Background: Left atrial (LA) myopathy with paroxysmal and permanent atrial fibrillation (AF) is frequent in chronic coronary syndromes (CCS) but sometimes occult at rest and elicited by stress. Aim: This study sought to assess LA volume and function at rest and during stress across the spectrum of AF. Methods: In a prospective, multicenter, observational study design, we enrolled 3042 patients [age = 64 ± 12; 63.8% male] with known or suspected CCS: 2749 were in sinus rhythm (SR, Group 1); 191 in SR with a history of paroxysmal AF (Group 2); and 102 were in permanent AF (Group 3). All patients underwent stress echocardiography (SE). We measured left atrial volume index (LAVI) in all patients and LA Strain reservoir phase (LASr) in a subset of 486 patients. Results: LAVI increased from Group 1 to 3, both at rest (Group 1 = 27.6 ± 12.2, Group 2 = 31.6 ± 12.9, Group 3 = 43.3 ± 19.7 mL/m2, p < 0.001) and at peak stress (Group 1 = 26.2 ± 12.0, Group 2 = 31.2 ± 12.2, Group 3 = 43.9 ± 19.4 mL/m2, p < 0.001). LASr progressively decreased from Group 1 to 3, both at rest (Group 1 = 26.0 ± 8.5%, Group 2 = 23.2 ± 11.2%, Group 3 = 8.5 ± 6.5%, p < 0.001) and at peak stress (Group 1 = 26.9 ± 10.1, Group 2 = 23.8 ± 11.0 Group 3 = 10.7 ± 8.1%, p < 0.001). Stress B-lines (≥2) were more frequent in AF (Group 1 = 29.7% vs. Group 2 = 35.5% vs. Group 3 = 57.4%, p < 0.001). Inducible ischemia was less frequent in SR (Group 1 = 16.1% vs. Group 2 = 24.7% vs. Group 3 = 24.5%, p = 0.001). Conclusions: In CCS, rest and stress LA dilation and reservoir dysfunction are often present in paroxysmal and, more so, in permanent AF and are associated with more frequent inducible ischemia and pulmonary congestion during stress.

Cilj: Prikazati najčešće razloge odbijanja potencijalnih darivatelja krvi po spolu i usporediti ih između gradova Osijeka i Zagreba. Ispitanici i metode: Istraživanje je provedeno po principu retrospektivne studije tijekom 2021. godine iz baze podataka Hrvatskog zavoda za transfuzijsku medicinu u Zagrebu i Kliničkom zavodu za transfuzijsku medicinu u Osijeku. Korišten je χ2-test, dok je statistička analiza napravljena pomoću programskog sustava MedCalc (inačica 14.12.0, MedCalcSoftware) uz razinu značajnosti od P < 0,05. Rezultati: Hrvatski zavod za transfuzijsku medicinu u Zagrebu kao najčešći razlog odbijanja potencijalnih darivatelja krvi navodi sniženu koncentraciju hemoglobina zbog koje je odbijeno 7 119, od kojih 2 583 (36 %) muškarca i 4 536 (64 %) žena. Također, Klinički zavod za transfuzijsku medicinu u Osijeku odbio je najviše potencijalnih darivatelja krvi zbog snižene koncentracije hemoglobina, njih 660, od kojih 235 (36 %) muškaraca i 425 (64 %) žena. Nakon obrade podataka nema statistički značajne razlike u odbijanju potencijalnih darivatelja krvi zbog hemoglobina u Zagrebu i Osijeku uspoređujući ih po spolu (P = 0,729). Zbog krvnog tlaka odbijenih potencijalnih darivatelja krvi u Zagrebu bilo je 3 855, 2 375 (62 %) muškaraca i 1 480 (38 %) žena. Odbijenih potencijalnih darivatelja krvi zbog krvnog tlaka u Osijeku je bilo 369, 141 (38 %) muškarac i 228 (62 %) žena. Statistički značajna razlika u odbijanju potencijalnih darivatelja krvi zbog krvnog tlaka u gradovima po spolu postoji (P < 0,001). Zaključak: Najčešći razlozi odbijanja dobrovoljnih darivatelja krvi tijekom 2021. godini u Hrvatskom zavodu za transfuzijsku medicinu u Zagrebu i Kliničkom zavodu za transfuzijsku medicinu u Osijeku jesu snižena koncentracija hemoglobina te krvni tlak kod obaju spolova.

