The primary goal of this research was to determine the differences in kinematic parameters between the first and second serves in tennis among the elite players of the German league. The sample of respondents in this research consisted of 30 elite male senior players of the German League who have "Leistungklasse" from 1 to 7. The kinematic parameters that were analyzed are: Height of ball impact (KPVUL), Racket speed (KPBRE), Ball speed (KPBLO), The angle at the elbow joint of the arm that hits the ball (KPULZ), Oscillation of the vertical projection of the center of gravity of the body (KPOVP), Jump height (KPVSK), Ball launch height (KPVIL), The point of contact between the ball and the racket "sweetspot" (KPMLR), Ball rotation "Top spin" (KPRLO). The video recording required for kinematic analysis was acquired with two Casio EX-F1 digital cameras at a frequency of 200 images per second. The camera was placed at an angle of 900 in relation to the recording plane, and they were at a distance of 10 m. Space calibration was performed with the help of a calibration frame (200 x 200 cm). We have installed Zepp Tennis Smart Sensor 2.0 in the handle of the Wilson Pro Staff RF97 Autograph racket, using the Zepp Tennis application software. "Kinovea" software was used for service analysis and obtaining kinematic parameters from video recordings. By analyzing the results of the T-test for independent samples, it can be seen that there are statistically significant differences in five of the nine analyzed kinematic parameters : KPBRE – kinematic parameter of racket speed (Sig.=.000), KPBLO – kinematic parameter of ball speed (Sig.=.000), KPULZ – kinematic parameter angle in the elbow joint (Sig.=.000), KPMLR – kinematic parameter point of contact between the ball and the racket (Sig.=.000), as well as a variable KPRLO – kinematic parameter of ball rotation (Sig.=.000). Larger numeric values in variables: KPVUL – kinematic parameter ball impact height, KPOVP – kinematic parameter of oscillation of the vertical projection of the center of gravity of the body, KPVSK – kinematic parameter jump height and KPVIL – kinematic parameter ball impact height, show a difference but it is not enough to be statistically different. Key words: tennis, kinematic analysis, racket speed, Zepp sensor

Crop insurance is used to reduce risk in agriculture. This research is focused on selecting an insurance company that provides the best policy conditions for crop insurance. A total of five insurance companies that provide crop insurance services in the Republic of Serbia were selected. To choose the insurance company that provides the best policy conditions for farmers, expert opinions were solicited. In addition, fuzzy methods were used to assess the weights of the various criteria and to evaluate insurance companies. The weight of each criterion was determined using a combined approach based on fuzzy LMAW (the logarithm methodology of additive weights) and entropy methods. Fuzzy LMAW was used to determine the weights subjectively through expert ratings, while fuzzy entropy was used to determine the weights objectively. The results of these methods showed that the price criterion received the highest weight. The selection of the insurance company was made using the fuzzy CRADIS (compromise ranking of alternatives, from distance to ideal solution) method. The results of this method showed that the insurance company DDOR offers the best conditions for crop insurance for farmers. These results were confirmed by a validation of the results and sensitivity analysis. Based on all of this, it was shown that fuzzy methods can be used in the selection of insurance companies.

The subject of this research is the evaluation of electric cars and the choice of car that best meets the set research criteria. To this end, the criteria weights were determined using the entropy method with two-step normalization and a full consistency check. In addition, the entropy method was extended further with q-rung orthopair fuzzy (qROF) information and Einstein aggregation for carrying out decision making under uncertainty with imprecise information. Sustainable transportation was selected as the area of application. The current work compared a set of 20 leading EVs in India using the proposed decision-making model. The comparison was designed to cover two aspects: technical attributes and user opinions. For the ranking of the EVs, a recently developed multicriteria decision-making (MCDM) model, the alternative ranking order method with two-step normalization (AROMAN), was used. The present work is a novel hybridization of the entropy method, full consistency method (FUCOM), and AROMAN in an uncertain environment. The results show that the electricity consumption criterion (w = 0.0944) received the greatest weight, while the best ranked alternative was A7. The results also show robustness and stability, as revealed through a comparison with the other MCDM models and a sensitivity analysis. The present work is different from the past studies, as it provides a robust hybrid decision-making model that uses both objective and subjective information.

