Actin nucleators initiate formation of actin filaments. Among them, the Arp2/3 complex has the ability to form branched actin networks. This complex is regulated by members of the Wiscott-Aldrich syndrome protein (WASp) family. Polymerization of actin filaments can be evaluated through flow cytometry by fluorescent phalloidin staining before and after stimulation with N-formyl-methionyl-leucyl-phenylalanine (fMLP). We identified a missense mutation in the gene ARPC1B (Arp2/3 activator subunit) resulting in defective actin polymerization in four patients (three of them were related). All patients (1 male, 3 female) developed microthrombocytopenia, cellular immune deficiency, eczema, various autoimmune manifestations, recurrent skin abscesses and elevated IgE antibodies. Besides four patients with homozygous mutation in ARPC1B, we also identified six heterozygous carriers without clinical disease (3 males, 3 females) within the same family. We developed a functional test to evaluate Arp2/3 complex function, which consists of flow cytometric detection of intracellular polymerized actin after in vitro fMLP stimulation of leukocytes. Median fluorescence intensities of FITC-phalloidin stained actin were measured in monocytes, neutrophils and lymphocytes of patients, carriers, and healthy control subjects. We detected non-efficient actin polymerization in monocytes and neutrophils of homozygous patients compared to carriers or the healthy subjects. In monocytes, the increase in median fluorescence intensities was significantly lower in patients compared to carriers (104 vs. 213%; p < 0.01) and healthy controls (104 vs. 289%; p < 0.01). Similarly, the increase in median fluorescence intensities in neutrophils was significantly increased in the group with carriers (208%; p < 0.01) and healthy controls (238%; p < 0.01) and significantly decreased in the patient's group (94%). Our functional fMLP/phalloidin test can therefore be used as a practical tool to separate symptomatic patients from asymptomatic mutation associated to actin polymerization.

The electrochemical methods are very good tool for determination of trace concentrations of various species in water samples. The analysis carried out using these methods are usually simple, fast and also the cost of the required equipment is much lower comparing to other instrumental methods. Furthermore, the electroanalytical methods are easy to automate and computerize. Among five major groups of these methods (potentiometry, voltammetry, coulometry, conductometry and dielectrometry), potentiometry and voltammetry attract the greatest attention of researchers. In this paper, experimental results of research related to development of procedures (voltammetric and potentiometric) for the determination of elements in environmental water samples were presented. Due to their common occurrence in environment and possible toxic effects on living organisms, vanadium and nitrate ions were selected for investigation. Optimization of voltammetric procedure for V(V) determination were carried out in matrix containing different surfactants and humic acids, using lead film electrode as a working electrode. Results showed that only nonionic surfactant Brij-35 did not interfere with the voltammetric signal. Other surfactants as well as humic acids reduced the signal, and possibility of their elimination with suitable resins were also investigated. Potentiometric measurements were consisted of preparation and determination of analytical properties of nitrate ion-selective electrodes with solid contact. The results showed that among three different membrane composition, the best response was achieved by membrane containing: Ni(Phen)2, THTDPCl, PVC and NPOE in the ratio of 1:2:33:64 wt. %, respectively. With the detection limit of 2.8 × 10-6 mol L-1, the working concentration range from 5 × 10-5 to 1 × 10-1 mol L-1 and a slope of -55.1 mV per decade, this electrode showed good selectivity to sulfate, acetate, carbonate, dihydrogen phosphate, fluoride and chloride ions, and also good potential reversibility.

