Flood quantile estimation in ungauged basins is often performed using regional analysis. A regionalization procedure consists of two phases: the definition of homogeneous regions among gauged basins, i.e., clusters of stations, and information transfer to the ungauged sites. Due to its simplicity and widespread use, a combination of hierarchical clustering by Ward’s algorithm and the index-flood method is applied in this research. While hierarchical clustering is very efficient, its shortcomings are the lack of flexibility in the definition of clusters/regions and the inability to transfer objects/stations from one cluster center to another. To overcome this, using silhouette width for induced clustering of stations in flood studies is proposed in this paper. A regionalization procedure is conducted on 53 gauging stations under a continental climate in the West Balkans. In the induced clustering, a negative silhouette width is used as an indicator for the relocation of station(s) to another cluster. The estimates of mean annual flood and 100-year flood quantiles assessed by the original and induced clustering are compared. A jackknife procedure is applied for mean annual flood estimation and 100-year flood quantiles. Both the Hosking–Wallis and Anderson–Darling bootstrap tests provide better results regarding the homogeneity of the defined regions for the induced clustering compared to the original one. The goodness-of-fit measures indicate improved clustering results by the proposed intervention, reflecting flood quantile estimation at the stations with significant overestimation by the original clustering.

Only several cases of postprocedural choleresis (biliary hyperproduction) were reported, and guidance on management is scarce, although an application of octreotide was anecdotally described. We herein present a rare post-obstructive choleresis complicated with acute kidney injury due to dehydration, successfully treated with an off-label application of octreotide. A 58-year-old female, following cholecystectomy and choledochotomy with numerous stones extraction, developed excessive bile loss via a T-tube complicated with acute kidney injury. Despite aggressive fluid replacement, the patient continued to deteriorate, prompting a trial of subcutaneous octreotide 0.1 mg three times per day over five days. Therapy yielded a rapid decline in bile production with improved diuresis and normalizing kidney function. The patient was discharged with a ligated T-tube, which we removed a month later. The followup was unremarkable, with normalized laboratory findings and symptom-free. Early use of octreotide could help resolve complicated biliary hyperproduction; however, further research is required to determine the risks and benefits of such an approach.

Aim: To present a very rare case of empyema cavuma septi pellucidi. Case report: A 5-year-old male child was admitted to the Department of Infectious Diseases Cantonal Hospital Zenica because of fever (38.30C), headache and vomiting. The patient developed intracranial hypertension as a result of a compressive purulent collection formed due to meningitis between the lamine of the septum pelucidum with consequent intracranial hypertension. Conclusion: The decision regarding the modality of treatment was not easy. We considered that empyema evacuation using the transcallosalinterhemispheric approach allows the complete removal of purulent collection and the placement of drainage, which allows additional emptying of the empyema cavity and prevents empyema recurrence. Empyema evacuation with drainage and antibiotic therapy have shown beneficial results.

Objective – The aim of the study was to establish the prevalence of hearing and sight impairment, and the differences in relation to school grade and sex in school children in the area of the Jajce municipality.Materials and Methods – Screening of sight and hearing impairment in school children took place in 2018 and 2019. Vision screening covered a total of 1002 students from 1st to 5th grades, and hearing screening 768 students from 2nd to 5th grades in all central and district (rural) schools in the area of the municipality of Jajce.Results – Of the total number of students covered by the vision screening, in 163 (16%) some impairment was noticed, and they were sent for further diagnostic testing by a specialist. In relation to sex, there was a higher percentage of girls, 60%, than boys, 40%. In relation to screening of hearing, 44 (6%) of the students were sent for further diagnostics, of which 57% were boys and 43% girls. During the vision screening, 5% of the students were wearing dioptric glasses. In relation to age, the largest number of students were in first grade, 14 (27%), then in second grade, 10 students (19%). Conclusion – In this study, the results showed that a large percentage of school children were found with hearing and vision impairment, which indicates the pressing need to continue running these preventive programmes.

In a ternary mixture with the Soret effect, the interplay between cross-diffusion, thermodiffusion, and convection can lead to rich and complex dynamics including spatial patterns and oscillations. We present an experimental and three-dimensional numerical study of dynamic regimes in the toluene-methanol-cyclohexane ternary mixture with the Soret effect in the geometry of a thermogravitational column. An important feature of the system is that for the first component, toluene, the Soret and thermodiffusion coefficients have opposite signs, which triggers the oscillatory instability. Our experiments and numerical analysis show that the primary long-wave instability manifests itself in the form of a standing wave, and the secondary one emerges in the form of a swinging pattern. The computational model provides insight into the role of cross-diffusion coefficient D12 in the emergence and development of oscillatory instability. This study demonstrates that the long-wave oscillatory instability in transverse direction occurs only within a limited range of the D12 values and outside of this range it decays to a stationary pattern of either Turing-like or monotonic instability.