Analysis of mechanical properties of external unilateral fixation device „ Ultra X “, in the case of torque load, is presented in this paper. Fixation device is applied on lower leg in the case of unstable fracture. Computer aided design (CAD) model and finite element model (FEM) are developed according to the dimensions and material properties of real fixation device. In the next step principal stress and deformation analysis is performed in CATIA V5 software. During numerical analysis values of stresses at critical places are monitored and analyzed. In addi - tion, values of displacements are measured on important places on fixation device and bone fracture. Using values of displacements at the place of bone fracture, stiffness of the fracture is calculated. The same methodology is used to calculate stiffness of the fixation device. Using obtained results, several conclusions about the mechanical properties of the fixation device “Ultra X” are formulated at the end of the paper.

3115 Background: TAPUR is a phase II basket study evaluating antitumor activity of commercially available targeted agents in pts with advanced cancers with specific genomic alterations. Results in a cohort of pts with solid tumors with BRCA1/2 mut treated with Tala are reported. Methods: Eligible pts had measurable disease, ECOG performance status (PS) 0-2, adequate organ function, and no standard treatment (tx) options. Genomic testing was performed in CLIA-certified, CAP-accredited site selected labs. Pts received 1 mg of Tala orally daily until disease progression. Primary endpoint was disease control (DC) per investigator defined as complete (CR) or partial (PR) response or stable disease (SD) of at least 16+ weeks (wks) duration (SD16+) per RECIST v1.1. The hypothesized null DC rate of 15% was evaluated by a 1-sided exact binomial test (alpha 0.10; 82% power). Secondary endpoints were progression-free survival (PFS), overall survival (OS), duration of response (DOR) and SD, and safety. DOR is defined as time from pt’s first documented objective response (OR) to progressive disease (PD). Duration of SD is defined as time from tx start to PD. Results: 28 pts with 16 solid tumors (6/28 pts had lung cancer) with BRCA1 (n=9) , BRCA2 (n=16) , or BRCA1/2 (n=3) mut were enrolled from Dec 2019 to Sept 2021. All pts were included in efficacy analyses. Demographics and outcomes are shown. 1 CR, 9 PR and 6 SD16+ were observed for a DC rate of 57% (1-sided 90% CI: 43% to 100%) and an OR rate of 36% (95% CI: 19% to 56%); the null hypothesis of a 15% DC rate was rejected (p<0.001). 11/16 pts with OR or SD16+ had a BRCA2 mut, 4 had BRCA1 mut, and 1 had both. The pt with a CR (duration of 93 wks) had non-melanoma skin cancer, with BRCA2 and ATM muts, and was microsatellite instability high with 41 muts per megabase. Pts with PR had various solid tumors; 6/9 pts had BRCA2 mut, 2 had BRCA1 mut , 1 had both. Of pts with DC, 11 had tumor types for which PARP inhibitors are not yet FDA approved. Median duration of PR was 20 wks (range, 11-80). 10/16 pts with DC had a co-alteration in the 24 homologous recombination-related genes examined, mainly ATM (3) or ARID1A (2). 13 pts had ≥1 grade 3 tx-related adverse or serious adverse events including: anemia, AST or bilirubin increase, hyponatremia, nausea, vomiting, neutrophil, platelet, or white blood cell decrease. Conclusions: Tala demonstrated antitumor activity in heavily pretreated pts with advanced solid tumors with BRCA1/2 mut. Additional study is warranted to confirm the efficacy of Tala in non-breast, non-ovarian cancer pts with BRCA1/2 mut. Clinical trial information: NCT02693535 . [Table: see text]

