Background: Left atrial (LA) myopathy with paroxysmal and permanent atrial fibrillation (AF) is frequent in chronic coronary syndromes (CCS) but sometimes occult at rest and elicited by stress. Aim: This study sought to assess LA volume and function at rest and during stress across the spectrum of AF. Methods: In a prospective, multicenter, observational study design, we enrolled 3042 patients [age = 64 ± 12; 63.8% male] with known or suspected CCS: 2749 were in sinus rhythm (SR, Group 1); 191 in SR with a history of paroxysmal AF (Group 2); and 102 were in permanent AF (Group 3). All patients underwent stress echocardiography (SE). We measured left atrial volume index (LAVI) in all patients and LA Strain reservoir phase (LASr) in a subset of 486 patients. Results: LAVI increased from Group 1 to 3, both at rest (Group 1 = 27.6 ± 12.2, Group 2 = 31.6 ± 12.9, Group 3 = 43.3 ± 19.7 mL/m2, p < 0.001) and at peak stress (Group 1 = 26.2 ± 12.0, Group 2 = 31.2 ± 12.2, Group 3 = 43.9 ± 19.4 mL/m2, p < 0.001). LASr progressively decreased from Group 1 to 3, both at rest (Group 1 = 26.0 ± 8.5%, Group 2 = 23.2 ± 11.2%, Group 3 = 8.5 ± 6.5%, p < 0.001) and at peak stress (Group 1 = 26.9 ± 10.1, Group 2 = 23.8 ± 11.0 Group 3 = 10.7 ± 8.1%, p < 0.001). Stress B-lines (≥2) were more frequent in AF (Group 1 = 29.7% vs. Group 2 = 35.5% vs. Group 3 = 57.4%, p < 0.001). Inducible ischemia was less frequent in SR (Group 1 = 16.1% vs. Group 2 = 24.7% vs. Group 3 = 24.5%, p = 0.001). Conclusions: In CCS, rest and stress LA dilation and reservoir dysfunction are often present in paroxysmal and, more so, in permanent AF and are associated with more frequent inducible ischemia and pulmonary congestion during stress.

Abstract Morphologic changes in organs vary from nonspecific to specific ones, depending on causes of sudden death, e.i whether it is an acute, subacute or chronic event. The aim of this pilot study was to observe the appearance and occurrence of morphological characteristics on organs that were exposed to long-term effects of hyperthermia. A sample of 7 rats was exposed to a water temperature of 41 °C, which is defined in the literature as “heat stroke temperature”, both sexes, weighing 250 to 300 g were used. Tissue samples, obtained by dissection of rats, were fixed in 10% buffered neutral formalin, at room temperature, then incorporated into paraffin blocks, cut at 4-5 microns, mounted and stained with standard hematoxylin-eosin (HE) method. In order to prove/exclude lipid and glycogen accumulation in hepatocytes we did additional histochemical staining, using Sudan black and Periodic Acid Shiff (PAS) method, respectively. We obtained samples from kidney, liver, pancreas, spleen, lung and brain. Analyzing tissue samples of different organs obtained from seven Wistar rats, we gained insight into morphological changes caused by induced hyperthermia. All sampled organs showed congestion and some degree of oedema. The most prominent changes were observed in liver and lung samples. Tissue samples of the lung of all seven rats showed signs of acute bronchitis and bronchiolitis, together with signs of initial bronchopneumonia. We also noticed signs of focal acute emphysema as well as focal accumulations of foamy macrophages. Our study suggests that changes in the vascular bed occur soon after hyperthermia and while some organs are more tolerant to heat stroke than others, most organs show similar changes consisting of capillary dilation, congestion and interstitial extravasation, observed after 30 minutes at a temperature of 40.5 °C, with the most significant changes observed in liver and lung samples.

Abstract Background/aim: Diabetes mellitus is a metabolic disorder of multiple etiologies characterized by a lack of insulin, with a consequent disordered metabolism of glucose, fats, and proteins. A number of complications, such as diabetic nephropathy and retinopathy, may develop as a result of long-term diabetes. The aim of this study aimed to determine the correlation between diabetic nephropathy and diabetic retinopathy as long-term complications of diabetes mellitus. Materials and methods: Retrospective, descriptive, and analytical research was conducted at the department of Endocrinology, Clinical Center, University of Sarajevo. The study included 158 patients hospitalized in time between 1st of January and 31st of December 2012. Results: New-onset diabetes was found in 38%, and diabetes type 2 patients 132 (83.5%), female 105 (66.5%) while older than 60 years were 100 (63.3%). Upon discharge from hospital 83,7% of patients were discharged with glycemia <10 mmol / l. We found that 47,5% of patients had HbA1c> 10%. Reduced kidney function, different degrees of failure was at 66.5%. More than half (62.7%) patients had proteinuria as a sign of diabetic nephropathy. Diabetic retinopathy was diagnosed with different types in 54.4%. Conclusion: Diabetes leads to an increase in nitrogen compounds, and the development of diabetic nephropathy manifests as various degrees of renal insufficiency. The duration of diabetes and occurrence of diabetic retinopathy were significantly interrelated. The correlation between the degree of renal failure and changes in the ocular fundus has not been proven, but more severe renal insufficiency is associated with a higher incidence of diabetic retinopathy compared to patients with less impaired renal function.

