Background Classical ST‐T waveform changes on standard 12‐lead ECG have limited sensitivity in detecting acute coronary syndrome (ACS) in the emergency department. Numerous novel ECG features have been previously proposed to augment clinicians' decision during patient evaluation, yet their clinical utility remains unclear. Methods and Results This was an observational study of consecutive patients evaluated for suspected ACS (Cohort 1 n=745, age 59±17, 42% female, 15% ACS; Cohort 2 n=499, age 59±16, 49% female, 18% ACS). Out of 554 temporal‐spatial ECG waveform features, we used domain knowledge to select a subset of 65 physiology‐driven features that are mechanistically linked to myocardial ischemia and compared their performance to a subset of 229 data‐driven features selected by multiple machine learning algorithms. We then used random forest to select a final subset of 73 most important ECG features that had both data‐ and physiology‐driven basis to ACS prediction and compared their performance to clinical experts. On testing set, a regularized logistic regression classifier based on the 73 hybrid features yielded a stable model that outperformed clinical experts in predicting ACS, with 10% to 29% of cases reclassified correctly. Metrics of nondipolar electrical dispersion (ie, circumferential ischemia), ventricular activation time (ie, transmural conduction delays), QRS and T axes and angles (ie, global remodeling), and principal component analysis ratio of ECG waveforms (ie, regional heterogeneity) played an important role in the improved reclassification performance. Conclusions We identified a subset of novel ECG features predictive of ACS with a fully interpretable model highly adaptable to clinical decision support applications. Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT04237688.

Sustainable traffic system management under conditions of uncertainty and inappropriate road infrastructure is a responsible and complex task. In Bosnia and Herzegovina (BiH), there is a large number of level crossings which represent potentially risky places in traffic. The current state of level crossings in BiH is a problem of the greatest interest for the railway and a generator of accidents. Accordingly, it is necessary to identify the places that are currently a priority for the adoption of measures and traffic control in order to achieve sustainability of the whole system. In this paper, the Šamac–Doboj railway section and passive level crossings have been considered. Fifteen different criteria were formed and divided into three main groups: safety criteria, road exploitation characteristics, and railway exploitation characteristics. A novel integrated fuzzy FUCOM (full consistency method)—fuzzy PIPRECIA (pivot pairwise relative criteria importance assessment) model was formed to determine the significance of the criteria. When calculating the weight values of the main criteria, the fuzzy Heronian mean operator was used for their averaging. The evaluation of level crossings was performed using fuzzy MARCOS (measurement of alternatives and ranking according to compromise solution). An original integrated fuzzy FUCOM–Fuzzy PIPRECIA–Fuzzy MARCOS model was created as the main contribution of the paper. The results showed that level crossings 42 + 690 (LC4) and LC8 (82 + 291) are the safest considering all 15 criteria. The verification of the results was performed through four phases of sensitivity analysis: resizing of an initial fuzzy matrix, comparative analysis with other fuzzy approaches, simulations of criterion weight values, and calculation of Spearman’s correlation coefficient (SCC). Finally, measures for the sustainable performance of the railway system were proposed.

Abstract Seven spider mite species were recorded for the first time in Serbia: Bryobia macedonica Hatzinikolis & Panou, 1996 and Bryobia querci Hatzinikolis & Panou, 1997 from Bryobiinae, and Eutetranychus orientalis Klein, 1936; Oligonychus bicolor Banks, 1894; Oligonychus platani McGregor, 1950 Tetranychus canadensis McGregor, 1950 and Tetranychus ludeni Zacher, 1913 from Tetranychinae. Together with previously reported data, these findings raise the number of known tetranychid species in Serbia to 44, the second highest number of spider mite species recorded in the Balkan countries. The records of O. bicolor and T. canadensis are also the first ones on the Balkan Peninsula. The most frequent species were T. ludeni and E. orientalis, found in 24 and 13 out of 57 sampling locations. Spider mites were recorded on host plants in four basic habitat types, but predominantly in cultivated habitats and woodlands. A total of 27 plant species from nine families were recorded as hosts for newly recorded spider mites, including 12 plant species as new hosts for four tetranychids, and three plant species as new hosts for the family Tetranychidae. Plant family Rosaceae had the highest number of new hosts (7) and harbored the highest number of spider mite species (5). Tetranychus ludeni had the highest number of host plants (11) with two plant species as its new hosts. Oligonychus bicolor was found on eight host plants including five new hosts for this species and one new host for the family Tetranychidae. The other two new hosts for the family Tetranychidae harbored O. platani and B. querci, respectively. Symptoms of heavy infestations by E. orientalis and T. ludeni were recorded on host plants in several locations.