3117 Background: TAPUR is a phase II basket study evaluating antitumor activity of commercially available targeted agents in pts with advanced cancers with genomic alterations. Results in cohorts of pts with breast cancer (BC) and other solid tumors with PIK3CA mut treated with T are reported. Methods: Eligible pts had BC or other solid tumors, measurable disease, ECOG performance status (PS) 0-2, adequate organ function, and no standard treatment (tx) options. Genomic testing was performed in CLIA-certified, CAP-accredited site selected labs. After antihistamine pre-tx, 25 mg of T was infused over 30-60 minutes once weekly until disease progression. Primary endpoint was disease control (DC), defined as complete or partial (PR) response, or stable disease of at least 16+ weeks (wks) duration (SD16+) per RECIST v1.1. For the BC cohort, Simon’s optimal 2-stage design with null DC rate of 15% vs. 35% (power=0.85, α=0.10) was used with stage 1 (n=10) stopping for futility if < 2/10 pts had DC. Low accruing histology-specific cohorts with PIK3CA and T tx were collapsed into 1 histology-pooled (HP) cohort. For the HP cohort, the hypothesized null DC rate of 15% was evaluated by a 1-sided exact binomial test with α=0.10. Secondary endpoints were progression-free survival (PFS), overall survival (OS), and safety. Results: 12 pts with PIK3CA mut with BC and 29 pts with PIK3CA mut in other solid tumors (across 9 tumor types) were enrolled. 2 pts (1 in each cohort) were found to be ineligible after enrolling and were not included in efficacy analyses. Demographics and outcomes for each cohort are shown. At the end of stage 1 in the BC cohort, 1 PR was observed for DC and OR rates of 9%; the cohort was closed for futility (p=0.83). For the HP cohort, 3 PR and 5 SD16+ were observed for DC rate of 29% (p=0.049) and OR rate of 11%; the null hypothesis was rejected. Cancer types in pts with OR or SD16+ included cervical, ovarian and head/neck; most common muts were H1047R/L (3), E545K (2) and E542K (2). 1 pt with ovarian and H1047R has ongoing PR at 86 wks. 11/41 pts had ≥1 tx-related grade 3-4 adverse or serious adverse event, including anemia, headache, hyperglycemia, hypertension, hypertriglyceridemia, mucositis oral, lymphocyte, neutrophil or platelet count decrease, pneumonitis, and sepsis. Conclusions: Although T does not appear to have antitumor activity in pts with BC with PIK3CA mut, it does show antitumor activity in pts with other solid tumors with PIK3CA mut and warrants further study. Clinical trial information: NCT02693535 . [Table: see text]

Introduction: Heart failure (HF) still remains as one of the most common causes of hospital admission with a high mortality rate. Aim: To investigate the possible prognostic role of brain natriuretic peptide (BNP), high-sensitivity (hs) cardiac troponin (cTn) I, cystatin C, and cancer antigen 125 (CA125) in the prediction of decompensation after an index hospitalization and to investigate their possible additive prognostic value. Patients and Methods: Two hundred twenty-two patients hospitalized with acute HF were monitored and followed for 18 months. Results: BNP at discharge has the highest sensitivity and specificity in the prediction of decompensation. For a cutoff value of 423.3 pg/ml, sensitivity was 64.3% and specificity was 64.5%, with a positive predictive value of 71.6% and an area under the curve (AUC) of 0.69 (P < 0.001). The hazard risk (HR) for decompensation when the discharge BNP was above the cutoff value was 2.18. Cystatin C, at a cutoff value of 1.46 mg/L, had a sensitivity of 57% and specificity of 57.8%, with a positive predictive value of 65.8% and an AUC of 0.59 (P = 0.028). CA125, in the prediction of decompensation in patients with acute heart failure (AHF) and at a cutoff value of 80.5 IU/L, had a sensitivity of 60.5% and specificity of 53.3%, with a positive predictive value of 64.5% and an AUC of 0.59 (P = 0.022). The time till onset of decompensation was significantly shorter in patients with four versus three elevated biomarkers (P = 0.047), with five versus three elevated biomarkers (P = 0.026), and in patients with four versus two elevated biomarkers (P = 0.026). The HR for decompensation in patients with five positive biomarkers was 3.7 (P = 0.001) and in patients with four positive biomarkers was 2.5 (P = 0.014), compared to patients who had fewer positive biomarkers. Conclusion: BNP, cystatin C, and CA125 are predictors of decompensation, and their combined usage leads to better prediction of new decompensation.

