Introduction Between 2021 and 2023, a project was funded in order to explore the mortality burden (YLL–Years of Life Lost, excess mortality) of COVID-19 in Southern and Eastern Europe, and Central Asia. Methods For each national or sub-national region, data on COVID-19 deaths and population data were collected for the period March 2020 to December 2021. Unstandardized and age-standardised YLL rates were calculated according to standard burden of disease methodology. In addition, all-cause mortality data for the period 2015–2019 were collected and used as a baseline to estimate excess mortality in each national or sub-national region in the years 2020 and 2021. Results On average, 15–30 years of life were lost per death in the various countries and regions. Generally, YLL rates per 100,000 were higher in countries and regions in Southern and Eastern Europe compared to Central Asia. However, there were differences in how countries and regions defined and counted COVID-19 deaths. In most countries and sub-national regions, YLL rates per 100,000 (both age-standardised and unstandardized) were higher in 2021 compared to 2020, and higher amongst men compared to women. Some countries showed high excess mortality rates, suggesting under-diagnosis or under-reporting of COVID-19 deaths, and/or relatively large numbers of deaths due to indirect effects of the pandemic. Conclusion Our results suggest that the COVID-19 mortality burden was greater in many countries and regions in Southern and Eastern Europe compared to Central Asia. However, heterogeneity in the data (differences in the definitions and counting of COVID-19 deaths) may have influenced our results. Understanding possible reasons for the differences was difficult, as many factors are likely to play a role (e.g., differences in the extent of public health and social measures to control the spread of COVID-19, differences in testing strategies and/or vaccination rates). Future cross-country analyses should try to develop structured approaches in an attempt to understand the relative importance of such factors. Furthermore, in order to improve the robustness and comparability of burden of disease indicators, efforts should be made to harmonise case definitions and reporting for COVID-19 deaths across countries.

BACKGROUND: Left atrial strain (LAS) analysis represents a newer non-invasive, sensitive and specific technique for assessing left atrial (LA) function and early detection of its deformation and dysfunction. However, its applicability in mitral regurgitation (MR) in pediatric population remains unexplored, raising pertinent questions regarding its potential role in evaluating the severity and progression of the disease. OBJECTIVE: To investigate the impact of chronic MR in children and adolescents on LA remodeling and function. METHODS: The study included 100 participants. Patients with primary and secondary chronic MR lasting at least 5 years fit our inclusion criteria. The exclusion criteria from the study were: patients with functional mitral regurgitation due to primary cardiomyopathies, patients with artificial mitral valve, patients with MR who had previously undergone surgery due to obstructive lesions of the left heart (aortic stenosis, coarctation of the aorta), patients with significant atrial rhythm disorders (atrial fibrillation, atrial flutter). The echocardiographic recordings were conducted by two different cardiologists. Outcome data was reported as mean and standard deviation (SD) or median and interquartile range (Q1–Q3). RESULTS: The study included 100 participants, of whom 50 had MR and the remaining 50 were without MR. The average age of all participants was 15.8 ± 1.2 years, with a gender distribution of 37 males and 63 females. There was a significant difference in the values of LA volume index (LAVI), which were higher in patients with MR ( p = 0.0001), S/D ratio (and parameters S and D; p = 0.001, p = 0.0001, p = 0.013), mitral annulus radius ( p = 0.0001), E/A ratio ( p = 0.0001), as well as septal e’ (m/s), lateral e’ (m/s), and average E/e’ ratio, along with the values of TV peak gradient and LV global longitudinal strain (%). There was no significant difference in LA strain parameters, nor in LA stiffness index (LASI). CONCLUSION: Our findings revealed significant differences in several echocardiographic parameters in pediatric patients with MR relative to those without MR, providing insight into the multifaceted cardiac structural and functional effects of MR in this vulnerable population.

Talent management is an essential area within human resource management and has been increasingly receiving attention over the past several decades. The focus of talent management is on the most crucial employees within an enterprise. Therefore, it is vital to have a specialized and tailored management system for them to maximize business results. This paper addresses the connection between talent management and enterprise competitiveness. It aims to examine the relationship between these two variables within the business environment of Bosnia and Herzegovina. This paper significantly contributes to both theory and practice because it proposes a new, more comprehensive process model of talent management based on a detailed analysis and synthesis of all available scientific and research works. Following this, the paper tests the proposed model in practice and measures its success by examining enterprise competitiveness. The research was conducted on 101 service enterprises in Bosnia and Herzegovina in the second quarter of 2023. Managers of service enterprises involved in human resource management were surveyed. The questionnaire was formulated based on a combination of existing research in the specified fields. The data were subjected to correlation and regression analysis, and the research results were presented according to the previously set objectives and hypotheses. The research results showed that talent management is a significant predictor of competitive advantage. Additionally, a positive impact on competitiveness was confirmed for each individual group of talent management activities presented in the proposed process model.

