This paper introduces a simultaneous optimization approach to synthesizing work and heat exchange networks (WHENs). The proposed work and heat integration (WHI) superstructure enables different thermodynamic paths of pressure and temperature-changing streams. The superstructure is connected to a heat exchanger network (HEN) superstructure, enabling the heat integration of hot and cold streams identified within the WHI superstructure. A two-step solution strategy is proposed, consisting of initialization and design steps. In the first step, a thermodynamic path model based on the WHI superstructure is combined with a model for simultaneous optimization and heat integration. This nonlinear programming (NLP) model aims to minimize operating expenditures and provide an initial solution for the second optimization step. In addition, hot and cold streams are identified, enabling additional model reduction. In the second step of the proposed solution approach, a thermodynamic path model is combined with the modified HEN model to minimize the network’s total annualized cost (TAC). The proposed mixed integer nonlinear programming (MINLP) model is validated by several examples, exploring the impact of the equipment costing and annualization factor on the optimal network design. The results from these case studies clearly indicate that the new synthesis approach proposed in this paper produces solutions that are consistently similar to or better than the designs presented in the literature using other methodologies.

Introduction: Patients following the acute stage of Severe Acute Respiratory Syndrome Coronavirus 2 were shown to present with persisting symptoms including fatigue, dyspnea, joint pain, and chest pain. The aim of this study was to investigate the effect of a 6-week home physiotherapy program on the psychological and physical symptoms, as well as the physical abilities to perform activities of daily living in post-COVID-19 patients. Methods: The subjects were 39 adult patients who had been diagnosed with COVID-19 and had been hospitalized at the University Clinical Center of Kosovo. Patients initially underwent a physiotherapy assessment 2-3 weeks after discharge from the hospital, including sociodemographic data, psychological and physical symptoms, and functional performance in daily activities using the Patient-Specific Functional Scale (PSFS). Based on their functional capacity, the patients received two types of brochures for a home physiotherapy program that was carried out over the next 6 weeks. Upon the completion of the physiotherapy program, 23 patients reported for the second physiotherapy assessment. The Mann–Whitney Wilcoxon test was used for comparison of the variables obtained during the first and second assessments. Results: Pre–post analysis showed that the symptoms including excessive fatigue, difficulty breathing, and insomnia were significantly less present following the home physiotherapy program (p = 0.005; p = 0.008; p = 0.034). On the PSFS scale, the mean score increased from 5.2 (2.1) to 7.8 (0.5) for stair climbing, from 5.5 (1.8) to 8.8 (1.6) for walking longer distances, and from 3.7 (3.2) to 4.0 (5.6) for running. Conclusion: Although limited by the absence of a control group, the findings from this study indicate that home physiotherapy intervention can be feasible and effective in enhancing psychological and physical symptoms, as well as activities of daily living in post-COVID-19 patients following hospitalization.

Background Breast cancer-related lymphedema (BCRL) is a potentially disabling and often irreversible consequence of breast cancer treatment, caused by the mechanical incompetence of the lymphatic system, resulting in reduced drainage capacity and functional overload due to an excessive volume of interstitial fluid surpassing the system’s transport capacity in the arm. We wanted to determine the impact and explore the differences in independent risk factors for the occurrence of BCRL; incidence of BCRL over a five-year period at the Institute of Oncology Vojvodina in Sremska Kamenica and to answer the research question regarding the influence of the prehabilitation program on the overall incidence of BCRL during the observed five-year period. Methods From 2014 to 2018, a retrospective study was conducted at the Institute of Oncology of Vojvodina in Sremska Kamenica, analyzing female patients who had undergone breast cancer surgery. Results The study included 150 breast cancer patients who developed secondary lymphedema following surgery with the mean age of 59.2 ± 11.3 years. Fluctuations in hospitalization rates were observed over the five-year period, with the highest number of admissions in 2014 (24.0%) and a decline in 2018 (14.0%). The most common surgical procedure performed was left quadrantectomy (24.0%), followed by right quadrantectomy (20.0%) and left amputation (15.3%). The mean number of removed lymph nodes was 15.2 ± 6.1, with no statistically significant association between the number of removed lymph nodes and the manifestation of secondary lymphedema. The severity of secondary lymphedema varied based on patient age, with a higher incidence of moderate and severe lymphedema observed in patients aged 61 years and older. Patients who underwent radical surgery were more likely to experience severe lymphedema compared to those who had conservative surgery, although this difference was not statistically significant. Conclusion In our study, the type of surgery, elapsed time since surgery, and the number of removed lymph nodes were not influencing factors for the occurrence of BCRL. However, concerning its severity, a greater number of systemic therapy modalities combined with radiotherapy were associated with a more frequent occurrence of mild and moderate BCRL. Also, the severity of BCRL varied among different age groups, with a higher incidence of moderate and severe lymphedema observed in patients aged 61 years and older. Ultimately, improving the quality of life for individuals affected by secondary lymphedema remains a crucial goal in the field of oncology.

