Advances in respiratory medicine have presented a clear need for the continuous training and accreditation of health professionals, as well as of institutions providing and delivering care to respiratory patients. EBAP holds a central overarching position across Europe and overseas as an independent accreditor of training centres and educational activities with transferable and recognised CME/CPD points across countries https://bit.ly/3uZb5WT

SARS-CoV-2 virus has attracted a lot of attention globally due to the autoimmune and inflammatory processes that were observed during the development of Covid-19 disease. Excessive activation of immune response and triggering of autoantibodies synthesis as well as an excessive synthesis of inflammatory cytokines and the onset of cytokine storm has a vital role in the disease outcome and the occurring autoimmune complications. This scenario is reminiscent of infiltration of lymphocytes and monocytes in specific organs and the increased production of autoantibodies and chemoattractants noted in other inflammatory and autoimmune diseases. The main goal of this study is to investigate the complex inflammatory processes that occur in Covid-19 disease and to find similarities with other inflammatory diseases such as multiple sclerosis (MS), acute respiratory distress syndrome (ARDS), rheumatoid arthritis (RA) and Kawasaki syndrome to advance existing diagnostic and therapeutic protocols. The therapy with Interferon-gamma (IFN-γ) and the use of S1P receptor modulators showed promising results. However, there are many unknowns about these mechanisms and possible novel therapies. Therefore, the inflammation and autoimmunity triggered by Covid-19 should be further investigated to improve existing diagnostic procedures and therapeutic protocols for Covid-19.

Background: After successful reperfusion is achieved (extended Thrombolysis in Cerebral Infarction (eTICI) ≥2b50), decision on pursuing additional treatment strategies in order to achieve complete reperfusion (eTICI=2c/3), is multifactorial and depends on patient’s clinical and imaging characteristics. We have developed and validated a clinical decision tool to provide individualized predictions on achieving delayed reperfusion based on individual patient data. Methods: Single-center registry analysis for all consecutive patients admitted between 02/2015 - 12/2020. Primary variable of interest was perfusion imaging outcome in patients with incomplete reperfusion (eTICI 2a-2c), evaluated on the 24-hour follow-up imaging. This variable was dichotomized into delayed reperfusion, in case of non-observable perfusion deficit, and persistent perfusion deficit, in case of perfusion deficit captured on the final angiography imaging. Final model variable selection was performed via bootstrapped (n=200) stepwise backwards regression. Model was split into a training and testing set (80:20 ratio), with 10-fold cross validation resampling. Results: 372 patients (50.8% female, mean age 74) were included, with 228 (61.2%) of them having delayed reperfusion. Final model identified seven variables of importance including: age, sex, atrial fibrillation, Intervention-to-Follow-Up time, maneuver count, eTICI and collateral status. Model’s discriminative ability for predicting delayed reperfusion was adequate (AUC 0.83, 95% CI 0.74 -0.92), with an overall adjusted calibration (Brier score 0.17, 95% CI 0.15-0.18). Conclusions: Current model presents a tool that may aid clinical decision-making process in selection of patients for pursuing additional treatment strategies after incomplete reperfusion has been achieved. This is an important next step towards personalized treatment of stroke patients undergoing mechanical thrombectomy.

Background: 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. Conclusion: 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.

We aimed to investigate expression of the novel susceptibility genes for CAKUT, DLG1 and KIF12, proposed by a systematic in silico approach, in developing and postnatal healthy human kidneys to provide information about their spatiotemporal expression pattern. We analyzed expression of their protein products by immunohistochemistry and immunofluorescence and quantified relative mRNA levels by RT-qPCR. Statistically significant differences in expression patterns were observed between certain developmental stages. Strong expression of DLG1 was observed in the developing kidney, with a gradual decrease from the first phase of kidney development (Ph1) until the third phase (Ph3), when most nephrons are formed; at later stages, the highest expression was observed in the tubules. KIF12 was highly expressed in the developing structures, especially in Ph1, with a gradual decrease until the postnatal phase, which would indicate a significant role in nephrogenesis. Co-localization of DLG1 and KIF12 was pronounced in Ph1, especially on the apical side of the tubular epithelial cells. Thereafter, their expression gradually became weaker and was only visible as punctate staining in Ph4. The direct association of DLG1 with KIF12 as control genes of normal kidney development may reveal their new functional aspect in renal tubular epithelial cells.

