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Kerim Obarcanin, Dzenita Skulj, Bakir Lacevic

This article presents two approaches to power circuit breakers condition assessment. The first one covers a wide variety of machine learning classification algorithms where the input for the classification is a manually selected feature set. The second one utilizes deep learning classification based on the convolutional neural network. Both approaches revolve around the idea behind spectral kurtosis, one of which exploits its visual representation in the form of kurtogram. The first approach uses a spectral kurtosis curve as the base for feature extraction while the second approach uses a spectral kurtosis kurtogram as a single input into the convolutional neural network. The validation is performed on a large set of vibration signatures and compared to competing state-of-the-art algorithms. The results indicate promising features of the proposed approach.

M. Kovačević, Nermina Rizvanović, Adisa Sabanovic Adilovic, Senada Čaušević

Aim To determine the relationship between coagulation disorders and septic condition in COVID-19 critically ill patients. Methods Data from 99 patients who presented with COVID-19 acute hypoxemic respiratory failure (CAHRF) were divided into two groups: Group 1- patients who developed sepsis, and Group 2 - patients who developed septic shock. Age, sex, comorbidities, quick Sequential Organ Failure Assessment (qSOFA) score, vasopressor and inotrope requirement, laboratory findings (platelets, neutrophils, lymphocytes, procalcitonin - PCT, C-reactive protein, fibrinogen, D-dimer, sepsis-induced coagulopathy - SIC, and disseminated intravascular coagulation - DIC score) were recorded on the day of admission and on the day of starting invasive mechanical ventilation. The primary outcome was to establish COVID-19 associated coagulopathy with sepsis and septic shock; the secondary outcome measure was incidence of coagulopathy in septic COVID-19 critically ill patients. Results The most common coagulation abnormality was international normalized ratio (INR) (p=0.019) for Group 2, followed by the values of inflammatory parameters PCT (p=0.002) and lymphocytes (p=0.011) also for Group 2. The statistical significance of SIC score was observed for both groups (p=0.007) and p=0.012, respectively. Norepinephrine (p=0.000) and dobutamine (p=0.000) for Group 2, qSOFA for both groups (p = 0.000) were statistically significant. Conclusion The observed coagulation abnormalities met the criteria for a SIC diagnosis, therefore, the management of coagulation disorders at this stage of the disease should follow the management of a septic condition.

Asmira Ljuca, Nermina Rizvanović, Senad Ljuca, Alma Jahić

Aim To evaluate the predictive significance of the red blood cell distribution width (RDW) >14.5 at admission to the Intensive Care Unit (ICU) on outcome parameters: length of hospital stay (LOHS), incidence of hospital mortality, 30-day mortality and 30-day survival after hospital discharge in unselected (surgical and non-surgical) critically ill patients. Methods A total of 325 surgical and non-surgical critically ill patients were divided based on the RDW value at admission to the ICU into two groups: Group 1 (RDW >14.5) and Group 2 (RDW ≤14.5). Demographic and clinical parameters, laboratory findings,treatment and outcome parameters were compared between the groups. The predictive significance of RDW>14.5 on outcome parameters was analysed using linear regression analysis and univariate and multivariate logistic regression analysis, as appropriate. Results In Group 1, LOHS was higher (19.77±15.15; p<0.000) as was the prevalence of hospital mortality (46.6%; p<0.0523), while 30-day survival after hospital discharge was lower (52.9%; p>0.026) compared to Group 2. RDW >14.5 was positively linearly related (r=0.64; r2=0.40; p=0.000) with LOHS. RDW >14.5 predicted the prevalence of in-hospital mortality with a 73.7% positive predictive value (AUC 0.62; sensitivity 70.1%; specificity 59.5%; p<0.05) and 30-day survival after hospital discharge with a 34.5% negative predictive value (AUC 0.45; sensitivity 58.3%; specificity 68.7%; p<0.05). Conclusions RDW value >14.5 at admission to the ICU can predict prolonged hospital stay, higher mortality and lower survival rate. RDW >14.5 may be an inexpensive and widely available early warning to redirect diagnostic and therapeutic decisions and improve outcomes.

