Sentinel node (SN) biopsy (SNB) detects clinically occult metastases of breast cancer and melanoma in 20–30%. Wound infections, seroma and lymph edema occur in up to 10%. Targeted ultrasound (US) of the SN, (with fine needle aspiration cytology (FNAC) if appropriate) has been investigated as a minimally invasive alternative, but reported sensitivity rates are too low to replace SNB. Our hypothesis is that the use of a handheld gamma probe concomitant with US may improve sensitivity. Our aim is to provide an overview of the current literature on preoperative nodal staging of clinical N0 melanoma patients, report on a pilot, and present a study protocol for a minimally invasive alternative to the SNB: Gamma probe and Ultrasound guided Fine needle aspiration cytology of the sentinel node (GULF trial). The GULF trial is a multicenter open single arm observational trial. Newly diagnosed cT1b-4N0M0 cutaneous melanoma or cT1-3N0M0 breast cancer patients, aged >18 years, presenting for SNB are eligible. 120 patients will be included for preoperative targeted gamma probe guided US and FNAC of the SN. Afterwards all patients proceed to surgical SNB. Primary endpoint is the sensitivity of FNAC. Secondary endpoints include SN identification rate and the histopathological compatibility of Core Needle Biopsy and FNAC vs. SNB. Secondary endpoints were investigated in a pilot with 10 FNACs and marker placements, and 10 FNACs combined with Core Needle Biopsy. A pilot in 20 patients showed that SN identification rate was 90%, supporting the feasibility of this technique. There is broad experience with US (in combination with FNAC) prior to SNB, but sensitivity and specificity are too low to completely abandon SNB. Promising alternative techniques potentially will replace SNB in the future but more evidence is needed in the form of prospective studies. Accurate identification of the SN for US-FNAC has been proven feasible in our pilot. When adequate sensitivity can be reached, US-FNAC provides a minimally invasive alternative for the surgical SNB procedure. The GULF trial is registered in the Netherlands Trial Registry (NTR), ID: NRT5193 . May 1st 2015.

Hepatitis C virus infection (HCV), one of the greatest causes of liver disease, is a frequent complication in patients with end-stage renal disease (ESRD) on dialysis. ESRD is defined as decreased glomerular filtration and also accompanied by impaired function of the immune system. Galectin-3 is a β-galactoside-binding lectin, involved in various biological processes including pathogenesis of chronic renal disease. The aim of our study was to estimate disease severity in ESRD HCV+ patients and analyze the serum concentrations of IL-1β, IL-4, IL-23, and IL-6; anti-HCV antibodies; and galectin-3. Also, we attempted to determine potential correlation between galectin-3 level and parameters of disease severity ALT and AST. Our results showed decreased levels of ALT and AST (p = 0.00), demonstrating less liver destruction in ESRD HCV+ patients in comparison to HCV+ patients. Increased levels of IL-6 (p = 0.03) implicate a hepatoprotective role of IL-6 in these patients. Also, level of galectin-3 (p = 0.00) in the serum of ESRD HCV+ patients was higher than that of HCV+ patients. This alteration was accompanied with negative correlation between galectin-3 and AST and ALT, respectively (p = 0.029; p = 0.033). The presence of increased systemic levels of IL-6 and Gal-3 in ESRD HCV+ patients may be an attempt to counteract or limit ongoing proinflammatory processes and to downregulate chronic inflammation, suggesting the new aspects of HCV infection in ESRD patients.

Herzegovina Abstract This work is dedicated to solving the direct and inverse spectral task Sturm-Liouville type with linear delay and dispensed boundary conditions. Under the direct spectral assignment, we mean the construction of solutions . 2 2 y z y D = The aim of this paper is to solve the inverse task for the operator , 2 D which our knowledge is not known in the literature. We propose a new method. This method is based on the transformation of F in such a form that establishes a connection between the Fourier coefficients of a specific set of functions and values of their own operator , 2 D second. In this article, we will assume that .0 = h

Real-time object detection is crucial for many applications of Unmanned Aerial Vehicles (UAVs) such asreconnaissance and surveillance, search-and-rescue, and infras-tructure inspection. In the last few years, Convolutional NeuralNetworks (CNNs) have emerged as a powerful class of modelsfor recognizing image content, and are widely considered inthe computer vision community to be the de facto standardapproach for most problems. However, object detection basedon CNNs is extremely computationally demanding, typicallyrequiring high-end Graphics Processing Units (GPUs) thatrequire too much power and weight, especially for a lightweightand low-cost drone. In this paper, we propose moving thecomputation to an off-board computing cloud, while keepinglow-level object detection and short-term navigation onboard. We apply Faster Regions with CNNs (R-CNNs), a state-of-the-art algorithm, to detect not one or two but hundreds of objecttypes in near real-time.