Scanning tunneling microscopy tip-induced deprotonation has been demonstrated experimentally and can be used as an additional control mechanism in electric-field induced molecular switching. The goal of the current work is to establish whether (de)protonation can be used to inhibit or enhance the electric field controlled thermal and photoisomerization processes. Dihydroxyazobenzene is used as a model system, where protonation/deprotonation of the free hydroxyl moiety changes the azo bond order, and so modifies the rate of electric field induced isomerization. Through the combined action of deprotonation and applied field, it was found that the cis-to-trans thermal isomerization barrier could be completely removed, changing the isomerization half-life from the order of several months. In addition, due to the presence of multiple isomerization mechanisms, electric fields could modify the isomerization kinetics by increasing the number of energetically viable isomerization pathways, rather than reducing the activation barrier of the lowest energy pathway. Excited state calculations indicated that the protonation state and electric field could be used together to control the presence of electronic degeneracies along the rotation pathway between S0/S1, and along all three pathways between S1/S2. This work provides insight into the mechanisms that enable the use of protonation state, light, and electric fields in concert to control molecular switches.

Nondipole effects occurring in the process of atomic ionization by an intense, mid‐infrared, counter‐rotating bicircular laser field are investigated using the strong‐field approximation with leading‐order nondipole corrections. The time integrals appearing in the expression for the differential ionization rate are computed in two ways: numerically, and by applying the saddle‐point approximation. The nondipole corrections introduce an asymmetry in the photoelectron momentum distribution along the field propagation direction. The asymmetry is quantified by the partial average value of the propagation‐direction momentum component of the photoelectrons and by the normalized difference of the differential ionization rates computed including and excluding the nondipole corrections. Using the saddle‐point approximation, it is investigated how the nondipole corrections change the solutions for direct photoelectrons and how this affects the momentum spectra. The impact of nondipole corrections increases with increasing photoelectron energy. Analysis of the complete photoelectron spectra including both direct and rescattered photoelectrons shows that, in the low‐energy region, a shift against the propagation direction occurs. The partial average of the propagation–direction momentum component in the rescattering region exhibits a plateau structure and also a local minimum structure that was recently observed in an experiment with a linearly polarized laser field (Lin et al., Phys Rev. Lett. 128, 023201 (2022)).

This study deals with the selection of a sustainable supplier on the example of the agribusiness company Mamex from Bosnia and Herzegovina. The main problem of this research is the selection of a sustainable supplier as a part of the sustainable strategy of the Mamex company. One of the prerequisites is that suppliers must present sustainability principles in business by having an appropriate certificate. The results of the selection of sustainable suppliers are completed using a new hybrid fuzzy approach with the methods IMF SWARA (Improved Fuzzy Stepwise Weight Assessment Ratio Analysis) and fuzzy TRUST (multi-normalization multi-distance assessment) CRADIS (compromise ranking of alternatives from distance to ideal solution) methods. The innovative approach is reflected in the use of a combination of these methods, especially by combining the TRUST and CRADIS methods into one method. The IMF SWARA method shows that the most important main criterion is the economic criterion, while the least important is the social criterion. By applying the fuzzy TRUST CRADIS method, it is found that out of the observed six suppliers, the second supplier has the best indicators. These results are confirmed by other fuzzy methods: MABAC (multi-attributive border approximation area comparison), WASPAS (weighted aggregated sum product assessment), fuzzy SAW (simple additive weighting), MARCOS (measurement of alternatives and ranking according to compromise solution), ARAS (a new additive ratio assessment), and TOPSIS (technique for order preference by similarity to an ideal solution). This research shows that applying more normalization when ranking alternatives reduces the influence of individual normalizations, and this approach should be used in future research.