Significance S-layer proteins (SLPs) are self-assembling, crystalline proteins coating the cell surfaces of many prokaryotes. This study presents experimental atomic resolution structures of lactobacilli SLPs, deriving functional insight into key probiotic Lactobacillus strains. The structures of SlpA and SlpX proteins highlight the domain swapping critical for SlpX integration, particularly in response to environmental stress. Two binding regions are identified as crucial for attachment of the S-layer to (lipo)teichoic acid. The structure of assembled S-layer provides a foundation for employing (designed) SLPs as a therapeutic agent in the treatment of inflammatory diseases. Additionally, it opens broad avenues for the use of SLPs in vaccine development and in crafting nanostructures with tailored properties, including those designed for targeted drug delivery.

The transition process from fossil fuels to environmentally friendly renewable energy sources carries the risk of creating new environmental damages. Photovoltaic technology represents one of the alternatives with the least risk of harmful environmental impact. However, this technology has two important drawbacks: the significant land occupation for the installation of PV systems and the uncontrollability of production. By constructing floating photovoltaic plants on hydroelectric reservoirs, both of these problems can be reduced to an acceptable level. Some artificial reservoirs, originally built for hydroelectric power plants, have acquired a significant secondary function as recreational areas and fish breeding sites. Therefore, there is justified resistance from the local community to change the existing appearance and purpose of such reservoirs. This paper proposes a completely new concept of integrating the interests of the local community into such objects. In addition to preserving existing uses, the concept also offers new features. This can make the entire system environmentally friendly and sustainable. This paper details the technology behind the construction of floating photovoltaic power plants on artificial reservoirs and emphasizes their various advantages. These benefits include the non-utilization of cultivable land, the ease of assembly and construction, integration into existing power grids, and the potential to address electricity storage issues. For instance, Buško Lake, covering an area of 55.8 km2, may host 2.93 km2 of installed floating photovoltaic (FPV) facilities, enabling a total installed capacity of 240 MW. With an average of 5.5 h of daily sunshine, this totals 2007 annual hours, equivalent to a 55 MW thermal power plant. An analysis showed that, with losses of 18.2%, the average annual production stands at 302 GWh, translating to an annual production value of 18 million € at 60 €/MWh. The integration of this production into an existing hydroelectric power plant featuring an artificial reservoir might boost its output by 91%. The available transmission line capacity of 237 MW is shared between the hydroelectric power plant (HPP) and FPV; hence during the FPV maximum power generation time, the HPP halts its production. HPP Orlovac operates a small number of hours annually at full capacity (1489 h); therefore in combination with the FPV, this number can be increased to 2852 h. This integration maintains the lake’s functions in tourism and fishing while expanding its capabilities without environmental harm.

BACKGROUND: Despite improvements, survival rates for gastric cancer remain low, even in developed countries, confirming the role of primary and secondary prevention. OBJECTIVE: This study aims to demonstrate the role of additional suspension sutures on the esophagojejunal anastomosis (EJA) to strengthen the anastomosis, i.e., relieve the mechanical suture. METHODS: A retrospective cohort study was conducted from 2011 to 2022 at the Clinic for Surgery, University Clinical Center Tuzla, Bosnia and Herzegovina. The experimental group consisted of patients placed with a suspension suture at the esophagojejunal anastomosis (EJA) site after total gastrectomy. The control group was patients without a suspension suture. The clinical and laboratory parameters available from the medical history were analyzed, X-ray passage, surgical complications, non-surgical complications, the length of hospitalization, the postoperative course, time of onset of postoperative complications, postoperative radiological follow-up and endoscopic postoperative follow-up were then analyzed. RESULTS: A total of 212 patients were included in the study: 87 in the experimental group with suspension sutures on the EJA and 125 in the control group without suspension sutures on the EJA. The two cohorts did not differ in other clinicopathologic parameters except perineural invasion, which was more prevalent in the control group. Patients in both groups were anemic and elevated values of C reactive protein (CRP) and decreased levels of proteins, albumin and globulin, with no significant difference between the two groups. The most common general complication was pleural effusion (28%), followed by pneumonia ( ∼ 22%). The most common complication in the experimental group was an intraabdominal abscess, while in the control group, it was a surgical wound infection. CONCLUSION: Our study did not show a statistically significant difference between the two analyzed EJA techniques created with a circular stapler, when it comes to postoperative course and outcome in patients with gastric cancer.

