7. Cabrera C, Radolec M, Prescott A, De La Cruz C, Beck S. Interdisciplinary approach for the medical management of gestational gigantomastia. AJP Rep. 2020;10(03):e304e308. 8. Lesavoy MA, GomezGarcia A, Nejdl R, Yospur G, Syiau TJ, Chang P. Axillary breast tissue: clinical presentation and surgical treatment. Ann Plast Surg. 1995;35(4):356360. 9. Fletcher MB, Corsini LM, Meyer MD, Osswald SS. Gestational gigantomastia: a case report and brief review of the literature. JAAD Case Rep. 2020;6(11):11591161. 10. Mangla M, Chhatwal J, Nautiyal R, Prasad D. Gestational gigantomastia in the setting of myasthenia gravis. J Obstet Gynaecol India. 2019;69(S1):8487. 11. Husain M, Khan S, Bhat A, Hajini F. Accessory breast tissue mimicking pedunculated lipoma. BMJ Case Rep. 2014;2014:bcr20142 04990. 12. Khan RN, Parvaiz MA, Khan AI, Loya A. Invasive carcinoma in accessory axillary breast tissue: a case report. Int J Surg Case Rep. 2019;59:152155. 13. Lokuhetty MD, Saparamadu PA, AlSajee DM, AlAjmi R. Gigantomastia in pregnancy with an accessory axillary mass masquerading as inflammatory carcinoma. Diagn Cytopathol. 2011;39(2): 141143. 14. Swelstad MR, Swelstad BB, Rao VK, Gutowski KA. Management of gestational gigantomastia. Plast Reconstr Surg. 2006;118(4): 840848. 15. Antevski BM, Smilevski DA, Stojovski MZ, Filipovski VA, Banev SG. Extreme gigantomastia in pregnancy: case report and review of literature. Arch Gynecol Obstet. 2007;275(2):149153. 16. Alhindi N, Mortada H, Alzaid W, Al Qurashi AA, Awan B. A systematic literature review of the clinical presentation, management, and outcome of gestational gigantomastia in the 21st century. Aesthetic Plast Surg. 2022;47:1029. 17. Hassayoune N, Mhallem Gziri M, Lentini A, et al. Severe gestational gigantomastia: from mastectomy to staged autologous breast reconstruction. A case report. JPRAS Open. 2021;29:6570. 18. Lapid O. Breast reconstruction after mastectomy for gestational gigantomastia. Aesthetic Plast Surg. 2013;37(2):388391. 19. Qin F, Si L, Zhang H, et al. Management of gestational gigantomastia with breast reconstruction after mastectomy: case report and literature review. J Int Med Res. 2020;48(6):030006052092046.

Type of funding sources: None. Obesity and overweight play a key role in the development of cardiovascular disease or myocardial ischemia, particularly today, as does their relationship to traditional and non-traditional risk factors. Despite, diet and weight management are grossly under-met per desired body mass index (BMI) threshold goals among very high-risk patients with established atherosclerotic cardiovascular disease (ASCVD). Thus, we aimed to investigate the presence of overweight and obesity in patients with established atherosclerotic cardiovascular disease who were admitted to our center. Patients and methods: Out of 790 patients admitted in our center between May and October 2021, we analyzed 341 patients who underwent isolated coronary artery by-pass surgery. Risk factors were noted as well as previous drug therapy, previous COVID 19 infection and vaccination. Anthropometric data were measured and BMI was determined. Obesity was defined as a BMI >_30 kg/m2 and overweight as a BMI between 25 and 30 kg/m2 . Patients with a BMI >_40 kg/m2 were considered morbidly obese. Early cardiac rehabilitation (phase 1) was performed by using personalized approach in all patients. Out of 341 patients (64.68±7.91 years of age), 275 were males (80.6%). The total of 97 (28.44%) had previous myocardial infarction. Blood pressure was well controlled. Majority of the patients reached the step 2 goals according to EAPC Guidelines on prevention (130.7±6.45/75.27±6.54mmHg), and were adherent to prescribed drugs. Mean heart rate was 65±5.65/minute. Only 27% of females and 22% of males had normal weight with BMI between 18.5 and 24.9.kg/m2. The mean BMI was 27.76 kg/m2. 50% of males and females were overweight. Obesity was noted in 23% of females and 27% of males (0.7% morbidly obese. Early cardiac rehabilitation was performed in all patients and they were all referred to participate the phase 2 programs. Diet and body weight reduction in overweight and obese ASCVD patients should continue to be a priority given the impact on cardiovascular risk. There is a potential for optimizing management of overweight and obesity in patients. In addition to a better risk factor profile, weight loss also leads to a better quality of life. Cardiovascular prevention and rehabilitation programs should include weight loss intervention. Different forms of self-support and use of digital health might be used as a specific component of a comprehensive intervention to reduce total cardiovascular risk, extend life expectancy, and improve quality of life.

