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M. Matusko, I. Ryger, G. Goavec-Mérou, J. Millo, C. Lacroûte, É. Carry, J. Friedt, M. Delehaye

This article reports on the use of a Field Programmable Gate Array (FPGA) platform for local ultra-stable optical frequency distribution through a 90 m-long fiber network. This platform is used to implement a fully digital treatment of the Doppler-cancellation scheme required by fiber links to be able to distribute ultra-stable frequencies. We present a novel protocol that uses aliased images of a digital synthesizer output to directly generate signals above the Nyquist frequency. This approach significantly simplifies the setup, making it easy to duplicate within a local fiber network. We demonstrate performances enabling the distribution of an optical signal with an instability below 10-17 at 1 s at the receiver end. We also use the board to implement an original characterization method. It leads to an efficient characterization of the disturbance rejection of the system that can be realized without accessing the remote output of the fiber link.

C. Franck, Chi-Ching Hsu, Yungong Xiao, P. Bleuler, Gaëtan Frusque, M. Muratovic, T. Polonelli

One of the cornerstones of a reliable transmission and distribution (T&D) grid operation is fully functional components that can operate robustly and with a low outage rate under all specified operating conditions. Dependable maintenance strategies are thus indispensable and are applied by grid operators around the world. One of the present key challenges in many countries with a widely developed T&D grid system is aging components that reach their anticipated end of life. Asset management faces the question of whether the lifetime of components could be prolonged and the replacement could be delayed. For this, the health of the components needs to be assessed and is ideally continuously monitored. In addition to this, the currently ongoing transition of the entire energy system leads to a change and increase of stress on the T&D equipment. The integration of new renewable energy sources on all voltage levels leads to bidirectional power flows and increased variability. The higher demand for electric power not only increases power-flow levels on average, but also in particular, peak flows. The result of this changed and increased stress on the equipment is an accelerated aging component and the need for maintenance strategies to be adopted for this new situation.

Abstract Objectiv: Anatomic characterization of the nutrient artery of upper extremity long bones differs among the several textbooks on human anatomy. To elucidate the anatomical features of the nutrient foramen (NF) through which the nutrient arteries pass, we examined the morphology and topography of the NF on the diaphysis of the long bones of the upper extremities. Methods: A total of 150 (50 humeri, 50 radii, 50 ulnae) macerated and degreased adults, long bones of the upper extremities, unknown age, and gender were used as material in this study. The following parameters were determined for each bone: total number of NF, foramina index (FI), total bone length, position of the NF based on the FI value and the surface of the shaft/body of the bones, and obliquity of the nutritional canal (NC). Results: The largest number of NF was found on the middle third of the anteromedial side of the humerus diaphysis, with NC directed distally, that is, towards the elbow. Radius and ulna had predominantly one NF, on middle third of anterior surface, with NC directed proximally. Conclusion: This study provides additional and important information on the location and number of NF in the long bones of the upper and lower extremities in the Bosnian and Herzegovinian population.

Sulejman Skoko, Cosimo Micheletti, E. Grifoni, Franco Egidi, Tommaso Giovannini, A. Pucci, Chiara Cappelli