Background The optimal anesthetic strategy for endovascular therapy (EVT) in acute ischemic stroke is still under debate. The aim of this study was to compare the clinical outcomes of patients with isolated posterior cerebral artery (PCA) occlusion stroke undergoing EVT by anesthesia modality with conscious sedation (non-GA) versus general anesthesia (GA). Methods Patients from the Posterior CerebraL Artery Occlusion (PLATO) study were analyzed with regard to anesthetic strategy. GA was compared with non-GA using multivariable logistic regression and inverse probability of weighting treatment (IPTW) methods. The primary endpoint was the 90-day distribution of the modified Rankin Scale (mRS) score. Secondary outcomes included functional independence or return to Rankin at day 90, and successful reperfusion, defined as expanded Thrombolysis in Cerebral Infarction (eTICI) 2b to 3. Safety endpoints were symptomatic intracranial hemorrhage and mortality. Results Among 376 patients with isolated PCA occlusion stroke treated with EVT, 183 (49%) had GA. The treatment groups were comparable, although the GA group contained more patients with severe stroke and lower posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS). On IPTW analysis, there was no difference between groups with regard to ordinal mRS shift analysis (common OR 0.89, 95% CI 0.53 to 1.51, P=0.67) or functional independence (OR 0.84, 95% CI 0.50 to 1.39, P=0.49). There were greater odds for successful reperfusion with GA (OR 1.70, 95% CI 1.17 to 2.47, P=0.01). Safety outcomes were comparable between groups. Conclusion In patients with isolated PCA occlusion undergoing EVT, patients treated with GA had higher reperfusion rates compared with non-GA. Both GA and non-GA strategies were safe and functional outcomes were similar.

In our recent attempt to explain flavor hierarchies [1], a gauged SU(2) flavor symmetry acting on left-handed fermions provides a ground to introduce three independent rank-one contributions to the Yukawa matrices: a renormalizable one for the third family, a mass-suppressed one for the second family, and an additional loop-suppressed factor for the first family. Here, we demonstrate how minimal quark-lepton unification à la Pati-Salam, relating down-quarks to charged leptons, can significantly improve this mechanism. We construct and thoroughly analyze a renormalizable model, performing a comprehensive one-loop matching calculation that reveals how all flavor hierarchies emerge from a single ratio of two scales. The first signatures may appear in the upcoming charged lepton flavor violation experiments.

The Lithium-Ion battery at the end of life represents a valuable source of secondary raw materials such as lithium, nickel, cobalt etc. Deep discharging, as a part of battery recycling, is a time-consuming process in which the battery's thermal dependency on the discharge parameters and voltage recovery effect is manifested. Adjusting the discharging process adequately to address those two phenomena leads to a safety increase and discharging time decrease. This paper treats two aspects. It is observed the effect of the constant and variable discharging current along with the depth of the discharge in the form of discharge end voltage parameter on the maximal cell temperature reached during the process. The second aspect is the battery recovery voltage trend after the discharging process and its dependency on the same parameters. The impact of these parameters is demonstrated experimentally on two battery cell types.

The International Transport Forum (ITF) predicts a significant increase in demand for transportation in the coming years, despite the shortage of drivers. To tackle this challenge, the Transport and Logistics (T&L) industry is increasingly relying on emerging technologies. While connected and autonomous driving offer promises of greater safety, efficiency, and environmental benefits, connected and autonomous driving face operational hurdles in complex environments. However, the existing limitations of autonomous vehicles, particularly in dense urban settings, highlight the need for complementary technologies, such as teleoperation. The European Horizon 2020 5G-Blueprint project aims to design and validate the technical architecture and business models for cross-border teleoperated transport, utilizing 5G technology. This study delves into the implementation of a real 5G Standalone (5G SA) network within a port environment, utilizing network slicing for teleoperation and Multi-Access Edge Computing (MEC) to enable real-time video processing at the network edge. Specifically focusing on Ultra-Reliable Low Latency Communications (URLLC) and enhanced Mobile Broadband (eMBB) slices, we conduct a comprehensive evaluation of a real-world 5G SA network. Our assessment examines key performance parameters such as Round-Trip Time(RTT) latency, Packet Delivery Rate (PDR), Reference Signals Received Power (RSRP), and corrupted frame rates, emphasizing the crucial role of 5G network slicing and MEC in enhancing operational reliability and efficiency in teleoperated transport systems.