Background: Diabetes mellitus type 1 (T1D) is an autoimmune organ-specific disease with a wide range of clinical manifestations, in which the β cells of the pancreatic islets of Langerhans are destroyed by the action of autoreactive T lymphocytes and the formation of autoantibodies against β cell components. Among used serological markers of T1D, anti-glutamic acid decarboxylase antibodies (GAD65), anti-tyrosine phosphatase antibodies (IA2), islet cell antibodies (ICA), insulin autoantibodies (IAA) and anti-zinc transporter antibodies (Zn-T8) are of great significance. Objective: This study aimed to analyze presence of type 1 diabetes-related autoantibodies (GAD65, IA2, ICA, IAA and Zn-T8 and effects of age and gender on their occurrence in pediatric population. Methods: Sixty seven (N=67) T1D pediatric patients were included in the study. The levels of immunological parameters such as anti-glutamic acid decarboxylase antibodies (GAD-Ab), anti-tyrosine phosphatase antibodies (IA2-Ab), islet cell antibodies (ICA) and insulin autoantibodies (IAA) were determined by chemiluminescence immunoassay (CLIA) and anti-zinc transporter antibodies (Zn-T8-Ab) were determined by enzyme-linked immunosorbent assay (ELISA). For statistical analysis, we used SPSS statistical program. Results: Our study revealed that among 67 patients with T1D (40 male and 27 female), with an average age of 12,1±3,9 years. The average age of diabetes diagnosis was 6,15±3,29 years. 24 (35,8%) cases were positive for GAD65, 15 (22,4%) for ICA, 34 (50,7%) for IAA, 16 (23,9%) for IA2 and 36 (53,7%) for Zn-T8. The largest number of patients had single positive antibody, the most dominated among them was IAA dominated (40,9%), then Zn-T8 (31,8%). According to Spearman correlation test Zn-transporter shows a significant positive correlation with age of the participants (p=0.027) and disease duration (p=0.006). Anti IA2 shows significant negative correlation with HbA1c (p=0.043). Zn-transporter is associated with patients age and duration of T1D. Conclusion: In most cases, patients with T1D are positive for at least one of the specific autoantibodies. Zn-T8 is the most frequently detected and is an important serological marker of type 1 diabetes mellitus. Gender effects on autoantibodies seems to be insignificant, while age alongside disease duration shows important effects.

Objective: The main objective of this research is to determine the prevalence and characteristics of neurological manifestations in hospitalized patients with SARS-CoV-2 infection. Methods: A cross-sectional study was conducted. 572 hospitalized patients at the COVID Department of Pulmonology of the Mostar University Clinical Hospital in the six-month period from October 31, 2020, to April 30, 2021, were included. We analyzed the incidence of neurological manifestations and the influence of comorbidities and metabolic syndrome on stroke incidence in COVID-19 patients. We analyzed hospital length of stay and mortality in patients with and without neurological manifestations. The research was conducted with respect to all the determinants of the Helsinki Declaration. Results: 572 patients, 351 men (61.4%), and 221 women (38.6%) were included. A fatal outcome was present in a quarter of patients (25.3%). Neurological manifestations were found in 163 patients (28.5%). Myalgia was the most common (16.1%). The following were reported: headache (9.6%), loss of taste (7.34%), loss of smell (6.8%), and vertigo (2.5%). There was a significant difference regarding loss of smell between males and females (p=0.04). The cerebrovascular incident was present in 2.97% of patients and was more frequent in the group of patients with metabolic syndrome. Patients with neurological manifestations had a longer hospital stay, but it was not statistically significant (p=0.9319). The presence of neurological manifestations in general did not influence the mortality rate. Conclusion: Patients with SARS-CoV-2 infection can present with neurologic findings such as myalgia, headache, loss of smell or taste, vertigo, as well as cerebrovascular incidents. Patients with neurological manifestations had longer hospital stays, but the presence of neurological manifestations in general did not influence the mortality rate.