Virus hepatitisa B (HBV), virus hepatitisa C (HCV) i virus humane imunodeficijencije (HIV) predstavljaju patogene koji se prenose krvlju i od posebnog su interesa za stomatoloski tim. U stomatoloskoj ordinaciji HBV, HCV i HIV se mogu prenijeti direktnim kontaktom sa krvlju i pljuvackom koja ima primjesa krvi, ili indirektnim kontaktom sa inficiranim instrumentima tokom i nakon rada. Upotreba ostrih instrumenata pri radu, te susretanje sa pacijentima koji trpe bol i stres predstavljaju faktore rizika za nastanak ekspozicijskih incidenata. Zbog toga se moraju preduzeti i dosljedno sprovoditi mjere zastite od virusnih infekcija. Specificna zastita protiv HBV je vakcina. Nespecificna zastita podrazumjeva zastitu osoblja, pacijenata, specifican odnos u radu sa kontaminiranim instrumentima, specificnu higijenu radnih povrsina i opreme u ordinaciji i zbrinjavanje medicinskog otpada. Prevencija ekspozicije je primarna strategija za smanjenje profesionalno nastalih infekcija, a pored toga, za HBV, HCV i HIV infekciju propisana je postekspozicijska profilaksa cija primjena ima zadovoljavajucu efikasnost

Introduction. The optic nerve is supplied by the arterial branches of the supericial pial plexus and direct intraneural branches. The aim of the study was to study the morphological characteristics (origin, number of arteries, calibers, and branching pattern) of perioptic arterial vascularization and intraoptic vascular network of the extracranial sections of the optic nerve: canalicular and intraorbital. Methods. The study included 18 pairs of the optic nerves of both sexes (11 males and 7 females), aged 51 to 78 years, with no signs of changes in the structures of the nervous system. The vasculature of the optic nerves was microdissected and examined under the stereoscopic microscope, after injecting their arteries with 10% mixture of India ink and gelatin, and 5% formaline ixation. Results. The intracanalicular part of the optic nerve received ine blood vessels from the ophthalmic artery, usually in two branches in 29 (82.9%) cases, while in 6 (17.1%) specimens there was only one branch for the nerve. The intraorbital segment of the optic nerve was supplied by two interconnected systems of blood vessels, peripheral and axial, both coming from the central retinal artery. Conclusion. On the basis of the obtained results, it has been conirmed that both segments of the optic nerve have a rich and very delicate vascular network. The supericial pial arterial plexus of the intracanalicular segment of the optic nerve has been identiied as the only source of its vascular supply. The intraorbital part of the optic nerve has two interconnected systems of blood vessels: peripheral and axial.

This study aimed to evaluate the effect of preoperative carbohydrate oral (CHO) loading on the postoperative metabolic and inflammatory response, perioperative discomfort and surgical clinical outcomes in open colorectal surgery compared with a conventional fasting protocol. Fifty patients were randomly allocated to either the intervention group (CHO), to receive preoperative oral carbohydrate supplementation, or the control group (FAST), to undergo preoperative fasting. Insulin resistance, insulin sensitivity, the Glasgow Prognostic Score (GPS) and IL-6 levels were analysed at 06 h on the day of surgery (T1), 6 h after surgery (T2) and at 06 h on postoperative day 1 (T3) and postoperative day 2 (T4). Thirst, hunger, dry mouth, weakness, anxiety and pain were assessed using the visual analogue scale (VAS) prior to anaesthesia induction and at 0–4, 4–8, 8–12 and 12–24 h after surgery. Surgical clinical outcomes included the return of gastrointestinal function, time to independent ambulation and postoperative discharge day. Postoperative insulin resistance was 30% lower (p < 0.03) and insulin sensitivity was 15% higher (p < 0.05) in the CHO group than in the FAST group. The GPS was lower in the CHO group at T1 (p < 0.001), T3 (p < 0.01) and T4 (p < 0.004). IL-6 serum levels were lower at the analysed postoperative time points in the CHO group (p < 0.001). The VAS well-being score was lower in the intervention group (p < 0.001); however, the VAS pain score was not significantly different between the groups. The evaluated surgical outcomes appeared earlier in the CHO group (p < 0.001). A preoperative CHO drink reduced the postoperative metabolic and inflammatory response and improved subjective well-being and surgical clinical outcomes but did not diminish the VAS pain score.