A. Mujanović, Omer F. Eker, G. Marnat, D. Strbian, P. Ijäs, C. Préterre, A. Triquenot, J. Albucher et al.

Introduction One potential benefit of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT) is pre‐interventional reperfusion. Currently, there is a paucity of data regarding the occurrence of pre‐interventional reperfusion in patients randomized to IVT or no‐IVT before MT. Methods SWIFT DIRECT was a randomized controlled trial including acute ischemic stroke IVT‐eligible patients being directly admitted to a comprehensive stroke center, with allocation to either MT alone or IVT + MT. Primary endpoint of this analysis was the occurrence of pre‐interventional reperfusion defined as pre‐interventional expanded Thrombolysis in Cerebral Infarction score ≥ 2a. The effect of IVT and potential treatment effect heterogeneity were analyzed using logistic regression analyses. Results Out of the 396 patients analyzed, pre‐interventional reperfusion occurred in 20 (10.0%) of patients randomized to IVT+MT, and 7 (3.6%) of patients randomized to MT alone. Receiving IVT favored the occurrence of pre‐interventional reperfusion (aOR 2.91 [95% CI 1.23 – 6.87]). There was no IVT treatment effect heterogeneity on the occurrence of pre‐interventional reperfusion with different strata of Randomization‐to‐Groin‐Puncture (p for interaction = 0.33), although the effect tended to be stronger in patients with Randomization‐to‐Groin‐Puncture >28 minutes (aOR 4.65 [95% CI 1.16 – 18.68]). There were no significant difference in rates of functional outcomes between patients with and without pre‐interventional reperfusion. Conclusions Even for patients with proximal large vessel occlusions and direct access to MT, IVT leads towards an absolute increase of 6.9% (95% CI 1.7‐12.2%) in the rates of pre‐interventional reperfusion. The effect of IVT tended to be more pronounced when Randomization‐to‐Groin‐Puncture intervals were longer, but this heterogeneity did not reach statistical significance.

Smiljka Cicmil, Ana Cicmil, Verica Pavlić, Jelena Krunić, Dragana Sladoje Puhalo, D. Bokonjić, M. Čolić

Although a strong relationship between periodontal disease (PD) and atherosclerosis was shown in adults, little data are published in younger PD patients. Therefore, this study aimed to investigate and correlate clinical parameters of PD, pro- and immunoregulatory cytokines in gingival crevicular fluid (GCF) and serum, biochemical and hematological parameters associated with atherosclerosis risk, and carotid intima-media thickness (IMT) in our younger study participants (n = 78) (mean age 35.92 ± 3.36 years) who were divided into two equal groups: subjects with and without PD. PD patients had higher values of IMT, hs-CRP, triglycerides, total cholesterol, and LDL; most proinflammatory and Th1/Th17-associated cytokines in GCF; and IL-8, IL-12, IL-18, and IL-17A in serum compared to subjects without PD. These cytokines in GCF positively correlated with most clinical periodontal parameters. Clinical periodontal parameters, TNF-α and IL-8 in GCF and IL-17A, hs-CRP, and LDL in serum, had more significant predictive roles in developing subclinical atherosclerosis (IMT ≥ 0.75 mm) in comparison with other cytokines, fibrinogen, and other lipid status parameters. Hs-CRP correlated better with the proinflammatory cytokines than the parameters of lipid status. Except for serum IL-17A, there was no significant association of clinical and immunological PD parameters with lipid status. Overall, these results suggest that dyslipidemia and PD status seem to be independent risk factors for subclinical atherosclerosis in our younger PD population.

Background: In recent years, there has been a significant increase in the prevalence of insulin resistance (IR) which has become a global health problem. Obesity is the typical clinical presentation of IR. The connection between underweight and IR is less known. Objective: The study aimed to investigate the characteristics of eating habits in underweight and obese patients with IR. After the obtained results, propose suitable dietary instructions specific to 2 subject groups. The task was to determine the difference in the nutritional status of underweight and obese patients with proven IR. The questionnaire was designed to collect data on diet and eating habits. Methods: The research included 60 subjects of both sexes between the ages of 20 and 60. Inclusion criteria for entering the study were: proven obesity (BMI ≥ 30), underweight (BMI≤18,5) and confirmed IR by assessment of the homeostatic model for insulin resistance (HOMA IR-2). BMI, waist-to-hip ratio (WHR), and visceral fat area (VFA) were calculated using the bioelectrical impedance. Data on dietary habits was collected using a questionnaire that included general patient data, physical activity, lifestyle and eating habits. Descriptive statistical methods were used to process and analyse the obtained data. Results: The average BMI in obese subjects was 34.32 kg/m2, and in underweight subjects, 17.26 kg/m2. There are statistically significant differences between BMI, WHR and VFA. The mean value of HOMA-IR in the obese patients was 2.87 and in the underweight, 2.45. Underweight subjects have a statistically significant (p<0.05) tendency to lose weight, consume milk and milk products, prefer lean meat, and drink more alcohol. Obese subjects are significantly (p<0.05) less physically active, more prone to insomnia, tend to gain weight, enjoy food, consume fewer fruits and vegetables and more carbohydrate food, do not follow clinical nutritional guidelines, and mostly eat in a social setting. Both groups rarely practiced mindful eating. Consumption of highly processed food and sweets is common in both groups. Conclusion: There are statistically significant differences in the dietary and lifestyle habits of underweight and obese patients diagnosed with IR. It is necessary to educate healthcare workers and the general population about the importance of nutrition for preventing IR, regardless of body weight.

