Uvod. Holesteatom se definise kao cisticna, ekspanzivna lezija temporalne kosti, ciju glavnu osobinu karakterise progresivan rast s erozijom okolne kosti. Cilj istraživanja je bio da se ispita status osikularnog lanca i kostanih zidova kavuma timpani kod ispitanika sa holesteatomom srednjeg uha. Metode. Studija je obuhvatila 100 ispitanika, oba pola, u dobi od 16 do 84 godine, operativno tretiranih zbog hronicne upale srednjeg uha u Klinici za bolesti uha, grla i nosa Univerzitetskog klinickog centra Republike Srpske, u razdoblju od 2015. do 2016. godine. Ispitanici su podijeljeni u dvije grupe od po 50 ispitanika prema prisustvu holesteatoma: eksperimentalnu grupu sa holesteatomom i kontrolnu grupu bez holesteatoma. Intraoperativnom eksploracijom ispitan je status osikularnog lanca i kostanih zidova kavuma timpani. Rezultati. U kontrolnoj grupi bez holesteatoma statisticki znacajno veci broj ispitanika je imao ocuvan anatomski integritet kostanih zidova kavuma timpani (47/50; χ2 = 38,720; p < 0,001) za razliku od eksperimentalne grupe gdje su statisticki znacajno ucestaliji bili ispitanici s destrukcijom pomenutih anatomskih struktura (41/50; χ2 = 22,224; p < 0,001). Utvrđena je statisticki znacajna razlika između grupe sa i bez holesteatoma u odnosu na status osikularnog lanca. U eksperimentalnoj grupi je zabilježena statisticki znacajno veca ucestalost ispitanika (36%) s nedostatkom inkusa i drske maleusa i erozijom suprastruktura stapesa, a u kontrolnoj statisticki znacajno veca ucestalost ispitanika (76%) s ocuvanim osikularnim lancem. Zakljucak. Destrukcija kostanih zidova kavuma timpani i osikularnog lanca je bila statisticki znacajno ucestalija kod ispitanika sa holesteatomom srednjeg uha. Prema stepenu destrukcije osikularnog lanca, statisticki najzastupljenija je bila kategorija ispitanika s nedostatkom inkusa, drske maleusa, kao i erozijom suprastruktura stapesa.

Recent developments in personal and mobile healthcare have shown promising results in term of patients' quality of life and quality of care improvements. This can be achieved through continuous monitoring of patients' physiological functions using wearable non-invasive biomedical sensors. The remote collection and processing of such data can then be used to provide rapid medical response if a problem is detected or to offer preventive measures. However, the integration of wearable sensors into wider-scale framework is still a major challenge, as real-time data collection and remote configuration capabilities must be integrated to strongly constrained devices. Here, we show how such requirements can be integrated into a multiparameter, cardiorespiratory wearable sensor and how this sensor can be integrated into wide-scale Internet-based frameworks. We thus manufactured a biomedical-grade heart rate, instantaneous heart-rate variability and respiratory sensor. The sensor was tested in real life ambulatory condition, and we showed an Internet-based proof of concept exhibiting the integration of our sensor into wide-scale healthcare frameworks. Finally, we anticipate that wearable healthcare will greatly improve patients' quality-of-life by using IoT-based wearable devices similar to the sensor developed in this paper.

Recent developments in personal and mobile healthcare have shown promising results in term of patients' quality of life and quality of care improvements. This can be achieved through continuous monitoring of patients' physiological functions using wearable non-invasive biomedical sensors. The remote collection and processing of such data can then be used to provide rapid medical response if a problem is detected or to offer preventive measures. However, the integration of wearable sensors into wider-scale framework is still a major challenge, as real-time data collection and remote configuration capabilities must be integrated to strongly constrained devices. Here, we show how such requirements can be integrated into a multiparameter, cardiorespiratory wearable sensor and how this sensor can be integrated into wide-scale Internet-based frameworks. We thus manufactured a biomedical-grade heart rate, instantaneous heart-rate variability and respiratory sensor. The sensor was tested in real life ambulatory condition, and we showed an Internet-based proof of concept exhibiting the integration of our sensor into wide-scale healthcare frameworks. Finally, we anticipate that wearable healthcare will greatly improve patients' quality-of-life by using IoT-based wearable devices similar to the sensor developed in this paper.