The aim of this study was to determine the frequencies of alleles and genotypes of the single nucleotide polymorphism of the FTO gene (rs17817449) and the intensity of physical activity in relation to the BMI of subjects in the student population. Genotyping was performed using the PCR-RFLP method. 94 subjects stated that they were not physically active, 57 subjects were moderately physically active and 52 were intensely physically active. In the total sample, the risk allele G of the investigated polymorphism rs17817449 of the FTO gene had a lower frequency (41.8%) compared to the normal allele T (58.13%). Although a higher frequency of the risk allele G was found in the group of overweight subjects compared to the group with BMI < 25, the difference was not statistically significant (p > 0.05).

Bacterial lipopolysaccharide (LPS) induces general inflammation, by activating pathways involving cytokine production, blood coagulation, complement system activation, and acute phase protein release. The key cellular players are leukocytes and endothelial cells, that lead to tissue injury and organ failure. The aim of this study was to explore the anti-inflammatory, antioxidant, and cytoprotective properties of two bile acids, ursodeoxycholic acid (UDCA) and chenodeoxycholic acid (CDCA) in LPS-induced endotoxemia in rats. The experiment involved six distinct groups of Wistar rats, each subjected to different pretreatment conditions: control and LPS groups were pretreated with propylene glycol, as a bile acid solvent, while the other groups were pretreated with UDCA or CDCA for 10 days followed by an LPS injection on day 10. The results showed that both UDCA and CDCA reduced the production of pro-inflammatory cytokines: TNF-α, GM-CSF, IL-2, IFNγ, IL-6, and IL-1β and expression of nuclear factor-κB (NF-κB) induced by LPS. In addition, pretreatment with these bile acids showed a positive impact on lipid profiles, a decrease in ICAM levels, an increase in antioxidant activity (SOD, |CAT, GSH), and a decrease in prooxidant markers (H2O2 and O2–). Furthermore, both bile acids alleviated LPS-induced liver injury. While UDCA and CDCA pretreatment attenuated homocysteine levels in LPS-treated rats, only UDCA pretreatment showed reductions in other serum biochemical markers, including creatine kinase, lactate dehydrogenase, and high-sensitivity troponin I. It can be concluded that both, UDCA and CDCA, although exerted slightly different effects, can prevent the inflammatory responses induced by LPS, improve oxidative stress status, and attenuate LPS-induced liver injury.

The topic of this research, chronic subdural hematoma (CSH), is one of the most common pathologies in neurosurgery, and it is more frequent in the elderly. Surgical evacuation has been widely considered the gold standard treatment. Despite the excellent outcomes, sometimes some cases require a different approach. The treatment choice depends on the general condition of the patients, as well as the clinical presentation and hematoma volume. Also, preexisting comorbidities in elderly patients, postoperative complications, and the ability to recover must be considered. Consequently, conservative treatment can be effective in carefully selected cases, and can be considered if the patient's neurological and physical conditions allow. Some drugs contribute to CSH resolution by changing the capsule membrane permeability and inhibiting the fibrinolytic and inflammatory systems. Our work is based on the efficacy of dexamethasone as a method of conservative therapy, and it was demonstrated in the case of a 91-year-old patient.