B. Prnjavorac, S. Kunić, Natasa Pejanovic-Skobic, N. Gorana, Dragana Zirojevic, Samra Kadić Vukas, M. Čampara, A. Skopljak

Background: Pregabalin is a first-line therapy of pain with additional positive effects on the states of depression and anxiety that often occur in patients with chronic pain, thus improving their quality of life. Objective: The aim of this study was to demonstrate the efficacy of pregabalin in reducing neuropathic pain and improving quality of life in patients with peripheral and central chronic neuropathic pain in Bosnia and Herzegovina. Also, the aim was to monitor the safety of therapy with pregabalin. Methods: The study included patients with neuropathic pain lasting more than 3 months. Based on the underlying disease, patients were divided into 5 groups: DM–patients with diabetes mellitus, M–patients after stroke, D–patients with lower back pain, MS–patients with multiple sclerosis, and P group–patients with spinal cord injury. During the baseline visit, the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) was used to assess neuropathic pain. During two follow-up visits (1.5 and 3 months after baseline), the 36-Item Short-Form Health Survey (SF 36) was used to assess the effectiveness of therapy on quality of life. The safety of the treatment was evaluated by monitoring the incidence of adverse drug reactions. Results: The study included 125 patients. During treatment with pregabalin, there was a statistically significant reduction in pain intensity in the DM, M, D and MS groups. In group P, the decrease in pain intensity was not statistically significant (p = 0.070). There was a significant improvement in different parameters of the quality of life in all analyzed groups, with the most prominent effects in the DM group. The effectiveness of treatment was rated as “good” and “very good” in more than 70% of subjects in each group. The expected side effects of treatment were recorded in 27.1% of patients in the DM group, in 20.0% in the M group and in 22.2% in the MS group. Unexpected side effects of treatment were observed in one patient (2.1%) in the DM group. Assessment of tolerability of the applied treatment showed “good” and “very good” response in 68.7% of patients in DM group, 73.3% in M group, 74.5% in D group, 88.9% in MS group and 85.8% in P group. Conclusion: Pregabalin is a safe and effective drug in treatment of neuropathic pain of different etiology.

J. Schermer, M. Branković, Đorđe Čekrlija, K. MacDonald, Joonha Park, Eva Papazova, Tatiana Volkodav, D. Iliško et al.

Senada Husarić, A. Salihovic, N. Kadrić, Samra Iljazovic-Topic, Jasmina Pašić, A. Divanović