Abstract The aim of this study was to examine the seroprevalence of Leptospira spp. in dogs and red foxes in the entity of the Republic of Srpska, Bosnia and Herzegovina, after heavy rainfall and floods in 2014 and for the two years thereafter. The seroepidemiological study involved testing serum samples from dogs (n = 98) and foxes (n = 112) using MAT (microscopic agglutination test). Antibodies to at least one Leptospira spp. serovar were found in 52.04% of the tested dogs. The dog seroprevalence in 2014 (81.25%) was significantly higher than in 2015 (51.42% p <0.0001) and 2016 (22.5% p<0.05). The highest seroprevalences were for serovars Australis (76.47%), Bratislava (70.58%), Sejroe (66.67%) and Autumnalis (45.09%). Antibodies to at least one Leptospira spp. serovar were detected in 34.82% of the examined red foxes. In 2015, the fox seroprevalence was significantly higher (52.94%) than in 2016 (6.82%) (p <0.0001). The highest seroprevalences were for serovars Sejroe (64.10%), Bratislava (48.72%), Australis (43.59%) and Bataviae (25.64%). The high seroprevalence of Leptospira spp. in dogs and foxes determined during this study indicates the importance of these carnivores in maintaining leptospirosis in the study area, and the potential risk of infection for humans and other animal species that come into contact with these canids. The results obtained indicate that heavy rainfall and intense floods can result in increased Leptospira spp. infection in these canids.

In the H2020 European project ASHVIN “Assistants for Healthy, Safe, and Productive Virtual Construction Design, Operation & Maintenance using a Digital Twin”, a set of Key Performance Indicators (KPIs) and Performance Indicators (PIs) to plan and control productive, resource efficient, and safe maintenance are being developed for transport infrastructure. This paper is presenting PIs and KPIs for the assessment and monitoring of the following aspects: Productivity, Resource Efficiency, Cost, Health & Safety during the operational life cycle stage, which is mainly focusing on the inspection and maintenance planning. Quantifiable and measurable PIs and KPIs are proposed and applied on two demonstration projects, highway bridge in Spain and airport runway in Croatia, as part of transportation infrastructure. Proposed PIs and KPIs are integrated into digital twins of the analyzed assets and into decision making tools for risk based maintenance planning. This paper presents the overview of the proposed digital PIs and KPIs applied on two demonstration projects and the integration into decision support tools for efficient and sustainable maintenance planning.

Among Enterococcus spp, only the virulence gene harboring strains of Enterococcus faecalis and E. faecium are associated with human infections, including urinary tract infections (UTI), pelvic, blood, intraabdominal, and skin and soft tissue infections (SSTI). Over the past decades, enterococcal antimicrobial resistance has escalated in many regions of the world, leading to ominous outcomes. The rising incidence of Healthcare-Associated Infections (HCAIs) secondary to Vancomycin-resistant strain (VRE) resulted in high morbidity and mortality, as well as substantial challenges in control, prevention, and management). The aim of this study is to examine the antimicrobial resistance of E. faecalis and E. faecium species in different human samples. The study included 184 clinical samples over a period of 6 months. E. faecalis was identified in 95.65% and E. faecium in 4.35% of cases. E. faecalis isolates showed resistance to gentamicin in 40.9% of cases and to ampicillin in 1.7% of cases. Resistance to nitrofurantoin and ciprofloxacin was observed in 6.1% and 35.7% of E. faecalis isolates. VRE was isolated in 1.1% of E. faecalis isolates tested for this antibiotic. Resistance of E. faecium isolates to ampicillin and gentamicin was observed in 87.5% of cases in both antibiotics. All urinary isolates of E. faecium were resistant to ciprofloxacin. All E. faecium isolates were sensitive to vancomycin. Based on the results of our study, the growing importance of Enterococcus spp. as a causative agent of hospital infections and infections in the general population, and its antimicrobial resistance to various drugs were observed.

Vehicular ad hoc network (VANETs) improves road safety and efficiency by organizing vehicles and infrastructure to provide a platform for application deployment. The availability of vehicles and infrastructure is critical to the operation of applications. Accurate failure detector (FD) has been one of the fundamental components for maintaining high availability in VANETs. However, it is hard to find the vehicle failure accurately and timely due to the dynamic nature of VANETs caused by the high mobility of vehicles and communications link failures. Therefore, it is important to achieve an accurate FD which can cope with the high mobility of VANETs. In this paper, we propose a dead reckoning based FD, called DR-FD. It can predict the mobility of vehicle accurately and avoid the impact of link failures on the detection results by the cooperation between vehicles. Experimental results are provided to confirm that the proposed DR-FD method can achieve at most 20% reduction in detection time, 30% improvement in mistake rate and 20% improvement in overhead.