In the H2020 European project ASHVIN “Assistants for Healthy, Safe, and Productive Virtual Construction Design, Operation & Maintenance using a Digital Twin”, a set of Key Performance Indicators (KPIs) and Performance Indicators (PIs) to plan and control productive, resource efficient, and safe maintenance are being developed for transport infrastructure. This paper is presenting PIs and KPIs for the assessment and monitoring of the following aspects: Productivity, Resource Efficiency, Cost, Health & Safety during the operational life cycle stage, which is mainly focusing on the inspection and maintenance planning. Quantifiable and measurable PIs and KPIs are proposed and applied on two demonstration projects, highway bridge in Spain and airport runway in Croatia, as part of transportation infrastructure. Proposed PIs and KPIs are integrated into digital twins of the analyzed assets and into decision making tools for risk based maintenance planning. This paper presents the overview of the proposed digital PIs and KPIs applied on two demonstration projects and the integration into decision support tools for efficient and sustainable maintenance planning.

At the beginning of 2020, few people could imagine that the new coronavirus, COVID-19, would impact that many aspects of our lives and change the content, structure, and teaching methods we knew before. Many language teachers (LT) worldwide who had been effectively implementing face-to-face instruction had to make an abrupt transition to online education, something they were not trained for or had experience with. The present study aims to discover whether LT successfully delivered online instruction and whether online teaching during the first online period impacted students’ learning habits. Using a specifically designed questionnaire, students who study at several public universities from Bosnia and Herzegovina (B&H), the Republic of North Macedonia (RNM), and Türkiye (TUR) were asked to evaluate their teachers’ professional adaptation and success during the first “emergency online teaching semester”, and to reflect on their learning habits during this period and the changes they personally experienced. The results of the study revealed that students in the three countries approached and evaluated their teachers’ pedagogical skills as appropriate for online teaching in the first COVID-19 period in remarkably similar ways. However, the impact on students’ learning habits is, to a certain extent, different in these countries. The findings of the study might provide relevant input to rethink the teaching profession in terms of competencies, means of instruction, and strategies for coping with processes that affect teaching. Education will not be the same in a post-pandemic world, we must use the knowledge we have gained, and the suggestions made by our students to enhance our educational systems.

BACKGROUND Global rise in antibiotics utilization has been strongly associated with the resistance of bacteria to antibiotics. The COVID-19 saw an increase in the use of antibiotics in some countries. The aim of this study was to evaluate antibiotics utilization from 2006 to 2021 in the Republic of Serbia. METHODS Data on antibiotic use were retrieved from the national annual reports on the official website of the Medicines and Medical Devices Agency of Serbia (ALIMS) during the period 2006-2021. To evaluate trends in the use of antibiotics in Serbia, linear and joint regression analyzes were performed. RESULTS The analysis of the antibiotics use over a sixteen-year period included a total of 50 antibiotics. A significant increase during the COVID-19 pandemic was observed for glycylcyclines i.e. new generation tetracyclines (tigecycline), third generation cephalosporins (ceftazidime, ceftriaxone, and cefixime), respiratory fluoroquinolones (levofloxacin and moxifloxacin), carbapenems (ertapenem) and oxazolidinones (linezolid) utilization. Moreover, an almost negligible use of new β-lactam/β-lactamase inhibitors during the pre-pandemic period increased significantly during the COVID-19 pandemic period. CONCLUSION A significant increasing trend in the use of specific antibiotics classified as the "Watch" and "Reserve" antibiotics during the pandemic period was observed.