Este é um estudo prospectivo, transversal, descritivo com abordagem quantitativa, desenvolvido de 2017 a 2018, numa unidade municipal de saúde de Belém-PA; e que tem como objetivo avaliar o conhecimento de comunicantes de hanseníase antes e após uma ação educativa, acerca dos sinais e sintomas da doença, os riscos de adoecimento e as formas de prevenção. Fizeram parte da pesquisa 93 comunicantes, das quais 48% acreditava que a doença era transmitida por utensílios, assim como 54% afirmava ser uma patologia letal. Existiam lacunas significativas de conhecimento sobre a hanseníase por parte dos contatos intradomiciliares contatados. Identificou-se impacto positivo da ação educativa, com aumento do nível de conhecimento sobre a hanseníase entre os comunicantes. 

Six blood groups (Rh, MN, Duffy, Kidd, Kell, and Lutheran) were investigated among three major ethnic groups (Bosniaks, Bosnian Croats, and Bosnian Serbs), as well as 10 regional subpopulations across Bosnia and Herzegovina (B&H): Krajina; Posavina; northeastern, eastern, middle, and central Bosnia; Sarajevo region; eastern, central, and western Herzegovina. This is the first study that introduces the molecular genetic typing of five blood groups within the B&H population, with the exception of the RhD blood group. The sample consisted of 450 buccal swabs from unrelated individuals. Five blood group systems (RhD, RhC, RhE, Kidd, MN) were genotyped by PCR with sequence specific primers, while three blood group systems (Kell, Duffy, Lutheran) were genotyped by the PCR-restriction-fragment-length polymorphism method. Minor variation of genetic diversity was observed within the three major B&H ethnic groups, as well as within the 10 subpopulations stratified according to geographical criteria. No genetic differentiation among ethnic groups was noticed. These results are in agreement with the results of previous studies based on different molecular genetics markers, which indicate that the three B&H ethnic groups belong to the same gene pool. A similar level of genetic variance was observed within regional subpopulations, with no significant genetic differentiation among them. Comparison of intrapopulation genetic diversity of the B&H population with other European and non-European populations, based on three loci (RHD, MN, and KEL), clearly show that the level of genetic diversity of the B&H population is within the European range.

BACKGROUND Aim of our study is to provide an insight into the genetic expression landscape of GREB1L, ITGA10 and CRELD2 which are important in human genitourinary tract development which might help elucidate the critical stages for the onset of kidney anomalies. METHODS Morphological parameters were analyzed using immunohistochemistry on human foetal (13-38 w) and postnatal (1.5 and 7.5y) human kidney samples. RESULTS GREB1L marker had a strong intensity and the highest rate in proximal tubules (PTC) of 1.5 years' kidney (90.25%). In the distal tubules (DCT) there were statistically significant differences in 13 w, 15 w, 16 w, 21 w, 38 w and 7.5y regarding 1.5y (Kruskal-Wallis test, p < 0.001). There was significantly more GREB1L in the glomeruli at 21 w and 38 w in regard to all other stages (Kruskal-Wallis test, p < 0.01). ITGA10 staining intensity was strongest in PCT with the highest rate in 13 w (92.75%), while the lowest rate was found in glomeruli and DCT (Kruskal-Wallis test, p < 0.001). CRELD2 had the strongest staining intensity in PCT with the highest rate in 13 w and 1.5y (92.25%) and lowest in the glomeruli of 7.5 years (24.3 %). In DCT there were statistically significant differences in CRELD2 positive cells in 13 w, 15 w, 16 w, 21 w, 38 w and 7.5y regarding 1.5y (Kruskal-Wallis test, p < 0.01). ITGA10 and CRELD2 co-localised in the postnatal period in DCT. CONCLUSION High kidney expressions of GREB1L, ITGA10 and CRELD2 even in the postnatal period implicate their importance not only for the onset of CAKUT in the case of their mutation but also for maintenance of kidney homeostasis.

The successful exploration of dimension stone mainly depends on the quality, size, and shape of extractable blocks of dimension stone. The investigated area is in the Pelješac Peninsula (Croatia), in the External Dinarides orogeny, built from thick carbonate succession, characterized by relatively small deposits of high-quality dimension stone. These conditions demand challenging geological investigations in the “pre-quarry” phase to find optimal quarry location. The size and shape of dimension stone blocks are mainly controlled by fracture pattern systems. In the rugged, covered terrains, it is very hard to obtain a satisfactory amount of fracture data from the surface, so it is necessary to collect them from the underground. Borehole camera technology can visualize the inner part of the rock mass and measure the fracture characteristics. The main conclusions are as follows: (1) the digital borehole camera technology provides a quick, effective, and low-cost geological survey of fractured rock mass; (2) statistical fracture distribution parameters, P10, fracture spacing, Volumetric Joint Count (Jv) based on borehole wall survey can reflect the integrity of rock mass, providing a solid decision-making base for further investment plans and dimension stone excavation method.