Background: Medical nutritional therapy (MNT) is a key component in the treatment of Diabetes mellitus (DM). MNT is completely individual and should be present in the treatment of diabetes from the very beginning, continuously with pharmacological therapy, taking into account lifestyle, dietary habits and the type of antidiabetic therapy. Mistakes that are made when planning the diet are the absence of individual adjustment of the diet, which means that the number and time of meals, as well as the amount of UH per meal, is not adjusted to the patients' oral or insulin therapy according to their pharmacokinetics and pharmacodynamics. Objective: This study investigated the effect of MNT with reduced carbohydrate content (MNT M-ADA) on the efficacy of human and analogue premix insulin in patients with T2DM. Methods: Subjects were randomized into two groups (human and analog premix insulins), and then each group into two subgroups of 30 subjects each. One subgroup each on therapy with human and analog biphasic insulins was educated about MNT and learned to count UH, and then they applied MNT M-ADA for 24 weeks, unlike the other two subgroups. In this review, we present only the subgroup analysis on human and analog premix insulins that applied MNT M-ADA (200 g UH/day). Efficacy outcomes in the analysis of these subgroups were estimated changes in each subgroup from baseline to end point (week 24) and differences between subgroups at the end of the study in levels of glycated hemoglobin (HbA1c), self-measured glucose values (SMBG) and frequency of hypoglycemia. Results: Both subgroups of subjects with MNT M-ADA improved glycemic control, which was assessed by improvements in HBA1C, SMBG levels, without an increase in the frequency of hypoglycemia, but at the end of the study there was no statistically significant difference in the mentioned parameters between the subgroups. Conclusion: The effectiveness of MNT M-ADA in people with T2DM did not depend on the type of insulin, both insulin regimens are effective if the amount of ingested UH is taken into account.

B. Kujundžić, Z. Andjelković, R. Marić, R. Lukić, V. Marić, Helena Marić, Miroslav Obrenović, S. Kojić

Abstract Periodontal disease is inflammatory pathological conditions in the gingiva and dental support structures that usually results in extracellular matrix and connective tissue destruction. During periodontitis, inflammatory cells facilitate collagen and connective tissue loss, affects the number and activity of fibroblasts and its production of local collagen networks. Aim of this study was to evaluate collagen density and accumulation of collagen producing fibroblast and macrophages in affected tissue of periodontal disease. Histological and immunohistochemical analyzes were performed on paraffin embedded tissue sections of gingival biopsies, obtained from 30 patients with diagnosis of periodontal disease and 10 healthy donors. Tissue sections of gingival of patients with periodontal disease had significantly decreased collagen volume density and visible fragmentation and lysis of the collagen fibers, decreased number of fibroblasts, accompanied with increased accumulation of macrophages. Presented data implicate that macrophages accumulation may be the cause of enzyme mediated collagen destruction

N. Žigić, E. Becirovic, M. Mirković-Hajdukov, N. Aljukić, H. Löffler‐Stastka

Introduction Developmental predisposition to schizophrenia can be a consequence of early experienced traumas. Transgenerational trauma is process in which traumatic experience of one generation is passed on to the next generation. Objectives To show connection between transgenerational transmission of trauma and development of schizophrenia. Methods Psychiatric interview, psychological testing. Results Patient G.E. age 29, admitted to Psychiatry Clinic due to altered behavior, aggressiveness and presence of delusions and hallucinations. First mental problems in form of a catatonic stupor appeared 6 years ago. Patient has history of earlier abuse of psychoactive substances. A drug test performed at admission was negative. Patient was born in Srebrenica in 1993, he escaped to Tuzla with his mother in July 1995, while father survived escaping on foot. Patient is a first child from his father’s second marriage. The father’s first wife and two minor children were shot by Bosnian Serbs in early 1992. Patient was born a year and a half after death of his siblings and was named after his half-sister. Patient’s father consumed alcohol after the war and was aggressive towards children. In the last two years, patient had frequent hallucinations, he told his parents that voices were telling him to kill his mother and told his father that his children were still alive. Diagnostic processing was performed and diagnosis of schizophrenia was stated. During hospitalization, patient was treated with olanzapine and low doses of haloperidol, along with haloperidol decanoate, which resulted in significant reduction of productive psychotic symptoms. A partial remission is achieved, negative schizophrenic symptoms and cognitive impairments verified by psychological instruments remain. Conclusions Case report emphasize transgenerational transmission of trauma: father‘s untreated trauma, alcohol dependency and abuse of the patient in childhood. These findings are important for treatment and therapeutic considerations. Mentalizing is a possible mediator between childhood abuse and negative symptoms. Parental bonding was explored within high expressed emotions theory as a risk factor for relapse to psychosis, especially the “affectionless control” in the parental (mainly father‘s) bonding style. Studies also stated that psychotic patients often show insecure attachment representations. Possible pathway for further analysis could be discussed: a cold parental bonding style leading to experienced emotional neglect and attachment avoidance might be reflected in lower capacity to mentalize. To improve the mentalization capacity, it would be essential to establish a sustainable therapeutic treatment frame. Disclosure of Interest None Declared