Introduction: Managing organizational culture has been increasingly viewed as a lever for health care improvement. The aim of this study was to investigate the correlation between the type of organizational culture and patient satisfaction in the selected health care centers in the Federation of Bosnia and Herzegovina (FBIH). Methods: We conducted a cross-sectional survey in two municipal primary health care (PHC) centers in the FBIH, referred as Primary health care (PHC) center A and Primary health care (PHC) center B. A validated questionnaire, known as the Organizational Culture Assessment Instrument (OCAI), was used for the assessment of organizational culture. The questionnaire was distributed among the family health care teams at the two PHCs. Simultaneously, we carried out a survey about patient satisfaction among patients during their visits to the family health care teams. Results: We observed the differences in the type of the organizational culture between the health care centers. The hierarchical culture was found the dominant culture in PHC center A, whereas the market culture was the dominant culture in PHC center B. Also, the statistical significance (t test) was recorded in the overall patient satisfaction in the health care center with the dominated hierarchical culture followed by the clan culture (PHC center A). Conclusions: Considering the lack of similar surveys in Bosnia and Herzegovina, we believe that this study might be a good starting point for education of human resource managers in health care.

Abstract Since the teaching content of Islamic religious instruction contains elements of a foreign language and description of rituals, in the learning process a counselor is essential. The question arises regarding the possibilities of learning this content with the use of information technology during students’ homework assignments. The study was conducted with elementary school pupils in “Jovan Jovanovic Zmaj” Primary School in Novi Pazar. The possibilities of using electronic materials by students were examined and it has been concluded that electronic materials would be best used when creating the form of static Web pages with text and graphics, as well as audio and video recordings. The influence of e-learning was examined with two groups of students who have equal school success. One group was taught the lessons and did their homework using the traditional methods of learning, while the other group used electronic learning. All students were graded in several aspects of the homework they had done and the scores were compared. It was revealed that better success was achieved by students who had used electronic material. The conclusion is that e-learning has a positive impact on the development of homework tasks in Islamic religious instruction in primary schools. Key words: e-lessons; e-learning; education; evaluation; website --- Sažetak S obzirom na to da nastavni sadržaji predmeta islamski vjeronauk sadrže elemente stranog jezika i opis obrednih radnji, u ucenju je neophodna pomoc strucne osobe. Postavlja se pitanje mogucnosti ucenickog svladavanja takvih dijelova gradiva uporabom informatickih tehnologija prilikom izrade domacih zadataka. Istraživanje provedeno među ucenicima O. S. "Jovan Jovanovic Zmaj" u Novom Pazaru. Ispitane su mogucnosti ucenicke upotrebe elektronickog materijala i zakljuceno da bi elektronicki materijal imao najbolju uporabu ako se izradi u formi staticnih internetskih stranica s tekstualnim i grafickim sadržajem, kao i poprati audiosnimkama i videosnimkama. Istraživanje utjecaja elektronickog ucenja izvrseno je nad dvjema skupinama ucenika ciji je uspjeh bio jednak. Jedna je skupina ucila gradivo i izrađivala domacu zadacu koristeci se tradicionalnim nacinom ucenja, a druga se koristila elektronickim ucenjem. Kod svih je ucenika ocijenjeno vise aspekata ispunjenog domaceg zadatka i uspoređene ocjene. Pokazalo se da su bolji uspjeh postigli ucenici koji su se koristili elektronickim materijalom. Zakljucak je da elektronicko ucenje ima pozitivan utjecaj na izradu domacih zadataka u nastavi islamskog vjeronauka u osnovnim skolama. Kljucne rijeci: e-gradivo; e-ucenje; edukacija; ocjenjivanje; internetska stranica.