Dry eye syndrome and allergic conjunctivitis are the most common inflammatory disorders of the eye surface. Although eye drops are the most usual prescribed dosage form, they are characterized by low ocular availability due to numerous barrier mechanisms of the eye. The use of biopolymers in liquid ophthalmic preparations has numerous advantages, such as increasing the viscosity of the tear film, exhibiting bioadhesive properties, and resisting the drainage system, leading to prolonged retention of the preparation at the site of application, and improvement of the therapeutic effect. Some mucoadhesive polymers are multifunctional excipients, so they act by different mechanisms on increasing the permeability of the cornea. Additionally, many hydrophilic biopolymers can also represent the active substances in artificial tear preparations, due to their lubrication and moisturizing effect. With the modification of conventional ophthalmic preparations, there is a need for development of new methods for their characterization. Numerous methods for the assessment of mucoadhesiveness have been suggested by the literature. This review gives an overview related to the development of mucoadhesive liquid ophthalmic formulations for the treatment of dry eye and allergic conditions.

Finance is integral to civilizational prosperity yet has impacted the global development of recent centuries, proved inherently inconsistent, and created multiple issues, i.e., inequalities. In this regard, Islamic finance (IF) offers solutions. Moreover, contemporary appraisals of the Integration of Knowledge (IoK) methodology represent a novel alternative to extant challenges and issues. The paper’s objectives are, therefore, to propose an IoK model of Islamic and conventional financial (CF) convergence with leverage to fintech and demonstrate the potential of the waqf sector for such convergence and its equivalent revival and reform along such methodological contours. This paper is a methodological contribution. However, library research, critical content analysis, and heterodox methods of concretization, synthesis, and transdisciplinary analytical reasoning substantiate the paper’s methodology. Islamic sources of knowledge, i.e., Qur’an, justify this study’s unorthodox methodology. A background depicts the CF problems and persistent issues that justify alternatives. It is followed by rationalizing IE development via IoK to converge IF and CF. The IoK model developed for IE development follows and is schematically demonstrated as novel findings of this paper to bridge the gap between IF and CF and leverage waqfs’ role and potential. Greater reference to waqf projects institutionalized implications for IF and integration with CF. Further, leveraging waqf and even fintech as an indicator of digitalization within the IoK model has implications for attaining the defined maqāṣid and developing IE genuinely. A conclusion summarizes and provides actionable recommendations linked with the IoK model’s objectives to reform extant IF and conventional practice based on sound Islamic philosophical foundations and maqāṣid-oriented envisioning of IE development.

This paper aims to propose a statistical model to assess pubertal growth spurt using the ratio of the anterior height projection to the posterior (Vba) of the fourth cervical vertebra body (C4) on cephalograms and to calculate the residual proportion of skeletal maturation and the time for the pubertal growth spurt to end for a given Vba. A sample of 538 cephalograms from healthy-living children aged between 5 and 15 years was analyzed. A segmented regression model was used to explain the different Vba stages relative to the pubertal growth spurt. In addition, the time to achieve skeletal maturation was evaluated for a given Vba between the beginning (Vba1) and the end (Vba2) of the pubertal growth spurt. A longitudinal sample of 25 males and 25 females was analyzed to validate the proposed method. The values of Vba corresponding to higher pubertal development rate ranged from Vba1 = 0.677 (95%CI, 0.644–0.711) to Vba2 = 0.966 (95%CI, 0.905–1.028) and from Vba1 = 0.669 (95%CI, 0.645–0.693) to Vba2 = 1.073 (95%CI, 1.044–1.101) in males and females, respectively. The validation process results showed that our model did not produce any incorrect forecasts. The proposed method estimates the beginning and the end of the pubertal growth spurt together with the residual proportion of skeletal maturation for a given Vba.