Aim To evaluate Helicobacter pylori (H. pylori) resistance to clarithromycin and quinolones in patients with dyspepsia in Tuzla Canton, Bosnia and Herzegovina, a region with no data on clarithromycin or quinolones resistance. Methods A prospective cross-sectional study was conducted at the Department of Gastroenterology and Hepatology at University Clinical Centre Tuzla between January 2021 and June 2022. The study included 99 patients who underwent esophagogastroduodenoscopy (EGDS) due to dyspepsia. In all patients biopsies were taken for rapid urease test (RUT) and histology findings, concomitantly with blood samples for IgG serology. All RUT positive patient samples were tested for clarithromycin and quinolones susceptibility with GenoType HelicoDr, a PCR method which detects point mutations in 23S rRNA and mutations in the gyrA gene. Results Out of 99 dyspeptic patients, 67 (67.7%) were serologically positive to H. pylori, 46 (46.4.%) were RUT positive, and 19 (19.2 %) had a positive histology finding. Antibiotic (AB) resistance was tested in the total of 46/99 (46.4%) patients. Resistance to clarithromycin was detected in 28.26% (13/46), quinolones resistance in 36.96% (17/46) , and resistance to both AB was detected in 8.69% (4/46) tested biopsies. Conclusions Due to high clarithromycin and quinolones resistance rates, we recommend the use of bismuth quadruple or non-bismuth concomitant quadruple therapy for H. pylori eradication in Tuzla Canton, Bosnia and Herzegovina.

L. M. Blanco-Donoso, S. Hodžić, Óscar Lecuona, Isabel Carmona-Cobo, E. Garrosa, Bettina Kubicek

BACKGROUND The Intensification of Job Demands Scale (IDS) is a multidimensional instrument designed to capture the phenomenon of work intensification that characterizes modern Western societies. However, in Spain the instrument has not been validated to assess this phenomenon. The aim of this study was to examine the psychometric properties of the IDS adaptation with a heterogeneous sample of Spanish workers. METHOD The sample consisted of 722 Spanish workers (57.8% female, 42.2% male) who completed a survey between January and April 2022. RESULTS A five-factor correlated model, as in the original IDS, had an optimal fit with 15 items, and displayed invariance across gender, level of education, and organizational tenure. Reliability coefficients were all satisfactory, and scale adaptation showed evidence of convergent, discriminant, and incremental validity. CONCLUSIONS The Spanish adaptation of the IDS is a valid, reliable measure for analyzing the phenomenon of work intensification and intensified job demands in Spain.

Maria Andersson, Jinghua Wu, David Wullimann, Yu Gao, M. Åberg, S. Muschiol, K. Healy, S. Naud et al.

Background Patients with chronic lymphocytic leukemia (CLL) are vulnerable to coronavirus disease 2019 (COVID-19) and are at risk of inferior response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, especially if treated with the first-generation Bruton’s tyrosine kinase inhibitor (BTKi) ibrutinib. We aimed to evaluate the impact of the third-generation BTKi, zanubrutinib, on systemic and mucosal response to SARS-CoV-2 vaccination. Methods Nine patients with CLL with ongoing zanubrutinib therapy were included and donated blood and saliva during SARS-CoV-2 vaccination, before vaccine doses 3 and 5 and 2 - 3 weeks after doses 3, 4, and 5. Ibrutinib-treated control patients (n = 7) and healthy aged-matched controls (n = 7) gave blood 2 - 3 weeks after vaccine dose 5. We quantified reactivity and neutralization capacity of SARS-CoV-2-specific IgG and IgA antibodies (Abs) in both serum and saliva, and reactivity of T cells activated with viral peptides. Results Both zanubrutinib- and ibrutinib-treated patients had significantly, up to 1,000-fold, lower total spike-specific Ab levels after dose 5 compared to healthy controls (P < 0.01). Spike-IgG levels in serum from zanubrutinib-treated patients correlated well to neutralization capacity (r = 0.68; P < 0.0001) and were thus functional. Mucosal immunity (specific IgA in serum and saliva) was practically absent in zanubrutinib-treated patients even after five vaccine doses, whereas healthy controls had significantly higher levels (tested in serum after vaccine dose 5) (P < 0.05). In contrast, T-cell reactivity against SARS-CoV-2 peptides was equally high in zanubrutinib- and ibrutinib-treated patients as in healthy control donors. Conclusions In our small cohort of zanubrutinib-treated CLL patients, we conclude that up to five doses of SARS-CoV-2 vaccination induced no detectable IgA mucosal immunity, which likely will impair the primary barrier defence against the infection. Systemic IgG responses were also impaired, whereas T-cell responses were normal. Further and larger studies are needed to evaluate the impact of these findings on disease protection.