Background Since the beginning of the COVID-19 pandemic, several inflammatory markers have been investigated as possible predictors of survival. Ferritin and from recently LDH have emerged as a possible marker that could serve to this purpose, with different cut-off levels than standard. Furthermore, serum elevations of these markers were reported in other viral infections such as dengue fever; while it has not been reported in MERS and SARS outbreaks and possibly making a biochemical distinction between COVID-19 and other similar diseases. The aim of this research was to establish independent admission levels of ferritin and LDH that predict lethal outcome more accurately. Methods In this prospective cohort study all the patients were hospitalized at UKC, B&H (n=137), between 28th of March and 1st of August 2020. The criteria for hospitalization was based on MEWS score, and all the inflammatory markers were evaluated in the first 72 hours of admission. Cut-off values of serum ferritin levels were set at 1500 ng/mL and LDH 350 U/L. Results Patients with serum ferritin levels >1500 ng/mL had 7.304 OR (CI95% 1.956-27.277; p=0.003) higher for lethal outcome than the group with <1500 ng/mL. Also, patients with levels of LDH >350 U/I had 5.560 (CI95% 2.480-12.468; p<0.001) higher OR of lethal outcome than patients with LDH <350 U/L. With the significant statistical difference between group means for both ferritin and LDH (p<0.001).Discussion Serum levels of ferritin >1500 ng/ml and LDH >350 U/L increase OR of lethal outcome. The levels of these inflammatory markers indicate the degree of inflammatory response and severity of the disaese as well as the possible outcome of the disease. Together these two markers could be used as predictors in clinical settings and treatment planning of patients with COVID-19.Conclusion: Together these two markers could be used as predictors in clinical settings and treatment planning of patients with COVID-19.

Most children with a proven coronavirus disease (COVID-19) infection are asymptomatic or have mild symptoms. However, a small number of children have been identified in the past 2 months with developed significant multisystem inflammatory response. All children were treated according to standard protocols. Children with this disease may require hospitalization in pediatric intensive care unit with a multisystem team approach to the disease, which includes pediatricians, infectologists, cardiologists, rheumatologists, immunologists, and epidemiologists. This extremely rare disease is curable if diagnosed in time. This rare syndrome has features in common with other pediatric inflammatory diseases including Kawasaki syndrome, staphylococcal and streptococcal toxic shock syndrome, bacterial sepsis, macrophage activation syndrome, and may present with unusual abdominal pain including elevated inflammation markers. Early recognition of this disease by a pediatrician or family doctor specialist is crucial for the timely treatment and outcome of the disease.

Purpose: To evaluate the results of the Kurjak antenatal neurodevelopmental test (KANET) in multicentric studies. Materials and methods: In KANET, normal, borderline, and abnormal fetuses postnatal development was followed. The Chi-square was considered significant if p < 0.05 was used in the statistical analysis. Specificity, sensitivity, prevalence, positive and negative predictive value, false-positive, and false-negative results were calculated. Results: In 3,709 singleton fetuses, KANET was assessed. Postnatal follow-up was available for 1,556 of 1,573 (42.4%) infants. For 2,136, the data were not available. Interrater reliability (κ coefficient) for low-risk fetuses was between 0.64 and 0.65 (agreement 94.2–97.3%), for high-risk fetuses was between 0.44 and 0.53 (agreement 70.5–78.9%), respectively. Borderline KANET was found in 153 (9.7%), abnormal in 52 (3.3%), both more prevalent in high-risk pregnancies ( χ 2 = 457.36; df = 2; p < 0.01). Abnormal KANET was connected with severe postnatal developmental delay ( χ 2 = 315.28; df = 6; p < 0.01). In 47 out of 1,102 children aged 2 years and more, abnormal KANET was found, among them in one with CP. In 1 out of 1,055 children with normal KANET, severe developmental delay was found. The KANET has low sensitivity for detection of developmental delay and CP. The KANET specificity is high for all tested variables, positive predictive value and the false-positive rate are high, the negative predictive value is high (99.77–99.95%), and the false-negative rate is low (0.23–0.05%). Conclusion: With normal KANET, there is a high probability of normal infant development. If the KANET score is borderline or abnormal in high-risk pregnancies, postnatal development may appear abnormal.

The article presents the possibility of using three-dimensional ultrasound in the prenatal period for assessment of fetal neurobehavior during the Kurjak Antenatal Neurodevelopmental Test (KANET). By analyzing fetal movements and structure, invaluable data on neurodevelopment can be obtained. The surprising position of the fetus and its reactions raise many questions about fetal intrauterine life. The aim of this clinical work is the early detection of the existence of neurodevelopment disorders.