Sleep is essential to physical and mental health. However, the traditional approach to sleep analysis—polysomnography (PSG)—is intrusive and expensive. Therefore, there is great interest in the development of non-contact, non-invasive, and non-intrusive sleep monitoring systems and technologies that can reliably and accurately measure cardiorespiratory parameters with minimal impact on the patient. This has led to the development of other relevant approaches, which are characterised, for example, by the fact that they allow greater freedom of movement and do not require direct contact with the body, i.e., they are non-contact. This systematic review discusses the relevant methods and technologies for non-contact monitoring of cardiorespiratory activity during sleep. Taking into account the current state of the art in non-intrusive technologies, we can identify the methods of non-intrusive monitoring of cardiac and respiratory activity, the technologies and types of sensors used, and the possible physiological parameters available for analysis. To do this, we conducted a literature review and summarised current research on the use of non-contact technologies for non-intrusive monitoring of cardiac and respiratory activity. The inclusion and exclusion criteria for the selection of publications were established prior to the start of the search. Publications were assessed using one main question and several specific questions. We obtained 3774 unique articles from four literature databases (Web of Science, IEEE Xplore, PubMed, and Scopus) and checked them for relevance, resulting in 54 articles that were analysed in a structured way using terminology. The result was 15 different types of sensors and devices (e.g., radar, temperature sensors, motion sensors, cameras) that can be installed in hospital wards and departments or in the environment. The ability to detect heart rate, respiratory rate, and sleep disorders such as apnoea was among the characteristics examined to investigate the overall effectiveness of the systems and technologies considered for cardiorespiratory monitoring. In addition, the advantages and disadvantages of the considered systems and technologies were identified by answering the identified research questions. The results obtained allow us to determine the current trends and the vector of development of medical technologies in sleep medicine for future researchers and research.

Occupational exposure in Bosnia and Herzegovina is regulated by the national regulation on radiation protection for occupational and public exposure. All radiation workers are required to be monitored using whole body passive thermoluminescent dosemeters and, in case of non-uniform external exposures, by dosemeters that would indicate dose to the most affected body parts. Exposed workers are almost exclusively employed in the medical field, and some of them work in nuclear medicine departments where they handle unsealed radioactive sources. Introduction of the positron emission tomography-computed tomography (PET-CT) in two largest clinical centers in the country was expected to cause the increase of equivalent doses to hands received by staff handling the positron emitting radionuclides. Hence, routine monitoring of finger doses became a necessity. The purpose of this study was to evaluate the available data on monitoring with ring dosemeters during PET-CT procedure in two hospitals in Bosnia and Herzegovina and compare them with other practices in the nuclear medicine department, as well as with the results of monitoring in other countries. In general, results confirm that effective doses, as well as equivalent doses to hands, are well below annual dose limits. Finger dosemeters have been proven to be an invaluable asset in the incidental situations that sometimes occur in nuclear medicine departments. Different number of patients and differences in injection methodologies are identified as a possible source of differences between doses in two hospitals. Overall, routine evaluation of doses to hands provides a sound basis for possible optimization processes, as well as confirmation of good practices.

