Abstract Introduction The optimal reperfusion technique in patients with isolated posterior cerebral artery (PCA) occlusion is uncertain. Previous studies in LVO and MeVO have demonstrated a correlation between good clinical outcomes and the first pass effect (FPE, eTICI 2c/3 on the first pass) but no differences in FPE rates or clinical outcomes between first‐line endovascular therapy techniques.1‐6 We compared clinical and technical outcomes with first‐line stent‐retriever (SR), contact aspiration (CA), or combined techniques in patients with isolated PCA occlusion. Methods This international cohort study was conducted at 30 sites in Europe and North America and included consecutive patients with isolated PCA occlusion and pre‐stroke modified Rankin Scale (mRS) 0‐3, presenting within 24 hours of time last seen well from January 2015 to August 2022.7 The primary outcome was the first‐pass effect (FPE), defined as eTICI 2c/3 on the first pass. Secondary outcomes included final successful reperfusion (eTICI 2b‐3), 90‐day excellent outcome (mRS 0 to 1), 90‐day functional independence (mRS 0 to 2), sICH, and 90‐day mortality. Patients treated with SR, CA, or combined technique were compared with multivariable logistic regression. This study was registered under NCT05291637. Results There were 326 patients who met inclusion criteria, consisting of 56.1% male, median age 75 (IQR 65‐82) years and median NIHSS 8 (5‐12). Occlusion segments were PCA P1 (53.1%), P2 (40.5%), and other (6.4%). Intravenous thrombolysis was administered in 39.6%. First‐line technique was SR, CA, and combined technique in 43 (13.2%), 106 (32.5%), and 177 (54.3%) patients, respectively; FPE was achieved in 62.8%, 42.5%, and 39.6%, respectively. Compared to SR, FPE was lower in patients treated with first‐line combined technique and similar in patients treated with first‐line CA (combined vs. SR: aOR 0.35 [0.016‐0.80], p=0.01; CA vs. SR: aOR 0.45 [0.19‐1.06], p=0.07). Final successful reperfusion (eTICI 2b‐3) was present in 81% of cases with no differences between treatment groups. Excellent outcome (mRS 0‐1) occurred in 30.7% of patients and functional independence (mRS 0‐2) occurred in 50.0% of patients. There were lower odds of functional independence in the first‐line CA versus SR alone group (aOR 0.52 [0.28‐0.95], p=0.04). FPE was associated with higher rates of favorable outcomes (mRS 0‐2: 58% vs. 43.4%, p=0.01; mRS 0‐1: 36.6% vs. 25.8%, p=0.05). sICH was observed in 5.6% (18/326) and mortality in 10.9% (35/326) with no differences between first‐line technique. Conclusion In patients with isolated PCA occlusion undergoing EVT, first line SR was associated with a higher rate of FPE compared to CA or combined techniques with no difference in final successful reperfusion. Functional independence at 90‐days was more likely with first‐line SR compared to CA in adjusted analyses. FPE was associated with higher rates of 90‐day excellent outcomes and functional independence. No difference in sICH or mortality was noted across the three techniques. As the endovascular field evolves to treat patients with distal vessel occlusion and milder severity of stroke, optimizing the efficacy and safety of the procedure is essential.8

Heart failure remains one of the most prevalent clinical syndromes associated with significant morbidity and mortality. According to current guidelines MRA are recommended to reduce the risk of HF hospitalization and death in all patients with symptomatic heart failure. The aim of our study was to determine the efficacy of eplerenone vs. spironolactone on left ventricular systolic function (LVEF) in patients with chronic heart failure, especially their effect on preventing hospitalization, reducing mortality, and improving clinical status among patients with chronic HF. From June 2021 to June 2022, the study was a randomized, prospective clinical trial single blind study. A total of 142 patients of chronic heart failure with reduced ejection fraction were selected by random sampling. Each patient was randomly allocated into either of the two groups and was continued receiving treatment with either spironolactone (Spiron-HF group) or eplerenone (Epler-HF group). Patients in Epler-HF group were compared with an arm of the same size. Each patient was evaluated clinically and echocardiographically at the beginning of treatment, after 6 months and at the end of 12th month. After 12 months of treatment, significant improvement of left ventricular ejection fraction was observed in eplerenone treated arm (37.9 ± 3.8 ± 4.6 in Spiron-HF group versus 40.1 ± 5.7 in Epler-HF group; P < 0.05). A significant reduction in left ventricular end-systolic volume (6.3 ± 2.5ml in Spiron-HF versus 17.8± 4.4ml in Epler-HF group; P < 0.05) and left ventricular systolic diameter volume (2.7 ± 0.5ml in Spiron-HF versus 6.7 ± 0.2ml in Epler-HF group; P < 0.05), occurred after 12 months of treatment. The effects of both MRA agents' spironolactone and eplerenone on the primary composite outcome, each of the individual mortality and hospital admission outcomes are shown in Figure 1 and 2. Patients of the Epler-HF group showed statistically significant lower cardiovascular mortality (HR 0.53; 95% CI 0.34–0.82; p= 0.007) and all-cause mortality (HR 0.64; 95% CI 0.44–0.93; p= 0.022) than patients of the Spiron-HF group. The statistical analysis did not show a statistically significant difference between Epler -HF and Spiron-HF study groups regarding the risk of the primary composite outcome; cardiovascular death or hospitalization due to HF (Hazard Ratio (HR) eplerenone vs. spironolactone = 0.95; 95% Confidence Interval (CI) 0.73– 1.27; p= 0.675). Our study has demonstrated favorable effects of eplerenone on cardiac remodeling parameters and reduction of cardiovascular mortality and all-cause mortality compared with spironolactone in the treatment of HFrEF. The ability of eplerenone to effectively block the mineralocorticoid receptor while minimizing side effects and a significant reduction in the risk of hospitalization and cardiovascular death confirms its key role in the treatment of patients with chronic HFrEFCumulative estimates of cardiovascular mCumulative incidence of the primary end-