Introduction: Various exercise programs have a positive effect on reducing the risk of falls in elderly people. Consequences of falls include fractures and injuries, reduced quality of life, fear of falling, loss of selfconfidence, and self-limited activity leading to reduced physical function and social interactions. Activity limitation impairs physical capacity and increases the risk of further falls. Falls are the primary cause of injury of the elderly, which can result in serious consequences such as fractures, head injuries, and even death, placing a significant burden on the public health system. Annually, between 28 and 35% of individuals aged 65 and over experience a fall worldwide, with rates reaching 32% - 42% among those aged 70 and over. Therefore, preventing falls has become a key global goal for the older adult population. Objective: To determine the effectiveness of different exercise programs in preventing falls in people of the third age. Methods: The search included an overview of the relevant databases: Medline, PubMed, Google Scholar, Research Gate. The systematic literature review included 12 different types of research. Results: Through a scientific review of the literature, the results of the significance and effectiveness of various programs of Otago exercises, Tai Chi, and Frenkle exercises in the prevention of falls in people of the third age are presented. The greatest effect is realized in the improvement of static and dynamic balance and the fear of falling. Conclusion: These studies show that different exercise programs have a huge and significant impact on reducing the risk of falls in older people. It is a long-term and continuous method of reducing the risk of falls in the elderly through exercise. Physical exercise is effective in improving components of balance, lower extremity strength, mobility, and reducing falls and fall-related injuries.

Increasingly, and often mutually conflicting requirements for the use of water resources, there is a need for more complex management methods, including the management of the volume of reservoirs. Silt filling of reservoirs is one of the most well-known problems of river hydraulics. Dams and reservoirs, created by damming river flows, cause the retention of river sediment (drag and floating sediment) that comes from the gravitating basins, or sub-basins of the reservoir's tributaries. By analyzing the sediment transport on the tributaries, and the total amount of sediment deposited in the Modrac multi-purpose reservoir, real data are obtained on the amount of sediment introduced into the Modrac multi-pupose reservoir, the dynamics of sediment input, and the degree of pollution of this type of water body. The Modrac multi-purpose reservoir is the only available water resource in the region of Tuzla and its surroundings. Acknowledging the fact that the useful volume of the reservoir is limited, and that over time the reservoir is filled with dragged sediment and coal dust as floating sediment, and that consumers - the population, industry and others must be provided with a water supply with a high degree of safety. Excess water needs to be used to the maximum for the purpose of electricity production, and there is a need to optimize the system, i.e. more efficient management of the water resources of the reservoir, i.e. to prove the maximum utilization of the reservoir while continuously providing all the necessary amounts of water to which the Modrac multi-purpose reservoir is connected.

Objectives: To measure and analyze the seroprevalence and risk factors of human brucellosis among clinically suspected patients in the Travnik area, Bosnia and Herzegovina in the period 2018-2023. Methods: A total of 337 samples of clinically suspected brucellosis patients in Travnik, Central Bosnia and Herzegovina were collected between 2018-2023. Rose Bengal agglutination was used for sera testing. Expressive and investigative statistics were considered. Differences between the prevalence of brucellosis according to age, sex, and the seasonal incidence rate were assessed. Results: The prevalence of brucellosis among the suspected patients was 23.30%. The highest prevalence rate 35.71%, was detected during year 2021. Higher rate of brucellosis was observed among males 63.86% than females 36.14%. Most cases were reported during month of June and October, 14.15% and 14.19% respectively. The highest prevalence, 56.76% rate was observed in age group 41–60 years old. Conclusion: Our survey found a high prevalence of human brucellosis among clinically suspected patients in Travnik area strongly indicating that clinical suspicion is a valid criterion, which requires fast laboratory detection and patient treatment. Detecting specific anti-Brucella antibodies using agglutination Rose Bengal test is a fast a reliable diagnostic procedure for clinically suspect individuals. There is a strong association between human brucellosis and age.

ABSTRACT Scholarship on diaspora political engagement is unfolding in novel ways exploring the participation of second-generation diaspora individuals and engagement patters of authoritarian and hybrid regimes. Focusing on the unique role of diaspora politicians, I contend that these individuals adeptly leverage their identity to impact politics and advocate for change. The article demonstrates their adaptability in different settings and evolving advocacy strategies. The article employs a multilingual analysis of social media, public interviews, and public appearances in Germany and Bosnia and Herzegovina using an exploratory case study of a German-Bosnian politician. This exploration underscores their flexibility and evolving advocacy dynamics. Furthermore, it illustrates the way these politicians enhance their profiles within the countries where they’ve been elected and in countries of their descent. This serves to strengthen their chances of re-election on one hand while also drawing attention to authoritarian tendencies, potentially clearing a path for democratic advancement on the other.