Objective: To investigate the arterial stiffness and risk factors in adolescence. Arterial stiffness often (AS) results from the degenerative process of the media layer of elastic arteries causing rigidity of the arteries. Arterial stiffness increases with age and it is associated with several risk factors as a disease predictor. But, arterial stiffness can be also increased in a healthy arteries as well. The increased sympathetic activity promotes vasoconstriction of resistant blood vessels i.e. arteries and arterioles that result in peripheral vasoconstriction. Adolescence age is the most important period of life for promoting future health. The certain dynamic risk factors in adolescence like, emotional dysregulation, psychological family stress, education pressure, lack of sleep, gambling, substance abuse, smartphone overuse and obesity can cause arterial stiffness. Design and method: The prospective open randomized study was designed. Adolescence age between 10 and 19 years have been investigated for increased arterial stiffness and risk factors. The inclusion criteria was healthy adolescence, while exclusion criteria was any disorder present. Arterial stiffness, non-invasive blood pressure and pulse wave datas have been measured using Agedio device. The risk factors were evaluated in every subject. The vascular age have been outlined as the final measure. Results: The preliminary results indicate the increase of Augmentation Index and Coefficient of Reflection. The average percentage of Augmentation Index was 40% and Coefficient of Reflection 65% (normal value 28% and 60% respectively). The main risk factors were educational pressure, lack of sleep and smartphone influence. The vascular age was on average, 3 years higher than biological age. Conclusions: Arterial stiffness in adolescence is increased mainly by peripheral vasoconstriction, manifested with Augmentation index and Coefficient of wave Reflection.

Abstract Advances in robotic technology have improved standard techniques in numerous surgical and endovascular specialties, offering more precision, control, and better patient outcomes. Robotic-assisted interventional neuroradiology is an emerging field at the intersection of interventional neuroradiology and biomedical robotics. Endovascular robotics can automate maneuvers to reduce procedure times and increase its safety, reduce occupational hazards associated with ionizing radiations, and expand networks of care to reduce gaps in geographic access to neurointerventions. To date, many robotic neurointerventional procedures have been successfully performed, including cerebral angiography, intracranial aneurysm embolization, carotid stenting, and epistaxis embolization. This review aims to provide a survey of the state of the art in robotic-assisted interventional neuroradiology, consider their technical and adoption limitations, and explore future developments critical for the widespread adoption of robotic-assisted neurointerventions.

Connected, Cooperative, and Autonomous Mobility (CCAM) will take intelligent transportation to a new level of complexity. CCAM systems can be thought of as complex Systems-of-Systems (SoSs). They pose new challenges to security as consequences of vulnerabilities or attacks become much harder to assess. In this paper, we propose the use of a specific type of a trust model, called subjective trust network, to model and assess trustworthiness of data and nodes in an automotive SoS. Given the complexity of the topic, we illustrate the application of subjective trust networks on a specific example, namely Cooperative Intersection Management (CIM). To this end, we introduce the CIM use-case and show how it can be modelled as a subjective trust network. We then analyze how such trust models can be useful both for design time and run-time analysis, and how they would allow us a more precise quantitative assessment of trust in automotive SoSs. Finally, we also discuss the open research problems and practical challenges that need to be addressed before such trust models can be applied in practice.

This study is established on the aim to analyse a game and determine differences in a shot efficacy in an offence the woman’s handball national teams at the Olympic games in Tokyo 2021. Four national teams were analysed: France, Russia, Norway and Sweden. To analyse a game in the offence, 12 variables were used: total number of shots (sut_uk), efficient number of shots (sut_usp), total number of shots from 6 meters (sut_m6_uk), efficient number of shots from 6 meters (sut_m6_us), total number of shots from wings (sut_kril_uk), the efficient number of shots from wings (sut_kr_us), total number of shots from 9 meters (sut_m9_uk), efficient number of shots from 9 meters (sut_m9_us), total number of shots from 7 meters (sut_m7_uk), efficient number of shots from 7 meters (sut_m7_us), total number of fast centres (brzc_uk) and total number of efficient fast centres (sut_brzc_us). All national teams had the approximal number of efficient shots on a goal. The highest number of efficient shots from 6 m had the French and Norwegian national teams. From the wing position, the highest number of efficient shots had the Norwegian national team, while the lowest number of efficient goals from the wing position had the Russian national team. The Norwegian and French national teams were approximately efficient in the shot’s realisation from 9 m. In a realisation of the fast centre, the Russian national team stands out with the highest number and the French national team had the lowest number of efficient shots. Key words: cumulative analysis, handball, woman, shooting accuracy, efficiency,Olympic games