To compare clinical, radiographic, biological and technical long-term outcomes of two types of dental implants over a period of 10 years. Ninety-eight implants were placed in 64 patients, randomly allocated to one of two manufacturers (AST and STM). All implants were loaded with fixed restorations. Outcome measures were assessed at implant insertion (Ti), at baseline examination (TL), at 1, 3, 5, 8 and 10 (T10) years. Data analysis included survival, bone level changes, complications and clinical measures. Re-examination was performed in 43 patients (23 AST and 20 STM) at 10 years. The implant level analysis was based on 37 (AST) and 32 (STM) implants. Survival rates of 100% were obtained for both groups. The median changes of the marginal bone levels between baseline and T10 (the primary endpoint) amounted to a loss of 0.07 mm for group AST and a gain of 0.37 mm for group STM (intergroup p = 0.008). Technical complications occurred in 27.0% of the implants in group AST and in 15.6% in group STM. The prevalence of peri-implant mucositis was 29.7% (AST) and 50.1% (STM). The prevalence of peri-implantitis amounted to 0% (AST) and 6.3% (STM). Irrespective of the implant system used, the survival rates after 10 years were high. Minimal bone level changes were observed, statistically significant but clinically negligible in favor of STM. Technical complications were more frequently encountered in group AST, while group STM had a higher prevalence of peri-implant mucositis.

The selection of unmanned aerial vehicles for different purposes is a frequent topic of research. This paper presents a hybrid model of an unmanned aerial vehicle (UAV) selection using the Defining Interrelationships Between Ranked criteria (DIBR), Full Consistency Method (FUCOM), Logarithm Methodology of Additive Weights (LMAW) and grey - Evaluation based on Distance from Average Solution (G-EDAS) methods. The above-mentioned model is tested and confirmed in a case study. First of all, in the paper are defined the criteria conditioning the selection, and then with the help of experts and by applying the DIBR, FUCOM and LMAW methods, the weight coefficients of the criteria are determined. The final values of the weight coefficients are obtained by aggregating the values of the criteria weights from all the three methods using the Bonferroni aggregator. Ranking and selection of the optimal UAV from twenty-three defined alternatives is carried out using the G-EDAS method. Sensitivity analysis confirmed a high degree of consistency of the solutions obtained using other MCDM methods, as well as changing the criteria weight coefficients. The proposed model has proved to be stable; its application is also possible in other areas and it is a reliable tool for decision-makers during the selection process.

This research focuses on the use of electric vehicles (EVs) to transport visitors and cargo within Bosnia and Herzegovina’s Kozara National Park. Reduced air pollution and the preservation of natural resources are required to help protect this aerial spa. Together with the expert employees of this NP, the EV that would best suit their needs was chosen. The process of decision-making combines subjective and objective methods. Employees first chose the criteria and alternatives and then weighed their importance. On that occasion, Z-numbers were used to include uncertainty in the decision, because it is not always possible to make decisions with complete certainty. Furthermore, the weight of these criteria was determined using the fuzzy PIPRECIA (PIvot Pairwise Relative Criteria Importance Assessment) method. Range (C1) became the most important criterion, followed by vehicle cost (C2), and the technical specifications of these EVs were used to compare them. Because these specifications vary, a rough set was used in which the minimum and maximum EV characteristics were taken based on specific criteria. To rank the alternatives, the R-CRADIS (Rough Compromise Ranking of Alternatives with Distance to Ideal Solution) method was used. According to the research results, the Mercedes eVito Tourer 90 kWh is the highest ranked EV and the validation of the results confirmed these findings. According to the research results, the Mercedes eVito Tourer 90 kWh is the highest ranked EV and the validation of the results confirmed these findings. The sensitivity analysis revealed that if criterion C1 is not as important, the other EVs are ranked higher. This research`s methodology has demonstrated flexibility, therefore it is recommended for use in similar research.