Diabetes mellitus, a group of metabolic disorders characterized by high levels of blood glucose caused by insulin defect or impairment, is a major risk factor for cardiovascular diseases and related mortality. Patients with diabetes experience a state of chronic or intermittent hyperglycemia resulting in damage to the vasculature, leading to micro- and macro-vascular diseases. These conditions are associated with low-grade chronic inflammation and accelerated atherosclerosis. Several classes of leukocytes have been implicated in diabetic cardiovascular impairment. Although the molecular pathways through which diabetes elicits an inflammatory response have attracted significant attention, how they contribute to altering cardiovascular homeostasis is still incompletely understood. In this respect, non-coding RNAs (ncRNAs) are a still largely under-investigated class of transcripts that may play a fundamental role. This review article gathers the current knowledge on the function of ncRNAs in the crosstalk between immune and cardiovascular cells in the context of diabetic complications, highlighting the influence of biological sex in such mechanisms and exploring the potential role of ncRNAs as biomarkers and targets for treatments. The discussion closes by offering an overview of the ncRNAs involved in the increased cardiovascular risk suffered by patients with diabetes facing Sars-CoV-2 infection. Graphical Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The fibrosis of the LA, which is characteristic of AF, causes mechanical dysfunction of the LA and may also be present in patients without LA enlargement. LA strain represents a surrogate marker of this mechanical dysfunction. Early detection of LA dysfunction may be crucial in identifying patients who are more likely to experience AF recurrence following cardioversion and ablation. Before cardioversion and ablation, the probability of AF recurrence might be predicted, which could lead to better patient selection, an individualized therapeutic strategy with reduced risk and focused follow-up. Purpose The aim of this study was to evaluate the additional predictive value of LA function assessed by using strain echocardiography for early AF recurrence after cardioversion and ablation. Methods 94 patients diagnosed with symptomatic persistent atrial fibrillation (EHRA symptom score ≥3 (mean age 59.4 ± 12.2 years, 58% male, 42%female), preserved LV ejection fraction were prospectively analyzed. In 39 (41,5%) patients pharmacological cardioversion was done after saturation with antiarhythmic drugs,in 27 (28,7%) patients planed electrical cardioversion was done after medical saturation with antiarrhythmic drugs and failure of pharmacological cardioversion, and in 28 (29,8%) patients planed RF ablation was performed. Complete echocardiography evaluation including strain and volume index LA was performed before cardioversion and ablation. The rhythm evaluation was done in the first month after cardioversion and RF ablation (35±5 days). The primary endpoint was persistent AF recurrence. Results 29 (30,8%) patients had AF recurrence in the overall study population, independently of duration of AF or method of rhythm control. Peak atrial longitudinal strain (PALS) ≤15% had the highest incremental predictive value for AF recurrence (HR =8.42, 95% CI: 3.17–25.12, p < 0.001). In patients with non-dilated LA, PALS≤15% remained an independent predictor of AF recurrence (HR = 5.32, 95% CI: 1.77–17.42, p = 0.005). Conclusion This study shown that, in addition to LA dilatation, LA function as determined by PALS can provide a prognostic value for early AF recurrence after cardioversion or ablation. PALS also predicted AF recurrence in patients with nondilated LA. These findings highlight the additional prognostic usefulness of LA strain and recommend its implementation in the systematic assessment of AF patients prior to the choice of rhythm/rate control.

In the strong-field ionization of atomic and molecular systems, the photoelectron is exposed to the long-range Coulomb force which is neglected in the standard theories based on the strong-field approximation (SFA). We introduce an ansatz which takes into account the Coulomb effects and at the same time is as simple as the standard SFA. Our Coulomb distorted plane wave-Volkov approximation provides analytical expressions for the relevant matrix elements. We also present a generalization of this approximation taking into account first-order term of an expansion in the atomic potential. Similarly as in the standard improved SFA, this generalized approximation describes well the rescattering plateau and the cutoff observed in the photoelectron spectra. Our new approximation is illustrated with numerical examples of strong-field ionization of the hydrogen atom exposed to linearly and circularly polarized laser pulses. The spectra obtained are slightly flatten in comparison with the SFA spectra and this effect is stronger for shorter laser wavelengths.

Background: Patients with acute pulmonary embolism (PE) may have various types of atrial fibrillation (AF). The role of AF in hemodynamic states and outcomes may differ between men and women. Methods: In total, 1600 patients (743 males and 857 females) with acute PE were enrolled in this study. The severity of PE was assessed using the European Society of Cardiology (ESC) mortality risk model. Patients were allocated into three groups according to their electrocardiography recordings taken during hospitalization: sinus rhythm, new-onset paroxysmal AF, and persistent/permanent AF. The association between the types of AF and all-cause hospital mortality was tested using regression models and net reclassification index (NRI) and integrated discrimination index (IDI) statistics with respect to sex. Results: There were no differences between the frequencies of the types of AF between men and women: 8.1% vs. 9.1% and 7.5% vs. 7.5% (p = 0.766) for paroxysmal and persistent/permanent AF, respectively. We found that the rates of paroxysmal AF significantly increased across the mortality risk strata in both sexes. Among the types of AF, the presence of paroxysmal AF had a predictive value for all-cause hospital mortality independent of mortality risk and age in women only (adjusted HR, 2.072; 95% CI, 1.274–3.371; p = 0.003). Adding paroxysmal AF to the ESC risk model did not improve the reclassification of patient risk for the prediction of all-cause mortality, but instead enhanced the discriminative power of the existing model in women only (NRI, not significant; IDI, 0.022 (95% CI, 0.004–0.063); p = 0.013). Conclusion: The occurrence of paroxysmal AF in female patients with acute PE has predictive value for all-cause hospital mortality independent of age and mortality risk.