Introduction. Burnout syndrome is a common problem among healthcare workers. The aim of the study was to investigate the level of stress, components of burnout syndrome and the most common causes of workplace stress among the physicians working in the Primary Health Care Center Banja Luka, after which the obtained results concerning family physicians and the physicians of other specialties were compared. Methods. The observational study was conducted by interviewing physicians during the period March to May 2018. All employed physicians were provided with the following questionnaires: The socio-demographic questionnaire, the questionnaire for self-assessment of the level of stress, the questionnaire about the most frequent causes of stress at work and the Maslach Burnout Inventory. Results. The study included 211 physicians, out of a total of 246 physicians (127 family physicians and 84 physicians of other specialties) working in the Primary Health Care Center Banja Luka. There was a significantly higher level of stress (p = 0.011), emotional exhaustion (p < 0.001) and depersonalization (p < 0.001) among family physicians compared to the physicians of other specialties. There was a significant difference in the presence of all causes of stress among family physicians, except the stress concerning the patients requiring emergency care. The multivariate logistic regression analysis found that stress was significantly associated with emotional exhaustion in both groups and with personal accomplishment in family physicians. In family physicians, there was a significant association between a high level of depersonalization and personal accomplishment. In physicians of other specialties significant association was found between education and emotional exhaustion as well as personal accomplishment, and between female gender and high level of depersonalization. Conclusion. The level of stress and the burnout syndrome were considerably more present in family physicians compared to physicians of other specialties.

Progress in diagnosis and treatment has led to a significant improvement in the fate of children born with tetralogy of Fallot, with the perioperative mortality of 2-3% and a 30-year survival rate of 90%. However, the majority of these patients have residual postoperative morphological and hemodynamic disorders, as well as heart rhythm disorders, primarily due to the volume loading of the right ventricle caused by chronic pulmonary regurgitation. Improved surgical techniques have reduced early mortality to less than 3%, but the annual mortality rate has increased 20-30 years after initial surgical remediation, mainly due to unwanted cardiac events. In longitudinal monitoring of patients after repair of tetralogy of Fallot, early detection of morphological and hemodynamic residual disorders both in asymptomatic and symptomatic patients is of great importance. The purpose of this is a timely identification of new therapeutic measures (e.g. pulmonary valve replacement) in order to improve the course and outcome of treatment. Cardiovascular magnetic resonance imaging is a diagnostic method that provides the most precise and accurate estimation of individual parameters of cardiac dysfunction and poor outcomes. Furthermore, it plays a significant role in defining the predictive ability of individual parameters. Previous research has shown that the increase in mortality risk coincides with progressive dilation and right ventricular dysfunction, by means of ventriculo-ventricular interaction and left ventricular dysfunction. Identification of parameters that can predict the high-risk patients for future unwanted cardiac events such as ventricular tachycardia and cardiac insufficiency can assist the customization of a therapeutic approach leading to improvement in quality of life and patient's survival rate.

BackgroundTiming and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted.MethodsThis worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018.ResultsA total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47 years (interquartile range [IQR] 28–66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6 days (IQR 4–10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80 years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate ≥ 22 breaths/min, systolic blood pressure < 100 mmHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO2) < 90% in air, platelet count < 50,000 cells/mm3, and lactate > 4 mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0–1, 22.7% for those who had scores of 2–3, 46.8% for those who had scores of 4–5, and 86.7% for those who have scores of 7–8.ConclusionsThe simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality.