We study the local dynamics and global character of third-order polynomial difference in the first octant of initial conditions with infinite number of prime period-three solutions (three cycles). It is also presented the case when the observed difference equation may be extended to the whole ℝ𝟑.

Šumske ceste kao trajni građevinski objekti zahtijevaju ispunjene minimalno propisane kvalitete i standarda tijekom izgradnje. Prema dostupnim podacima prosječni troškovi gradnje šumskih cesta u F BiH za 2019. godinu iznosili su 22.282,19 € po dužnom kilometru (Anon 2019a). Ovako niski troškovi gradnje nameću opravdano pitanje kvalitete novoizgrađenih šumskih cesta i potrebno mu je posvetiti odgovarajuću pozornost. Na području F BiH, zbog niza razloga, sve se više grade prilazne ili tzv. tehnološke šumske ceste, koje se zbog činjenice da se radi o vrsti šumskih cesta bez izvedene kolničke konstrukcije mogu koristiti samo po suhom vremenu te zbog toga ne ulaze u obračun klasične otvorenosti šuma. Osim toga, zbog nedostatka odvodnih jaraka i prevelikog uzdužnog nagiba nivelete na ovim cestama mogu nastati nesagledive ekološke posljedice. S obzirom da postojeća otvorenost šuma u F BiH nije na zadovoljavajućoj razini, cilj svih šumarskih poduzeća je njeno povećanje. Kako se gradnjom šumskih cesta bez izvedene kolničke konstrukcije ne utječe na povećanje otvorenosti, količina cesta koju je potrebno izgraditi za dostizanje ciljane klasične otvorenosti ostaje nepromijenjena. Kao rješenje za riješavanje navedene situacije, u praksi se u posljednje vrijeme sve više grade šumske ceste s elementima koji čine kombinaciju sporednih i prilaznih šumskih cesta. U ovom radu je izvršena analiza tehničkih i konstruktivnih elemenata za novoizgrađenu šumsku cestu „Braćinac - Doljanske stijene“ stacionaže 1,72 km. Na osnovi dobivenih rezultata, došlo se do saznanja o elementima koje na ovoj cesti treba unaprijediti kako bi se ista očuvala, odnosno kako bi se omogućilo njeno dugogodišnje korištenje. S tim u vezi evidentirana su odstupanja uzdužnog nagiba nivelete u odnosu na propisane veličine na 41% od ukupne dužine, na 26% od ukupne dužine nagibi škarpi usjeka nisu prilagođeni kategoriji materijala u kojoj su izgrađene, duž cijele šumske ceste nisu izgrađeni odvodni kanali. Navedena odstupanja daju za rezultat propadanje kolničke konstrukcije, s obzirom da su na 24% evidentirana manja, a na 9% veća oštećenja. Imajući u vidu da su mjerenja na terenu urađena samo godinu dana nakon izgradnje šumske ceste, nameće se zaključak da niska kvaliteta gradnje i nepridržavanje tehničkih propisia rezultira ubrzanim propadanje ceste.

(1) Background: With the ever-increasing number of polymer materials and limited data on polymer gear calculations, designers are often required to perform extensive experimental testing in order to establish reliable operational data for specific gear applications. This research investigates the potential of a Polyvinyldene fluoride (PVDF) polymer material in gear applications, considering various loading conditions and different types of gear transmission configurations, including both self-mated mesh and steel/PVDF mesh. (2) Methods: PVDF gear samples were tested on a specially designed test rig that enables active torque control and temperature monitoring in order to obtain the necessary design parameters and failure modes. Each test for certain load conditions was repeated five times, and to fully investigate the potential of PVDF gear samples, comparative testing was performed for Polyoxymethylene (POM) gear. (3) Results: Tribological compatibility, tooth load capacity, and lifespan assessment, along with the types of failure, which, for some configurations, include several types of failures, such as wear and melting, were determined. Temperature monitoring data were used to estimate the coefficient of friction at the tooth contact of analyzed gear pairs, while optical methods were used to determine a wear coefficient. (4) Conclusions: The tribological compatibility of polymer gear pairs needs to be established in order to design a gear pair for a specific application. PVDF gear samples mated with steel gear showed similar lifespan properties compared to POM samples. Temperature monitoring and optical methods serve as a basis for the determination of the design parameters. PVDF is an appropriate material to use in gear applications, considering its comparable properties with POM. The particular significance of this research is reflected in the establishment of the design parameters of PVDF gear, as well as in the analysis of the potential of the PVDF material in gear applications, which gives exceptional significance to the current knowledge on polymer gears, considering that the PVDF material has not previously been analyzed in gear applications.