RATIONALE Tobacco smoking and air pollution are primary causes of chronic obstructive pulmonary disease (COPD). However, only a minority of smokers develop COPD. The mechanisms underlying the defense against nitrosative/oxidative stress in non-susceptible smokers to COPD remain largely unresolved. OBJECTIVES To investigate the defense mechanisms against nitrosative/oxidative stress that possibly prevent COPD development or progression. METHODS Four cohorts were investigated: (1) sputum samples (healthy, n=4; COPD, n=37), (2) lung tissue samples (healthy, n=13; smokers without COPD, n=10; smoker+COPD, n=17), (3) pulmonary lobectomy tissue samples (no/mild emphysema, n=6) and (4) blood samples (healthy, n=6; COPD, n=18). We screened 3-nitrotyrosine (3-NT) levels, as indication of nitrosative/oxidative stress, in human samples. We established a novel in vitro model of a cigarette smoke extract (CSE)-resistant cell line and studied 3-NT formation, antioxidant capacity, and transcriptomic profiles. Results were validated in lung tissue, isolated primary cells and an ex vivo model using adeno-associated virus-mediated gene transduction and human precision-cut lung slices (hPCLS). MEASUREMENTS AND MAIN RESULTS 3-NT levels correlate with COPD severity of patients. In CSE-resistant cells, nitrosative/oxidative stress upon CSE was attenuated, paralleled by profound upregulation of heme-oxygenase-1 (HO-1). We identified carcinoembryonic-antigen-related-cell-adhesion-molecule-6 (CEACAM6) as a negative regulator of HO-1-mediated nitrosative/oxidative stress defense in human alveolar type 2 epithelial cells (hAEC2). Consistently, inhibition of HO-1 activity in hAEC2 increased the susceptibility towards CSE-induced damage. Epithelium-specific CEACAM6 overexpression increased nitrosative/oxidative stress and cell death in hPCLS upon CSE treatment. CONCLUSIONS CEACAM6 expression determines the hAEC2 sensitivity to nitrosative/oxidative stress triggering emphysema development/progression in susceptible smokers.

We present constraints on the left-handed dimension-6 interactions that contribute to semileptonic and leptonic decays of K, D, pions and to nuclear beta decay. We employ the flavour covariant description of the effective couplings, identify universal CP phases of New Physics and derive constraints from decay rates and CP-odd quantities. As a result, we can predict the maximal effects of such flavoured NP in D decays from stringent K decay constraints and vice-versa.

The Message Queuing Telemetry Transport (MQTT) protocol is one of the most widely used IoT protocol solutions. In this work, we are especially interested in open-source MQTT Broker implementations (such as Mosquitto, EMQX, RabbitMQ, VerneMQ, and HiveMQ). To this end, we engineer a network testbed to experimentally benchmark the performance of these implementations in an edge computing context with constrained devices. In more detail, we engineer an automated deployment and orchestration of the containerized MQTT broker implementations, with support for deployment across either moderately powerful AMD64 devices, or more resource constrained ARM64 devices. The proposed MQTT implementations are evaluated in terms of overhead response time and different payload sizes. Results showed that the hardware platform used as well as the message size, and the network parameters (latency, packet loss and jitter) have a significant impact on the performance differences between the brokers. All results, software tools and code are fully reproducible and free and open source.

Detecting phishing attacks is not straightforward, since there are many obstacles that derive from language complexity and technical aspects. Studying phishing attacks and other related issues heavily relies on computer datasets, i.e. digital corpora that reflect these linguistic and technical intricacies. Diverse studies using phishing datasets have been performed, but mainly for the English language. Research for other languages is scarce, and especially for not widely spoken languages. For the Croatian language there is an evident lack of corpora that are essential for diverse analyses and for constructing models that are capable of recognizing phishing attacks and protecting users. These datasets are necessary for natural language processing and building machine learning workflows, where results largely depend on corpora that must be specifically crafted for this purpose. Therefore, creating high-quality domain-specific corpora is of great importance in the domain of information security. Such corpora can be employed for teaching purposes in various courses in higher education, and could be analyzed in numerous ways in order to understand the underlying principles of phishing attack strategies. The aim of this paper is to demonstrate the entire process of data acquisition and corpus creation for the phishing detection domain. In addition, an analysis of the corpus is presented with regard to different aspects, such as descriptive attributes, terminology characteristics, metadata and language.

Courses in principles of digital computers usually begin with elementary logic circuits, proceed through increasingly complex ones, and often end with the design of a central processing unit. Such processors are typically simpler to explain than commercial microprocessors, but also often have very limited capabilities. The educational processor presented in this paper has a good balance between simplicity and capabilities. All its instructions, including multiplication and bit rotation, are executed in one clock cycle. The method of encoding and decoding instructions is quite simplified so that the encoding of instructions can be done even manually without tables, and the decoder unit is a simple forwarding of parts of the instruction word to the control bits of multiplexers. The processor is symmetric around the number 16: it has 16 three-operand instructions, 16 registers, each register is 16 bits wide, as well as the address and data bus. It is simulated at the logic gates level, a Verilog implementation on FPGA, and an emulated computer run by an implementation of a Forth interpreter written partly in its machine language.