This paper mainly refers to attitudes about the reasons for the avoidance of sports and sports activities of young people who have never been involved in these activities. In this survey involving 226 university and high school students, 110 stated that they had never been involved in sport or any sporting activities. They are surely the most reputed to answer these questions. Of the offered reasons (causes) that are responsible for avoiding and non-participation in sports and sports activities, in the first place is the lack of interest which is stated by about 90% of the respondents. Secondly, the reason why respondents do not deal with sports and sports activities are the obligations at school and at the faculty, and this was confirmed by 85% of respondents. Laziness follows, about this they were very self-critical and sincere, confirming in a percentage of 84.5% that this was one of the reasons for their abstinence from sports and sports activities. Immediately behind laziness are television, there are computers and cell phones with about 80%, and so on. The results showed that male and female, then smokers and non-smokers, do not differ significantly in attitudes about these reasons. It is the same with those who consume, occasionally consume and do not consume alcohol. There is a partial difference between high school students and university students in attitudes to some causes, as well as between those who live in the city, suburban village and village.

This video demonstrates microsurgical resection of intramedullary spinal cord metastasis of lung adenocarcinoma. Lung cancer is the predominant cause of rare metastatic intramedullary involvement of the spinal cord.1-4 Because of severe disabilities, these tumors should be considered for treatment with the goal of complete removal to preserve neurological functioning.5-9  Surgical resection improves symptoms, preserves ambulatory status, and increases survival time twice that of nonsurgical treatments.3,8,10 Surgery can be effective in arresting neurological decline.11,12 To our knowledge, this is the first video report of an intramedullary spinal cord metastasis resection.  A 69-yr-old male with history of lung cancer presented with acute onset left arm abduction, forearm flexion, and hand weakness (3/5) and gait disturbance. Cervical spine MRI revealed C4/C5 nonhomogenously enhancing intramedullary tumor measuring 22 × 10 × 7 mm. Sagittal T2-weighted image demonstrated extensive cord edema.  The C4 and C5 laminectomies were performed. Microsurgical techniques were employed.13-15 Metastasis involved the left lateral aspect of the cord with invasion of 2 left dorsal sensory nerve roots, which were resected. Further transection of the dentate ligament relaxed the spinal cord, enabling safer tumor resection. Pial dissection using bipolar forceps, microscissors, and microdissector enabled tumor delivery. Following resection, dural closure was reinforced with previously harvested fat tissue graft to prevent CSF leak.16  Postoperative MRI revealed complete macroscopic resection with improvement of spinal cord swelling. Patient improved his gate and his left arm motor strength was stable. Subsequently, patient received focal adjuvant radiotherapy. Written consent was obtained directly from the patient.

Explainable AI is an important area of research within which Explainable Planning is an emerging topic. In this paper, we argue that Explainable Planning can be designed as a service -- that is, as a wrapper around an existing planning system that utilises the existing planner to assist in answering contrastive questions. We introduce a prototype framework to facilitate this, along with some examples of how a planner can be used to address certain types of contrastive questions. We discuss the main advantages and limitations of such an approach and we identify open questions for Explainable Planning as a service that identify several possible research directions.

The aim of the study was to determine the differences in ventilation parameters between boys and girls in the 10-15 year age group (aged 10-15). The study was conducted on a sample of N = 1857 subjects divided into 2 subunits taken from the boys (n = 968) and girls (n = 889) from the area of the City of Mostar. The sample variables consisted of 3 variables for the assessment of anthropometric measures, 24 variables were used for the evaluation of the ventilation parameters using Spirovit SP1 of the company Schiller AG. Results processing was performed in SPSS 21.0. To determine quantitative differences between groups, a canonical discriminatory analysis was applied. A discriminatory analysis found that there are statistically significant quantitative differences between groups of boys and girls on a global level. One function is isolated which explains 100% of the total variance and has a statistically significant high value (Can.Corr.=.948). The value of Wilk’s lambda is low (.101) indicating high discrimination between groups. In quantitative terms, at the multivariate level, the greatest discrimination between groups in an isolated function is the variables of the Tiffen index (FEV1/FVCPRED), FEF50PRED, FEF75PRED and the percentage of the Tiffene index for respondents (FEV1/FVC%). This is also supported by the value of the centroid position in an isolated discriminatory function, where we can see the great distance between the centroid that is represented by groups of boys and girls in the space.