Mirela Lisičić-Konaković, S. Mesihović-Dinarević, Elmedin Bajrić, S. Jurišić, I. Musa Trolić, M. Ćubela, Zdenko Šarac, A. Zukanović

Aim To investigate the frequency of consumption of sweet and salty snacks among children aged 2-18 years in relation to their mothers' education level. Methods A descriptive epidemiological study was conducted in five dental practices at the School of Medicine of the University of Mostar from May to October 2022. The data were collected from medical records. Results: Out of a total of 477 children, 172 (36.1%) had mothers with a high school education, while 305 (63.9%) had mothers with a university degree. In the group of preschool children (aged 2-6 years), there were 42 mothers with high school education and 105 with university degree. In the group of school children (age 7-18 years) there were 130 mothers with high school education and 200 with university degree. The difference in the consumption of sweetened beverages among children of mothers with high school and university was not statistically significant. Similar results were found for the consumption of salty snacks, lollipops, caramels and candies. The frequency of the consumption of biscuits, chocolate and cakes (several times a day) was statistically significantly higher among the children of mothers with high school education (p=0.04), especially among school children. Eating habits of children, regardless of the level of education of their mothers, differed significantly only in the consumption of lollipops, caramels, and candies (p=0.03), which were consumed once a day by 79 (63.7%) schoolchildren and 45 (36.3%) of pre-schoolers. Conclusion A higher level of education among mothers does not necessarily equate to proper nutritional knowledge.

A. Jakovljević, F. Ideo, J. Jaćimović, A. Aminoshariae, V. Nagendrababu, A. Azarpazhooh, E. Cotti

INTRODUCTION This systematic review aimed to examine a potential link between apical periodontitis (AP) and gastrointestinal diseases (GIDs). METHODS The protocol of the review has been registered in PROSPERO (CRD42022330771). The following engines were used with the aim of searching for relevant literature: PubMed, Web of Science, Scopus, Cochrane Central Register of Controlled Trials, and grey literature, from inception to May 2022. There were no language restrictions included. Study selection, data collection and synthesis have been performed by two independent reviewers. For the purpose of estimating the quality of studies, the Newcastle-Ottawa Scale (NOS) was used. RESULTS Four matched case control studies, as well as a single longitudinal cohort study were included in the final review. These were published between 2017 and 2012,and comprised 537 participants whose age range was 18 to 87 years. It was not possible to perform a meta-analysis due to different study designs and evaluated outcomes of included studies. Except for one study that was categorized as 'Good', overall, for four out of five studies the quality was assessed as 'Fair'. CONCLUSIONS This review highlighted sparse knowledge present in the literature concerned with the association between AP and GIDs. Available evidence reveals a potential link between impaired endodontic status, assessed by the number of root filled teeth with periapical radiolucency, and GIDs. More research is needed to ascertain this association.

Danijela Mandić, L. Nežić, Ljiljana Amdžić, N. Vojinović, R. Gajanin, M. Popović, J. Đeri, M. T. Balint et al.