Drug shortages have been identified as a public health problem in an increasing number of countries. This can negatively impact on the quality and efficiency of patient care, as well as contribute to increases in the cost of treatment and the workload of health care providers. Shortages also raise ethical and political issues. The scientific evidence on drug shortages is still scarce, but many lessons can be drawn from cross-country analyses. The objective of this study was to characterize, compare, and evaluate the current systemic measures and legislative and organizational frameworks aimed at preventing or mitigating drug shortages within health care systems across a range of European and Western Asian countries. The study design was retrospective, cross-sectional, descriptive, and observational. Information was gathered through a survey distributed among senior personnel from ministries of health, state medicines agencies, local health authorities, other health or pharmaceutical pricing and reimbursement authorities, health insurance companies and academic institutions, with knowledge of the pharmaceutical markets in the 28 countries studied. Our study found that formal definitions of drug shortages currently exist in only a few countries. The characteristics of drug shortages, including their assortment, duration, frequency, and dynamics, were found to be variable and sometimes difficult to assess. Numerous information hubs were identified. Providing public access to information on drug shortages to the maximum possible extent is a prerequisite for performing more advanced studies on the problem and identifying solutions. Imposing public service obligations, providing the formal possibility to prescribe unlicensed medicines, and temporary bans on parallel exports are widespread measures. A positive finding of our study was the identification of numerous bottom-up initiatives and organizational frameworks aimed at preventing or mitigating drug shortages. The experiences and lessons drawn from these initiatives should be carefully evaluated, monitored, and presented to a wider international audience for careful appraisal. To be able to find solutions to the problem of drug shortages, there is an urgent need to develop a set of agreed definitions for drug shortages, as well as methodologies for their evaluation and monitoring. This is being progressed.

Three-dimensional (3D) geological models are useful tools in various geological, mining and other engineering activities. Geological model shows stratigraphic, structural and lithologic settings of the study area in 3D space, and serves as a 3D geodatabase for a variety of input data. The study area is one of the bauxite-bearing sites, Crvene Stijene, near Jajce (Bosnia and Herzegovina). During the last decades, a number of geological, geodetic, mining and other data were collected through intensive geological research and mining (exploration), with the aim of finding and exploiting bauxite deposits. Therefore, selected area is a great polygon for the implementing and testing of workflow for the construction of a 3D geological model of bauxite-bearing field and its application in current and future research and mining. Presented workflow includes collection, digitalization, organization and visualization for different types of existing and new data (600 boreholes, geological maps and cross-sections, DEM, structural measurements from the surface, as well as in tunnels and adits) in 3D geological database. For this study, different types of geological objects, fault planes and geological surfaces were modelled with different interpolation algorithms. The constructed model is interactive and it can be easily updated by new input data from current research and exploitation activities: boreholes, underground mining objects, etc. The 3D geological model represents a relevant foundation for planning new research and mining activities. Furthermore, newly found deposits and their volumes can be quickly modelled, contoured and calculated. Presented modelling workflow is applicable to other areas and other mineral resources