S. Isaković, E. Karahmet, S. Hamidović, J. Tahmaz, Ajla Smajlović

The main goal of this study was to determine the impact of the type of packaging to health safety sausage, and therefore the microbiological compliance with the requirements of the Regulation on microbiological criteria for foodstuffs. The study included the determination of the presence of bacteria of the genus: Salmonella, E.coli, Enterobacteria, Campylobacter, Listeria monocytogenes, and sulfitereducing Clostridiae as well as the total number of bacteria within each individual product. According to estimate the effect of the type of packaging (vacuum, MAP and bulk) to the safety of sausages was performed collecting samples of sausages packed in a vacuum packaging, modified atmosphere packaging of bulk and different manufacturers for each type of packaging. As a result of the study, out of 10 analyzed samples, bacteria from the Enterobacteriaceae family in the range of values from 1.8 to 2.55 CFU/mL., E. coli, in the range of 0, were found by isolation on selective mediafrom 0.51-1.23 CFU/mL. Total bacteria ranged from 2.6-4.02 CFU/mL. Yeasts and molds in the samples tested were between 2.22 – 3.84 CFU/mL. Microbiological tests did not reveal any bacteria from the following groups: Salmonella spp., Listeria and sulphite-reducing Clostridia. It was found that all samples correspond to the Regulation on microbiological safety.

Background: Sarcoidosis is a multisystem granulomatous disease of unknown etiology, characterized by presence of granulomas in affected tissues with variety in clinical presentations and presents a differential diagnostic and therapeutic dilemma. Clinical presentation of neurosarcoidosis is very variable. Diagnosis is based on clinical and radiological criteria and histological findings of disseminated non-necrotic granuloma followed by negative cultures for bacteria and fungi. MRI plays a key role in detection of lesions located in the brain parenchyma. Objective: The aim of this article was to present case of a 36-year-old male patient, who came to doctor with symptoms of fever, dry cough with whitish sputum, lymphadenopathy of neck region and neurological disturbances in form of headaches and vision problems. Case presentation: Patient underwent on pulmonary examination and results indicated presence of sarcoidosis. CT examination was performed (SIEMENS Somatom Definition AS, Erlangen, Germany), which confirmed presence of mediastinal and hilar lymphadenopathy. Ultrasound (US) examination of a neck region was also performed showed significantly enlarged and morphology altered lymph nodes. After biopsy of several neck lymph nodes, histopathological was proven diagnosis of sarcoidosis. Due to neurological disturbances in form of headaches and vision problems patient was examined by an ophthalmologist, neurologist and endocrinologist. Hormonal analysis showed an increase of prolactin and that raised suspicion for neurosarcoidosis. In further diagnostic evaluation it was indicated MRI examination of the brain with focus on sellar region. Conclusion: Contrast-enhanced MRI is the modality of choice for investigating suspected neurosarcoidosis. The versatility of MR recording and the amount of diagnostic informations obtained from MRI examination is huge. Comparison of MRI sequences obtained, facilitate interpretation of these findings. Obtained MRI information and available literature, correlating with other diagnostic modalities (ultrasound and CT) facilitate understanding of the specific pathology.

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