networks respectively, the proposed models use transductive transfer learning and domain adaptive ideas, and ladder networks as classification layers. Experimental results are provided to validate the proposed methods.

With the global transition to the IPv6 (Internet Protocol version 6), IP (Internet Protocol) validation efficiency and IPv6 support from the aspect of network programming are gaining more importance. As global computer networks grow in the era of IoT (Internet of Things), IP address validation is an inevitable process for assuring strong network privacy and security. The complexity of IP validation has been increased due to the rather drastic change in the memory architecture needed for storing IPv6 addresses. Low-level programming languages like C/C++ are a great choice for handling memory spaces and working with simple devices connected in an IoT (Internet of Things) network. This paper analyzes some user-defined and open-source implementations of IP validation codes in Boost. Asio and POCO C++ networking libraries, as well as the IP security support provided for general networking purposes and IoT. Considering a couple of sample codes, the paper gives a conclusion on whether these C++ implementations answer the needs for flexibility and security of the upcoming era of IPv6 addressed computers.

Aim To determine risk factors responsible for developing postoperative complications after the thoracic aorta reconstructive surgery. Methods Medical records of 100 patients, who had undergone elective or emergency thoracic aorta reconstructive surgery at the Clinic for Cardiovascular Surgery, University Clinical Center Tuzla, were analysed. Intraoperative data as cross-clamp time (CCT), duration of cardiopulmonary bypass (CPBT) and hypothermic circulatory arrest time (HCAT) were evaluated. Univariate analysis was used to show risk factors for developing postoperative cardiac, respiratory, surgical and renal complications. Results Between May 2019 and April 2021, 48 Bentall procedures (BP), 23 ascending aortic replacements (AAR), 20 BP and coronary artery bypass grafting (CABG) and 9 aortic valve replacements (AVR) with AAR were performed. Incidence of postoperative complications in the elective and emergency groups was as follows: respiratory 20% vs 38% (p=0.049), cardiac 18% vs 70% (p=0.015), renal 16% vs 48% (p=0.027) and surgical 4% vs 6% (p>0.05). Intrahospital 30 days morbidity was 44% with mortality rate of 13%. The results showed that CPBT>180 minutes was a risk factor for respiratory (p=0.034), cardiac (p=0.020) and renal (p=0.027) postoperative complications after acute type A aortic dissection surgery. Conclusion CPBT > 180 min is a risk factor for postoperative development of respiratory, cardiac and renal complications. Postoperative cardiac and renal complications were associated with longer HCAT.

N. Moellhoff, T. Arnež, E. Athanasopoulos, H. Costa, G. De Santis, S. de Mortillet, C. Demirdöver, G. Benedetto et al.

BACKGROUND Specialty training in plastic, reconstructive and aesthetic surgery is a prerequisite for safe and effective provision of care. The aim of this study was to assess and portray similarities and differences in the continuing education and specialization in plastic surgery in Europe. MATERIAL AND METHODS A detailed questionnaire was designed and distributed utilizing an online survey administration software. Questions addressed core items regarding continuing education and specialization in plastic surgery in Europe. Participants were addressed directly via the European Leadership Forum (ELF) of the European Society of Plastic, Reconstructive and Aesthetic Surgery (ESPRAS). All participants had detailed knowledge of the organization and management of plastic surgical training in their respective country. RESULTS The survey was completed by 29 participants from 23 European countries. During specialization, plastic surgeons in Europe are trained in advanced tissue transfer and repair and aesthetic principles in all parts of the human body and within several subspecialties. Moreover, rotations in intensive as well as emergency care are compulsory in most European countries. Board certification is only provided for surgeons who have had multiple years of training regulated by a national board, who provide evidence of individually performed operative procedures in several anatomical regions and subspecialties, and who pass a final oral and/or written examination. CONCLUSION Board certified plastic surgeons meet the highest degree of qualification, are trained in all parts of the body and in the management of complications. The standard of continuing education and qualification of European plastic surgeons is high, providing an excellent level of plastic surgical care throughout Europe. HINTERGRUND Die Facharzt-Weiterbildung für Plastische und Ästhetische Chirurgie ist eine Grundvoraussetzung für sichere und effektive Patientenversorgung. Ziel der vorliegenden Studie war die Darstellung von Gemeinsamkeiten und Unterschieden in der Weiterbildung für Plastische Chirurgie innerhalb von Europa. MATERIALIEN UND METHODEN Ein internetbasierter Fragebogen wurde mit Hilfe eines kostenlosen Formularerstellungstools erstellt und verteilt. Die Fragen betrafen Kernpunkte der Weiterbildung für Plastische Chirurgie in Europa. Die Teilnehmer wurden direkt über das European Leadership Forum (ELF) der European Society of Plastic, Reconstructive and Aesthetic Surgery (ESPRAS) kontaktiert. Alle Teilnehmer hatten weitreichende Kenntnisse über die Organisation und Struktur der plastisch-chirurgischen Weiterbildung in ihrem jeweiligen Land. ERGEBNISSE 29 Teilnehmer*innen aus 23 europäischen Ländern nahmen an der Umfrage teil. Die Weiterbildung für Plastische Chirurgie beinhaltet grundlegende Prinzipien und Techniken zur Wiederherstellung von Form und Funktion innerhalb der verschiedenen Säulen der Plastischen Chirurgie, sowie in allen Körperregionen. In den meisten europäischen Ländern ist eine Rotation in der Intensiv- und Notfallmedizin und die Behandlung kritisch kranker Patienten obligatorisch. Voraussetzung für die Facharztbezeichnung ist die mehrjährige, national organisierte Weiterbildung, der Nachweis einer festgelegten Anzahl selbstständig durchgeführter Operationen, sowie die mündliche und/oder schriftliche Abschlussprüfung. SCHLUSSFOLGERUNG Fachärzte für Plastische und Ästhetische Chirurgie sind hochqualifiziert und auch im Umgang mit Komplikationen geschult. Der Standard der Weiterbildung der europäischen Plastischen Chirurgen ist hoch, so dass innerhalb Europas eine hohe Qualität plastisch-chirurgischer Versorgung gewährleistet ist.

Aim A standardized assessment for the optimal repair of hypospadias remains elusive. The aim of this study was to assess a postoperative cosmetic outcome of hypospadias repair using a validated questionnaire, Hypospadias Objective Scoring Evaluation (HOSE). Methods During the period between January 2016 and May 2019, 40 patients who underwent hypospadias repair were identified and they agreed to a follow-up using the HOSE. Distal hypospadias repairs underwent a cross-sectional assessment of the cosmetic outcome. Cosmetic assessment was performed by an independent physician using the HOSE scoring system. Results The native meatus was coronal in 10 (25%), subcoronal in eight (20%), and distal penile in 22 (55%) patients. Mean followup was 35.90 months (SD ±29.58) postoperatively (range 12-162 months). Complications occurred in one (2.5%) patient. Out of 40 uncomplicated repairs, 39 (97.5%) were satisfactory. A vertical slit-like meatus located at the distal glans was created in 33 (82.5%) boys, and at the proximal glans in seven (17.5%). The urinary stream was single and straight in 39 and spray in one patient. A straight erection was observed in 39 (97.5%) boys. The median HOSE score was 16 (range 12-16). One patient had a small, single coronal fistula. The technique used included tubularised incised plate urethroplasty. Conclusion The HOSE score is simple, easy, non-invasive and non-expensive tool for objective assessment of long-term outcomes of hypospadias repair.

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