Background In last two decades, there have been substantial changes in the pattern of lipid-modifying medicines utilisation following the new treatment guidelines based on clinical trials. The main purpose of this study was to analyse the overall utilisation and expenditure of lipid-modifying medicines in the Republic of Srpska, Bosnia and Herzegovina during an 11-year follow-up period and to express its share in relation to the total cardiovascular medicines (C group) utilisation. Methods In this retrospective, observational study, medicines utilisation data were analysed between 2010 and 2020 period using the ATC/DDD methodology and expressed as the number of DDD/1000 inhabitants/day (DDD/TID). The medicines expenditure analysis was used to estimate the annual expenditure of medicines in Euro based on DDD. Results During the analysed period, the use of lipid-modifying medicines increased almost 3-times (12.82 DDD/TID in 2010 vs 34.32 DDD/TID in 2020), with a rise in expenditure from 1.24 million Euro to 2.15 million Euro in the same period. This was mainly driven by an increased use of statins with 163.07%, and among these, rosuvastatin increased more than 1500-fold, and atorvastatin with 106.95% increase. With the appearance of generics, simvastatin showed a constant decline, while the other lipid-modifying medicines in relation to the total utilisation had a neglecting increase. Conclusion The use of lipid-modifying medicines in the Republic of Srpska has constantly increased and strongly corresponded to the adopted treatment guidelines and the positive medicines list of health insurance fund. The results and trends are comparable with other countries, but still the utilisation of lipid-lowering medicines represents the smallest share of total medicines use for the treatment of cardiovascular diseases, compared to high-income countries.

Background: Colorectal cancer (CRC) is a diverse disease with various clinical, pathological and molecular features that affect tumor biological behavior, treatment response and prognosis. Objective: The aim of this study was to evaluate the correlation between metabolic 18F-FDG PET/CT parameters (SUVmax, MTV and TLG) and CEA in recurrent and metastatic CRC and to evaluate prognostic value of metabolic 18F-FDG PET/CT parameters in recurrent and metastatic CRC. Methods: A descriptive study of 100 patients with previously detected and surgically treated CRC referred to PET/CT with a suspicion of recurrent or metastatic CRC. CEA was measured within three months from the imaging. A low-dose PET/CT was performed per institutional protocol. For each hypermetabolic lesion, metabolic PET/CT parameters (SUVmax, MTV, TLG) were calculated semiautomatically. Pathohistology or clinical data from the follow-up were used as the gold standard. Sensitivity, specificity, PPV and NPV for 18F-FDG PET/CT and CEA in detection of recurrent or metastatic CRC were calculated. Correlation between CEA and SUVmax, MTV and TLG was calculated, separately. To assess the prognostic values of metabolic parameters in CRC, survival analysis with 18-month progression-free survival (PFS) as an endpoint was performed. Microsoft Excel sheets, ROC and Kaplan-Meier curves were used to present the data. Logrank and Tarone-Ware test and Cox model of proportional hazards were used to compare the groups. Results: Study included 100 patients, 45 males and 55 females, age range 36-81 years, mean age 61,4 years. Cancer site was colon in 56% and rectum in 44%. Sensitivity, specificity, PPV and NPV of 18F-FDG PET/CT in detection of recurrent or metastatic CRC was 95%, 73%, 70% and 95%, respectively. Sensitivity, specificity, PPV and NPV of CEA in detection of recurrent or metastatic CRC was 58%, 96%, 91% and 78%, respectively. SUVmax, MTV and TLG positively correlated with CEA, but only CEA-TLG correlation was considered significant (r=0,67). The regression model analysis revealed: SUVmax (HR=0,63, 95%CI=0,28-1,41, p=0,214), MTV (0,59, 95%CI=0,28-1,22, p=0,111) and TLG (HR=0,45 95%CI=0,21-0,99, p=0,028), and the prognostic role in CRC was proven for TLG only. Conclusion: Metabolic 18F-FDG PET/CT parameters may have the prognostic value in CRC, but further multicentric prospective studies are required for validation.