Background: Colorectal cancer (CRC) is a diverse disease with various clinical, pathological and molecular features that affect tumor biological behavior, treatment response and prognosis. Objective: The aim of this study was to evaluate the correlation between metabolic 18F-FDG PET/CT parameters (SUVmax, MTV and TLG) and CEA in recurrent and metastatic CRC and to evaluate prognostic value of metabolic 18F-FDG PET/CT parameters in recurrent and metastatic CRC. Methods: A descriptive study of 100 patients with previously detected and surgically treated CRC referred to PET/CT with a suspicion of recurrent or metastatic CRC. CEA was measured within three months from the imaging. A low-dose PET/CT was performed per institutional protocol. For each hypermetabolic lesion, metabolic PET/CT parameters (SUVmax, MTV, TLG) were calculated semiautomatically. Pathohistology or clinical data from the follow-up were used as the gold standard. Sensitivity, specificity, PPV and NPV for 18F-FDG PET/CT and CEA in detection of recurrent or metastatic CRC were calculated. Correlation between CEA and SUVmax, MTV and TLG was calculated, separately. To assess the prognostic values of metabolic parameters in CRC, survival analysis with 18-month progression-free survival (PFS) as an endpoint was performed. Microsoft Excel sheets, ROC and Kaplan-Meier curves were used to present the data. Logrank and Tarone-Ware test and Cox model of proportional hazards were used to compare the groups. Results: Study included 100 patients, 45 males and 55 females, age range 36-81 years, mean age 61,4 years. Cancer site was colon in 56% and rectum in 44%. Sensitivity, specificity, PPV and NPV of 18F-FDG PET/CT in detection of recurrent or metastatic CRC was 95%, 73%, 70% and 95%, respectively. Sensitivity, specificity, PPV and NPV of CEA in detection of recurrent or metastatic CRC was 58%, 96%, 91% and 78%, respectively. SUVmax, MTV and TLG positively correlated with CEA, but only CEA-TLG correlation was considered significant (r=0,67). The regression model analysis revealed: SUVmax (HR=0,63, 95%CI=0,28-1,41, p=0,214), MTV (0,59, 95%CI=0,28-1,22, p=0,111) and TLG (HR=0,45 95%CI=0,21-0,99, p=0,028), and the prognostic role in CRC was proven for TLG only. Conclusion: Metabolic 18F-FDG PET/CT parameters may have the prognostic value in CRC, but further multicentric prospective studies are required for validation.

Cyber-physical systems are taking on a permanent role in the industry, such as in oil and gas or mining. These systems are expected to perform increasingly autonomous tasks in complex settings removing human operators from remote and potentially hazardous environments. High autonomy necessitates a more extensive use of artificial intelligence methods, such as anomaly detection, to identify unusual occurrences in the monitored environment. The absence of data characterizing potentially hazardous events leads to disruptive noise displayed as false alarms, a common anomaly detection issue for hazard identification applications. Contrastingly, disregarding the false alarms can result in the opposite effect, causing loss of early indications of hazardous occurrences. Existing research introduces simulating and extrapolating less represented data to expand the information on hazards and semi-supervise the methods or by introducing thresholds and rule-based methods to balance noise and meaningful information, necessitating intensive computing resources. This research proposes a novel Warning Identification Framework that evaluates risk analysis objectives and applies them to discern between true and false warnings identified by anomaly detection. We demonstrate the results by analyzing three seismic hazard assessment methods for identifying seismic tremors and comparing the outcomes to anomalies found using the unsupervised anomaly detection method. The demonstrated approach shows great potential in enhancing the reliability and transparency of anomaly detection outcomes and, thus, supporting the operational decision-making process of a cyber-physical system.