The modular product $G\diamond H$ of graphs $G$ and $H$ is a graph on vertex set $V(G)\times V(H)$. Two vertices $(g,h)$ and $(g^{\prime},h^{\prime})$ of $G\diamond H$ are adjacent if $g=g^{\prime}$ and $hh^{\prime}\in E(H)$, or $gg^{\prime}\in E(G)$ and $h=h^{\prime}$, or $gg^{\prime}\in E(G)$ and $hh^{\prime}\in E(H)$, or (for $g\neq g^{\prime}$ and $h\neq h^{\prime}$) $gg^{\prime}\notin E(G)$ and $hh^{\prime}\notin E(H)$. A set $D\subseteq V(G)$ is a dominating set of $G$ if every vertex outside of $D$ contains a neighbor in $D$. A set $D\subseteq V(G)$ is a total dominating set of $G$ if every vertex of $G$ contains a neighbor in $D$. The domination number $\gamma(G)$ (resp. total domination number $\gamma_{t}(G)$) of $G$ is the minimum cardinality of a dominating set (resp. total dominating set) of $G$. In this work we give several upper and lower bounds for $\gamma(G\diamond H)$ in terms of $\gamma(G),$ $\gamma(H)$, $\gamma_{t}(\overline{G})$ and $\gamma _{t}(\overline{H})$, where $\overline{G}$ is the complement graph of $G$. Further, we fully describe graphs where $\gamma(G\diamond H)=k$ for $k\in\{1,2,3\}$. Several conditions on $G$ and $H$ under which $\gamma (G\diamond H)$ is at most $4$ and $5$ are also given. A new type of simultaneous domination $\bar{\gamma}(G)$, defined as the smallest number of vertices that dominates $G$ and totally dominates the complement of $G,$ emerged as useful and we believe it could be of independent interest. We conclude the paper by proposing few directions for possible further research.

In order to ensure the long-term sustainability of the conservation process of Norwegian plum germplasm, as well as to enhance the possibility of its utilization, a central plum heritage cultivar collection was established in 2020. In this study, 40 plum accessions maintained at the Ullensvang plum heritage cultivar collection were genetically characterized using a set of nine microsatellite markers recently approved by the ECPGR Prunus working group. The obtained molecular data were used to investigate the genetic identity, diversity, and structure among the analyzed accessions. No redundancies were detected among the plum accessions, which is in stark contrast to the previous molecular study on plum samples collected through an on-farm inventory of Southern Norway. Furthermore, the obtained data indicate that the Ullensvang collection contains a significant genetic diversity of Norwegian plum germplasm, previously held in decentralized sites. With that in mind, this collection can certainly be considered for the role of the National Clonal Plum Germplasm Repository. The nine microsatellite markers, recommended by ECPGR, revealed a genetic structure not entirely tied to previously proposed pomological groups, possibly indicating a history of hybridization among members of the various groups.

The auditory brainstem response (ABR) is a measure of subcortical activity in response to auditory stimuli. The wave V peak of the ABR depends on stimulus intensity level, and has been widely used for clinical hearing assessment. Conventional methods to estimate the ABR average electroencephalography (EEG) responses to short unnatural stimuli such as clicks. Recent work has moved towards more ecologically relevant continuous speech stimuli using linear deconvolution models called Temporal Response Functions (TRFs). Investigating whether the TRF waveform changes with stimulus intensity is a crucial step towards the use of natural speech stimuli for hearing assessments involving subcortical responses. Here, we develop methods to estimate level-dependent subcortical TRFs using EEG data collected from 21 participants listening to continuous speech presented at 4 different intensity levels. We find that level-dependent changes can be detected in the wave V peak of the subcortical TRF for almost all participants, and are consistent with level-dependent changes in click-ABR wave V. We also investigate the most suitable peripheral auditory model to generate predictors for level-dependent subcortical TRFs and find that simple gammatone filterbanks perform the best. Additionally, around 6 minutes of data may be sufficient for detecting level-dependent effects and wave V peaks above the noise floor for speech segments with higher intensity. Finally, we show a proof-of-concept that level dependent subcortical TRFs can be detected even for the inherent intensity fluctuations in natural continuous speech. Visual abstract Significance statement Subcortical EEG responses to sound depend on the stimulus intensity level and provide a window into the early human auditory pathway. However, current methods detect responses using unnatural transient stimuli such as clicks or chirps. We develop methods for detecting level-dependent responses to continuous speech stimuli, which is more ecologically relevant and may provide several advantages over transient stimuli. Critically, we find consistent patterns of level dependent subcortical responses to continuous speech at an individual level, that are directly comparable to those seen for conventional responses to click stimuli. Our work lays the foundation for the use of subcortical responses to natural speech stimuli in future applications such as clinical hearing assessment and hearing assistive technology.