Objective: The main objective of this research is to determine the prevalence and characteristics of neurological manifestations in hospitalized patients with SARS-CoV-2 infection. Methods: A cross-sectional study was conducted. 572 hospitalized patients at the COVID Department of Pulmonology of the Mostar University Clinical Hospital in the six-month period from October 31, 2020, to April 30, 2021, were included. We analyzed the incidence of neurological manifestations and the influence of comorbidities and metabolic syndrome on stroke incidence in COVID-19 patients. We analyzed hospital length of stay and mortality in patients with and without neurological manifestations. The research was conducted with respect to all the determinants of the Helsinki Declaration. Results: 572 patients, 351 men (61.4%), and 221 women (38.6%) were included. A fatal outcome was present in a quarter of patients (25.3%). Neurological manifestations were found in 163 patients (28.5%). Myalgia was the most common (16.1%). The following were reported: headache (9.6%), loss of taste (7.34%), loss of smell (6.8%), and vertigo (2.5%). There was a significant difference regarding loss of smell between males and females (p=0.04). The cerebrovascular incident was present in 2.97% of patients and was more frequent in the group of patients with metabolic syndrome. Patients with neurological manifestations had a longer hospital stay, but it was not statistically significant (p=0.9319). The presence of neurological manifestations in general did not influence the mortality rate. Conclusion: Patients with SARS-CoV-2 infection can present with neurologic findings such as myalgia, headache, loss of smell or taste, vertigo, as well as cerebrovascular incidents. Patients with neurological manifestations had longer hospital stays, but the presence of neurological manifestations in general did not influence the mortality rate.

Abstract The aim of this study was to examine the seroprevalence of Leptospira spp. in dogs and red foxes in the entity of the Republic of Srpska, Bosnia and Herzegovina, after heavy rainfall and floods in 2014 and for the two years thereafter. The seroepidemiological study involved testing serum samples from dogs (n = 98) and foxes (n = 112) using MAT (microscopic agglutination test). Antibodies to at least one Leptospira spp. serovar were found in 52.04% of the tested dogs. The dog seroprevalence in 2014 (81.25%) was significantly higher than in 2015 (51.42% p <0.0001) and 2016 (22.5% p<0.05). The highest seroprevalences were for serovars Australis (76.47%), Bratislava (70.58%), Sejroe (66.67%) and Autumnalis (45.09%). Antibodies to at least one Leptospira spp. serovar were detected in 34.82% of the examined red foxes. In 2015, the fox seroprevalence was significantly higher (52.94%) than in 2016 (6.82%) (p <0.0001). The highest seroprevalences were for serovars Sejroe (64.10%), Bratislava (48.72%), Australis (43.59%) and Bataviae (25.64%). The high seroprevalence of Leptospira spp. in dogs and foxes determined during this study indicates the importance of these carnivores in maintaining leptospirosis in the study area, and the potential risk of infection for humans and other animal species that come into contact with these canids. The results obtained indicate that heavy rainfall and intense floods can result in increased Leptospira spp. infection in these canids.

ABSTRACT Background The aim of this study was to provide an overview of age, sex and primary renal disease (PRD) distribution among first kidney transplant recipients across Europe. Method The European Renal Association (ERA) Registry database was used to obtain data on patients aged 20 years or older receiving their first kidney transplant between 2010 and 2019 from 12 European countries. The numbers and percentages of recipients in each age, sex and PRD group were calculated by country, donor type and year. Results In total, 99 543 adults received a first kidney transplant. Overall, 23% of the recipients were 65 years or older, 36% were female, and 21% had glomerulonephritis and 15% diabetes mellitus as PRD. Compared with deceased donor kidney transplant recipients, living donor kidney transplant recipients were less often 65 years or older (13% versus 26%), more often had glomerulonephritis (25% versus 20%) and less often diabetes mellitus (8% versus 17%) as PRD. We found large international differences, which were most prominent for age and PRD and less prominent for sex. Over time, the largest change in recipient characteristics was observed for the percentage of recipients aged 65 years or older, increasing from 18% in 2010 to 28% in 2019 for all countries combined with a similar trend in most countries. Conclusion We observed large differences for age and PRD distribution between recipients of living and deceased donor kidneys and between European countries. Over time, the percentage of older first kidney transplant recipients increased.

ABSTRACT

Not available.