Simple Summary This study aimed to investigate if the coexpression of ABC transporters and survivin is associated with R-CHOP treatment response. Bcl-2 was in strong positive correlation with clinical parameters and all biomarkers except P-gp/ABCB1. The overexpression of MRP1/ABCC1, survivin, and BCRP/ABCC2 presented as high immunoreactive scores (IRSs) was detected in Refractory and Relapsed groups, respectively, whereas the IRS of P-gp/ABCB1 was low. Significant correlations were found among either MRP1/ABCC1 and survivin or BCRP/ABCC2 expression in the Refractory and Relapsed groups, respectively. In multiple linear regression analysis, ECOG status along with MRP1/ABCC1 or survivin, and BRCP/ABCG2 was significantly associated with the prediction of the R-CHOP treatment response. DLBCL might have increased levels of certain molecules such as MRP1/ABCC1, survivin, and BCRP/ABCC2 that can predict resistance to R-CHOP. Abstract Background: Approximately 40% of patients with diffuse large B-cell lymphoma (DLBCL) experience treatment resistance to the first-line R-CHOP regimen. ATP binding cassette (ABC) transporters and survivin might play a role in multidrug resistance (MDR) in various tumors. The aim was to investigate if the coexpression of ABC transporters and survivin was associated with R-CHOP treatment response. Methods: The expression of Bcl-2, survivin, P-glycoprotein/ABCB1, MRP1/ABCC1, and BCRP/ABCC2 was analyzed using immunohistochemistry in tumor specimens obtained from patients with DLBCL, and classified according to the treatment response as Remission, Relapsed, and (primary) Refractory groups. All patients received R-CHOP or equivalent treatment. Results: Bcl-2 was in strong positive correlation with clinical parameters and all biomarkers except P-gp/ABCB1. The overexpression of MRP1/ABCC1, survivin, and BCRP/ABCC2 presented as high immunoreactive scores (IRSs) was detected in the Refractory and Relapsed groups (p < 0.05 vs. Remission), respectively, whereas the IRS of P-gp/ABCB1 was low. Significant correlations were found among either MRP1/ABCC1 and survivin or BCRP/ABCC2 in the Refractory and Relapsed groups, respectively. In multiple linear regression analysis, ECOG status along with MRP1/ABCC1 or survivin and BRCP/ABCG2 was significantly associated with the prediction of the R-CHOP treatment response. Conclusions: DLBCL might harbor certain molecular signatures such as MRP1/ABCC1, survivin, and BCRP/ABCC2 overexpression that can predict resistance to R-CHOP.

Zana Radic Savic, V. Ćorić, Stojko Vidović, V. Vidović, Jelena Bećarević, Irina Milovač, Zorica Reljic, B. Mirjanić-Azarić et al.

Current data suggest that aristolochic acid (AA) exposure is a putative cause of Balkan endemic nephropathy (BEN), a chronic kidney disease strongly associated with upper tract urothelial carcinoma. The cellular metabolism of AA is associated with the production of reactive oxygen species, resulting in oxidative distress. Purpose: Therefore, the aim of this study was to analyze individual, combined and cumulative effect of antioxidant gene polymorphisms (Nrf2 rs6721961, KEAP1 rs1048290, GSTP1AB rs1695, GSTP1CD rs1138272, GPX3 rs8177412 and MDR1 rs1045642), as well as GSTP1ABCD haplotypes with the risk for BEN development and associated urothelial cell carcinoma in 209 BEN patients and 140 controls from endemic areas. Experimental method: Genotyping was performed using polymerase chain reaction (PCR) and PCR with confronting two-pair primers (PCR-CTTP) methods. Results: We found that female patients carrying both variant GPX3 rs8177412 and MDR1 rs1045642 genotypes in combination exhibited significant risk towards BEN (OR 1 = 3.34, 95% CI = 1.16–9.60, p = 0.025; OR 2 = 3.79, 95% CI = 1.27–11.24, p = 0.016). Moreover, significant association was determined between GPX3rs8174412 polymorphism and risk for urothelial carcinoma. Carriers of variant GPX3*TC + CC genotype were at eight-fold increased risk of BEN-associated urothelial tumors development. There was no individual or combined impact on BEN development and BEN-associated tumors among all examined polymorphisms. The haplotype consisting of variant alleles for both polymorphisms G and T was associated with 1.6-fold increased risk although statistically insignificant (OR = 1.64; 95% CI = 0.75–3.58; p = 0.21). Conclusions: Regarding GPX3 rs8177412 polymorphism, the gene variant that confers lower expression is associated with significant increase in upper urothelial carcinoma risk. Therefore, BEN patients carrying variant GPX3 genotype should be more frequently monitored for possible upper tract urothelial carcinoma development.