Cyber-physical systems are taking on a permanent role in the industry, such as in oil and gas or mining. These systems are expected to perform increasingly autonomous tasks in complex settings removing human operators from remote and potentially hazardous environments. High autonomy necessitates a more extensive use of artificial intelligence methods, such as anomaly detection, to identify unusual occurrences in the monitored environment. The absence of data characterizing potentially hazardous events leads to disruptive noise displayed as false alarms, a common anomaly detection issue for hazard identification applications. Contrastingly, disregarding the false alarms can result in the opposite effect, causing loss of early indications of hazardous occurrences. Existing research introduces simulating and extrapolating less represented data to expand the information on hazards and semi-supervise the methods or by introducing thresholds and rule-based methods to balance noise and meaningful information, necessitating intensive computing resources. This research proposes a novel Warning Identification Framework that evaluates risk analysis objectives and applies them to discern between true and false warnings identified by anomaly detection. We demonstrate the results by analyzing three seismic hazard assessment methods for identifying seismic tremors and comparing the outcomes to anomalies found using the unsupervised anomaly detection method. The demonstrated approach shows great potential in enhancing the reliability and transparency of anomaly detection outcomes and, thus, supporting the operational decision-making process of a cyber-physical system.

Is it safe to have a pregnancy in women with prior history of hormone receptor-positive early breast cancer? Pregnancy following breast cancer treatments in young women with history of hormone receptor-positive disease is safe with no detrimental effect on patients’ prognosis. Breast cancer is the most common malignancy diagnosed in women of reproductive age. Both physicians and patients continue to have concerns about a potential detrimental effect of pregnancy after breast cancer, particularly in the setting of hormone receptor-positive disease. In recent years, several studies have demonstrated the safety of pregnancy after anticancer treatments in breast cancer survivors. A systematic literature search of Medline, Embase and Cochrane library with no language or date restriction up to January 1st, 2023, was performed following the PRISMA guidelines. We included retrospective or prospective case-control and cohort studies as well as prospective clinical trials comparing survival outcomes of premenopausal female patients with reported pregnancy or not after diagnosis and treatment for hormone receptor-positive breast cancer. Included patients were childbearing potential age women with a prior history of hormone receptor-positive early breast cancer. Outcomes of interest were disease-free survival and overall survival. Hazard ratios (HR) with 95% confidence intervals (CI) were extracted. Higgins I2 index was used to evaluate the degree of inconsistency in the results of the included studies. Pooled HRs were considered statistically significant with a P value of < 0.05 (two-sided). Eight studies were eligible to be included in the final analysis. A total of 3,805 patients with hormone receptor-positive breast cancer were included in these studies, of whom 1,285 had a pregnancy after treatments. Median follow-up of the included studies ranged from 3.81 years to 15.8 years. In three studies (n = 987 patients) reporting on disease-free survival outcomes, no difference was observed between patients with or without a subsequent pregnancy (HR 0.96, 95% CI 0.75 – 1.24, p = 0.781). Six studies (n = 3,504 patients) reported outcomes in terms of overall survival: patients with a pregnancy after breast cancer had better overall survival compared with those without a pregnancy (HR 0.46, 95% CI 0.27 – 0.77, p < 0.05). At the subgroup analysis on timing of pregnancy, no detrimental effect of pregnancy after breast cancer in terms of disease-free survival was observed for patients achieving a late pregnancy (defined as 2 or 5 years after diagnosis) as compared to patients without a subsequent pregnancy (HR 1.08, 95% CI 0.80 – 1.46, p = 0.611). Increased disease-free survival was observed in patients with an early pregnancy (HR 0.63, 95% CI 0.47 – 0.85, p < 0.05). This meta-analysis is based on abstracted data and most of the studies are retrospective cohort studies. Median follow-up in a large proportion of the studies was shorter than 10 years. Adjuvant hormone therapy before and after pregnancy was not available in many studies included. Our results strengthen the evidence that having a pregnancy in women with prior history of hormone receptor-positive breast cancer is safe. not applicable

The subject of this research is the evaluation of electric cars and the choice of car that best meets the set research criteria. To this end, the criteria weights were determined using the entropy method with two-step normalization and a full consistency check. In addition, the entropy method was extended further with q-rung orthopair fuzzy (qROF) information and Einstein aggregation for carrying out decision making under uncertainty with imprecise information. Sustainable transportation was selected as the area of application. The current work compared a set of 20 leading EVs in India using the proposed decision-making model. The comparison was designed to cover two aspects: technical attributes and user opinions. For the ranking of the EVs, a recently developed multicriteria decision-making (MCDM) model, the alternative ranking order method with two-step normalization (AROMAN), was used. The present work is a novel hybridization of the entropy method, full consistency method (FUCOM), and AROMAN in an uncertain environment. The results show that the electricity consumption criterion (w = 0.0944) received the greatest weight, while the best ranked alternative was A7. The results also show robustness and stability, as revealed through a comparison with the other MCDM models and a sensitivity analysis. The present work is different from the past studies, as it provides a robust hybrid decision-making model that uses both objective and subjective information.