INTRODUCTION Recent information on tortuosity in the prevertebral (V1) segment of the vertebral artery is based on case reports rather than systematic data on its presence, types, diameters, and sex- or left-right differences.

The well-being of students and staff directly affects their output and efficiency. This study presents the results of two focus groups conducted in 2022 within a two-phase project led by the Applied Biomedical and Signal Processing Intelligent e-Health Lab, School of Engineering at the University of Warwick, and British Telecom within “The Connected Campus: University of Warwick case study” program. The first phase, by involving staff and students at the University of Warwick, aimed at collecting preliminary information for the subsequent second phase, about the feasibility of the use of Artificial Intelligence and Internet of Things for well-being support on Campus. The main findings of this first phase are interesting technological suggestions from real users. The users helped in the design of the scenarios and in the selection of the key enabling technologies which they considered as the most relevant, useful and acceptable to support and improve well-being on Campus. These results will inform future services to design and implement technologies for monitoring and supporting well-being, such as hybrid, minimal and even intrusive (implantable) solutions. The user-driven co-design of such services, leveraging the use of wearable devices and Artificial Intelligence deployment will increase their acceptability by the users.

Introduction: Prediabetes is a state of impaired glucose homeostasis manifested either by an increase in fasting glucose or a decrease in glucose tolerance. Prediabetes carries a high risk of developing diabetes and cardiovascular complications. Aim: to determine the prevalence of prediabetes in pre-obese and obese individuals and the ten-year risk of developing T2DM in these subjects. Methods: The study was conducted in the family medicine clinics of the Educational Center for Family Medicine (ECFM) of the Banja Luka Health Center and the Tesliü Health Center. The study included pre-obese and obese patients older than 18 years of age, with a body mass index greater than 27.0 kg/m2. The research instrument was a questionnaire with sociodemographic data, a questionnaire for assessing the risk of developing diabetes mellitus type 2 (FINDRISC), and patient anthropometric measurements, arterial blood pressure measurements and laboratory findings (fasting glucose, lipid status, HbA1c) were performed. Results: The research included 264 patients. The prevalence of prediabetes in obese patients is 28.03%, while in pre-obese it is 21.21%. Subjects with a larger waist circumference are more likely to have prediabetes. With increasing age, the chance of getting prediabetes increases, over 30% of obese and pre-obese people who are over 70 years old have prediabetes. In relation to gender, women have a higher chance of developing prediabetes. Data from the FINDRISC questionnaire showed that 1.52% of patients from the pre-obese category have a 50% chance of developing diabetes within ten years, while 13.6% of obese patients have a 50% chance of developing T2DM within ten years. Conclusion: The role of family medicine doctors is in early identification of patients with prediabetes and diabetes, reduction of risk factors and possibly pharmacological treatment of these patients.

Alcohol drinks, especially wine, have been described since 6,000 B.C. For many years in modern medicine, wine in moderation has been considered healthy for cardiovascular prevention, i.e., recommended by nutrition committees. Some regional guidelines still recommend one to two standard drinks per day. By the very recent (January 2023), World Health Organization and Canadian Guidance on alcohol emphasize that any alcoholic drink is hazardous to the health and the safe amount is zero. The risk starts with every single drop. It was also nicely summarized in the manuscript “Alcohol-dose question and the weakest link in a chemical interplay” (Explor Cardiol. 2023;1:15–25. doi: 10.37349/ec.2023.00003) especially from the standpoint of a researcher in the cardiovascular arena. The newest recommendations are based on observational studies and their meta-analysis, therefore establishing associations, pointing out that alcohol may somewhat prevent cardiovascular diseases and diabetes type 2, but with a significant increase in non-cardiovascular morbidity and mortality, especially cancers. Previous recommendations, therefore, may be obsolete as they were based on studies where abstainers from alcoholic beverages had inherent higher risks. The current controversy with conflicting guidelines for alcoholic beverage consumption in the era of precision medicine may stimulate more fundamental investigations up to genetic ones and find the cause-effect relations. In the era of precision medicine, it may come closer to discovering the causes of cancers and many other diseases, enabling predictions of reactions to alcoholic beverages by each person, not just in the population.