The Transport and Logistics (T&L) sector faces numerous challenges, including the search for qualified personnel, as well as improving driver safety and work-life balance. Teleoperation emerges as the technology able to address these challenges. Thanks to 5G connectivity and network slicing, operating vehicles remotely from a Teleoperation Center (ToC) is becoming a reality. The European project 5G-Blueprint, funded by the European Union, has demonstrated the feasibility of 5G-based teleoperation, even in a cross-border context. Despite the fact that 5G and network slicing enable reliable and low-latency transmission of video data from cameras installed on Teleoperated Vehicles (ToVs) to ToC, the perception of the surrounding environment is different for the teleoperator compared to the driver who is physically present in the vehicle. In this paper, we introduce a real-world system that showcases synergy among different teleoperation elements, including intelligent traffic lights (iTL) and Vulnerable Road Users (VRU), aimed at supporting teleoperation by improving remote driver’s situational awareness. This synergy enhances the environmental perception of the teleoperator, bridging the gap between their experience and that of an in-vehicle driver. First, we evaluate the performance of a real-world 5G network with network slicing, based on actual data and testing scenarios conducted in both industrial and urban areas with 5G Standalone (5G SA) coverage. Then we validate the 5G capabilities for enabling a real-world system that showcases synergy among different teleoperation elements.

The native integration of AI and ML algorithms in the next-generation mobile network architecture will allow for meeting the expectations of 6G. This aspect is targeted by the DAEMON project, which proposed a solution to natively manage Network Intelligence (NI) through novel architectural elements and procedures. In this paper, we discuss how NI solutions based on AI and ML can leverage NI native procedures implemented by the NI Orchestrator to improve their lifecycle management. We also discuss how the architectural procedures can be implemented in practice, using state-of-the-art software components.

Intent-driven network management has become an important part of autonomous systems in Beyond 5G (B5G) towards Sixth-Generation (6G) networks, by enabling flexibility in the interaction among applications, operators and users. Intents play an important role in the communication of road users like autonomous vehicles and pedestrians to edge computing services. As sensor technologies for modern vehicles are cheaper, smaller, diverse and computing capable, more demand for applications and services on the road is increasing. A flexible intent interpretation and coordination are needed to deal with the dynamic environment and constantly changing goals. This paper presents a proof-of-concept of Zero-touch Network and Service Management (ZSM) for vehicular communication services, using an Intent Management Entity (IME) to translate user objectives into actionable directives. This paper describes a realistic testbed setup at the Smart Highway, where a Deep Reinforcement Learning (DRL) algorithm is used to optimize the selection of Roadside Units (RSUs) for service orchestration. This paper also discusses the challenges and opportunities of enhancing the IME with time-based intent coordination, using Artificial Intelligence and Machine Learning (AI/ML) techniques to estimate the waiting time and priority in intent coordination. The paper aims to demonstrate the benefits of ZSM and Intent-driven Management for vehicular edge computing and B5G/6G autonomous network management frameworks.

Network slicing enables multiple virtual networks to share physical resources, allowing network operators to deliver highly customizable and efficient networking solutions that meet the diverse requirements of modern applications. The automated management of network slices has been studied in the last years to make such solutions more flexible, ready to support new applications, and capable of optimizing network resource utilization. Many works in the literature give a top-down approach, focusing on the high-level decision processes, and relying on abstracted infrastructure managers and simulation tools to apply/execute such decisions. In this work, we leverage components that we previously developed for network monitoring, flexible traffic shaping, and Software-Defined Time-Sensitive Networking control, to create a bottom-up approach toward automated slice management. We describe the intricate coordination of elements required for an automated control loop and present the results achieved with a proof-of-concept executed in a real testbed of wired and Wi-Fi nodes. The results show the capability of the system to correctly identify the bottleneck of a flow and apply corrective actions to reestablish its intended performance level.