Wearable inertial sensors have been widely investigated for fall risk assessment and prediction in older adults. However, heterogeneity in published studies in terms of sensor location, task assessed and features extracted is high, making challenging evidence-based design of new studies and/or real-life applications. We conducted a systematic review and meta-analysis to appraise the best available evidence in the field. Namely, we applied established statistical methods for the analysis of categorical data to identify optimal combinations of sensor locations, tasks, and feature categories. We also conducted a meta-analysis on sensor-based features to identify a set of significant features and their pivot values. The results demonstrated that with a walking test, the most effective feature to assess the risk of falling was the velocity with the sensor placed on the shins. Conversely, during quite standing, linear acceleration measured at the lower back was the most effective combination of feature-placement. Similarly, during the sit-to-stand and/or the stand-to-sit tests, linear acceleration measured at the lower back seems to be the most effective feature-placement combination. The meta-analysis demonstrated that four features resulted significantly higher in fallers: the root-mean-square acceleration in the mediolateral direction during quiet standing with eyes closed [Mean Difference (MD): 0.01 g; 95% Confidence Interval (CI95%): 0.006 to 0.014]; the number of steps (MD: 1.638 steps; CI95%: 0.384 to 2.892) and total time (MD: 2.274 seconds; CI95%: 0.531 to 4.017) to complete the timed up and go test; and the step time (MD: 0.053; CI95%: 0.012 to 0.095; p = 0.01) during walking.

This paper provides a comprehensive analysis of the energy efficiency performance for different relaying schemes over the non-Gaussian power line communication (PLC) channel. Specifically, amplify-and-forward (AF), decode-and-forward (DF), selective DF (SDF) and incremental DF (IDF) relaying systems are investigated. For a more realistic scenario, the power consumption profile of the PLC modems is assumed to consist of both dynamic and static power. For each system, we derive accurate analytical expressions for the outage probability and the minimum energy-per-bit performance. For the sake of comparison and completeness as well as to quantify the achievable gains, we also analyze the performance of a single-hop PLC system. Monte Carlo simulations are provided throughout this paper to validate the theoretical analysis. Results reveal that AF relaying over the non-Gaussian PLC channel does not always enhance the performance and that the IDF PLC system offers the best performance compared to all other schemes considered. It is also shown that increasing the channel variance, which is related to the PLC network branching, and impulsive noise probability can considerably deteriorate the system performance. Furthermore, when the end-to-end distance is relatively small, it is found that the single-hop PLC approach can perform better than AF relaying.

Abstract In this video clip, the authors present the resection of a tuberculum sellae meningioma with compression of the left optic nerve and a chiasm (Fig. 1) through a standard cranial orbital (CO) skull base approach.1 2 3 The key step in the tumor resection was microsurgical dissection of left and right A1 segments of the anterior cerebral artery and the anterior communicating artery and the separation of the tumor from these vascular structures. This was followed by careful separation of the meningioma from both optic nerves, the chiasm and the pituitary stalk. The final step was coagulation and resection of the tumor origin on the dura of the tuberculum sellae, devascularizing the tumor. Once this was achieved, the tumor was removed. Using this approach, an optimal surgical corridor to the sellar area was provided while minimizing the retraction of frontal and temporal lobes. The link to the video can be found at: https://youtu.be/O59Fj2dNXB0.

Pediatrics is defined as the science of a healthy and sick child from birth to end of adolescence. Diseases of the cardiovascular system are the leading causes of mortality in adults, with frequent onset in childhood. The cardiologic examination starts with anamnesis in a pleasant atmosphere, refined space, enough time and patience, detailed measurements, and preferably a noncrying child. Anamnesis, regardless of the development of diagnostic procedures, still constitutes the basis of every clinical examination. The basic characteristics of pediatric cardiac anamnesis are comprehensiveness, that is, details, clarity, concurrency, and chronology. Proper and conscientiously taken anamnesis with a thorough clinical examination of a sick child is a solid protection against dehumanizing the relationship between a physician and patient. Pediatric cardiac anamnesis can be variable, completely negative, but very rich. Anamnesis should, first of all, clarify whether only a child is sick or it is perceived like that be his or her environment. Preschool and school-age children are normally attending anamnesis. High-quality, comprehensive medical history can keep the patient at one level of health care, with a strict focus primarily on the diagnostic processes, reduce crowds in specialist and subspecialist institutions, and make economic savings. A large number of patients in specialist and subspecialist clinics can be reduced by proper screening and by developing primary health-care system (from the local health-care center). Taking patient's medical history with thoroughness has a strong educative character for young doctors at the beginning of their careers.