Aim To assess morphological characteristics of carotid blood vessels in uremic patients before to the initiation of the dialysis treatment, and corelate data with various dialysis therapy modules. Methods The study included 30 patients with end-stage renal disease (ERDS) prior to commencing dialysis, 30 patients treated with haemodialysis and 30 patients treated with continuous ambulatory peritoneal dialysis. The control group consisted of 15 subjects with normal kidney function (eGFR>60ml/min). Carotid intima-media thickness (CIMT), as well as lipid status values (cholesterol, triglycerides, low-density lipoprotein (LDL), high-density lipoprotein (HDL), apolipoprotein A, apolipoprotein B) were evaluated. Results The significant difference in CIMT was detected between the control and haemodialysis groups (p<0.001), and between the control and the peritoneal dialysis group (p=0.004). In patients in the predialysis group, CIMT was influenced by cholesterol (p=0.013), HDL (p=0.044), LDL (p=0.001) and ApoB (p=0.042) values. A significant difference in CIMT was proved between the haemodialysis and predialysis group of patients (p<0.001). The only variable from the patient's lipometabolic profile significantly associated with the change in IMT in uremic patients was HDL. A significant difference was found in the average value for systolic blood pressure (p<0.001) and diastolic blood pressure (p=0.018) in patients before starting the dialysis treatment compared to patients treated with other dialysis methods. Conclusion Patients on haemodialysis treatment had a significantly greater CIMT, which is in relation with a higher cardiovascular risk.

S. Patil, F. Licari, S. Bhandi, K. Awan, A. Badnjević, V. Belli, G. Cervino, G. Minervini

Partial or complete dentures are constructed from thermoplastic resins that are thermally processed and molded. This review examines the presently available evidence for the cytotoxicity of thermoplasticized denture base resins on human gingival epithelial cells, adipose cells, and fibroblasts; human amnion fibroblasts; and mouse fibroblasts. Electronic searches were performed on PubMed, Scopus, Web of Science, and Google Scholar databases to identify relevant articles to be included in the review until September 2022. Clinical, in vivo, and in vitro studies in English language were searched for. The quality of the studies was assessed using the Toxicological data Reliability Assessment tool (ToxRTool) developed by the European Commission’s Joint Research Centre. GRADE assessment was used to evaluate the certainty of evidence. Seven in vitro studies were included in the review. The overall risk of bias was determined to be high, with the majority of studies assessed found to be reliable with restrictions or not reliable. Only two studies were considered reliable without restrictions based on ToxRTool assessment. The effect of thermoplastic denture base resins on viability and cell adherence of human gingival or amnion fibroblasts and mouse fibroblasts (L929s) is not significant. Conditioned media from unpolished specimens of resins were significantly more toxic to cultured cells than those from polished specimens. This may be of concern in cases of poor post-processing of dentures. Based on the limited evidence available, there is low-certainty evidence that thermoplastic denture base resins appear to be biocompatible and show insignificant cytotoxicity. Further well-designed trials adhering to standard reporting guidelines and using objective measures are necessary before outlining universal guidelines for best practice. Long-term in vivo and clinical assessment is necessary to corroborate laboratory findings with clinical outcomes. Denture base resins are in constant contact with oral tissues, and cytotoxic components released by the resins may irritate or inflame the tissues or provoke an allergic response.

- The influence of multi-hole orifice flow meter geometry parameters on the parameters of Newtonian fluid through multi-hole orifice meters was investigated using computational fluid dynamics as well as the effect of contamination in front of the MHO flow meter. The air flow was steady, three-dimensional, and turbulent. Analysed Newtonian fluid was air and physical properties that were considered were density and dynamic viscosity. The numerical method was finite volume method, and standard k-ε turbulence model was used for turbulence modelling. Multi-hole orifice meter with thre e different β parameters 0.5 5, 0.6 and 0.7, was observed and Reynold’s number was 10 5 . The pressure drop and discharge coefficient were analysed. Numerical simulations were performed using commercial software the STAR-CCM+ 2019.2. It was found that increase in 𝛽𝛽 parameter results with the decrease in pressure drop and increase in discharge coefficient. Also, it was found that that the influence of 𝛽𝛽 parameter is much higher when analyzing pressure drop rather than discharge coefficient values. Numerical simulations were also performed to investigate the effect of contaminations in front of the MHO plate with 𝛽𝛽 = 0.5, on the discharge coefficients. It was found that as the contamination angle is increased the discharge coefficient tends to increase.

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