Is it safe to have a pregnancy in women with prior history of hormone receptor-positive early breast cancer? Pregnancy following breast cancer treatments in young women with history of hormone receptor-positive disease is safe with no detrimental effect on patients’ prognosis. Breast cancer is the most common malignancy diagnosed in women of reproductive age. Both physicians and patients continue to have concerns about a potential detrimental effect of pregnancy after breast cancer, particularly in the setting of hormone receptor-positive disease. In recent years, several studies have demonstrated the safety of pregnancy after anticancer treatments in breast cancer survivors. A systematic literature search of Medline, Embase and Cochrane library with no language or date restriction up to January 1st, 2023, was performed following the PRISMA guidelines. We included retrospective or prospective case-control and cohort studies as well as prospective clinical trials comparing survival outcomes of premenopausal female patients with reported pregnancy or not after diagnosis and treatment for hormone receptor-positive breast cancer. Included patients were childbearing potential age women with a prior history of hormone receptor-positive early breast cancer. Outcomes of interest were disease-free survival and overall survival. Hazard ratios (HR) with 95% confidence intervals (CI) were extracted. Higgins I2 index was used to evaluate the degree of inconsistency in the results of the included studies. Pooled HRs were considered statistically significant with a P value of < 0.05 (two-sided). Eight studies were eligible to be included in the final analysis. A total of 3,805 patients with hormone receptor-positive breast cancer were included in these studies, of whom 1,285 had a pregnancy after treatments. Median follow-up of the included studies ranged from 3.81 years to 15.8 years. In three studies (n = 987 patients) reporting on disease-free survival outcomes, no difference was observed between patients with or without a subsequent pregnancy (HR 0.96, 95% CI 0.75 – 1.24, p = 0.781). Six studies (n = 3,504 patients) reported outcomes in terms of overall survival: patients with a pregnancy after breast cancer had better overall survival compared with those without a pregnancy (HR 0.46, 95% CI 0.27 – 0.77, p < 0.05). At the subgroup analysis on timing of pregnancy, no detrimental effect of pregnancy after breast cancer in terms of disease-free survival was observed for patients achieving a late pregnancy (defined as 2 or 5 years after diagnosis) as compared to patients without a subsequent pregnancy (HR 1.08, 95% CI 0.80 – 1.46, p = 0.611). Increased disease-free survival was observed in patients with an early pregnancy (HR 0.63, 95% CI 0.47 – 0.85, p < 0.05). This meta-analysis is based on abstracted data and most of the studies are retrospective cohort studies. Median follow-up in a large proportion of the studies was shorter than 10 years. Adjuvant hormone therapy before and after pregnancy was not available in many studies included. Our results strengthen the evidence that having a pregnancy in women with prior history of hormone receptor-positive breast cancer is safe. not applicable

Connected, Cooperative, and Autonomous Mobility (CCAM) will take intelligent transportation to a new level of complexity. CCAM systems can be thought of as complex Systems-of-Systems (SoSs). They pose new challenges to security as consequences of vulnerabilities or attacks become much harder to assess. In this paper, we propose the use of a specific type of a trust model, called subjective trust network, to model and assess trustworthiness of data and nodes in an automotive SoS. Given the complexity of the topic, we illustrate the application of subjective trust networks on a specific example, namely Cooperative Intersection Management (CIM). To this end, we introduce the CIM use-case and show how it can be modelled as a subjective trust network. We then analyze how such trust models can be useful both for design time and run-time analysis, and how they would allow us a more precise quantitative assessment of trust in automotive SoSs. Finally, we also discuss the open research problems and practical challenges that need to be addressed before such trust models can be applied in practice.

Background In last two decades, there have been substantial changes in the pattern of lipid-modifying medicines utilisation following the new treatment guidelines based on clinical trials. The main purpose of this study was to analyse the overall utilisation and expenditure of lipid-modifying medicines in the Republic of Srpska, Bosnia and Herzegovina during an 11-year follow-up period and to express its share in relation to the total cardiovascular medicines (C group) utilisation. Methods In this retrospective, observational study, medicines utilisation data were analysed between 2010 and 2020 period using the ATC/DDD methodology and expressed as the number of DDD/1000 inhabitants/day (DDD/TID). The medicines expenditure analysis was used to estimate the annual expenditure of medicines in Euro based on DDD. Results During the analysed period, the use of lipid-modifying medicines increased almost 3-times (12.82 DDD/TID in 2010 vs 34.32 DDD/TID in 2020), with a rise in expenditure from 1.24 million Euro to 2.15 million Euro in the same period. This was mainly driven by an increased use of statins with 163.07%, and among these, rosuvastatin increased more than 1500-fold, and atorvastatin with 106.95% increase. With the appearance of generics, simvastatin showed a constant decline, while the other lipid-modifying medicines in relation to the total utilisation had a neglecting increase. Conclusion The use of lipid-modifying medicines in the Republic of Srpska has constantly increased and strongly corresponded to the adopted treatment guidelines and the positive medicines list of health insurance fund. The results and trends are comparable with other countries, but still the utilisation of lipid-lowering medicines represents the smallest share of total medicines use for the treatment of cardiovascular diseases, compared to high-income countries.