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Publikacije (45098)

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C. Federici, L. Pecchia

By using a case-study on a fall-prediction device for elderly patients with orthostatic hypotension we aim to demonstrate how the MAFEIP tool, developed as part of the European Innovation Programme on Active and Healthy Ageing (EIP on AHA), can be used to inform manufacturers on their product development based on a cost-effectiveness criterion. Secondly, we critically appraise the tool and suggest further improvements that may be needed for a larger-scale adoption of MAFEIP within and beside the EIP on AHA initiative. The model was implemented using the MAFEIP tool. Within the tool one way sensitivity analyses were performed to assess the robustness of the model against the relative effectiveness of the fall-prevention device at different price levels. The MAFEIP tool was applied to a novel fall-prediction device and used to estimate the expected cost-effectiveness and perform threshold analysis. In our case study, the device produced estimated gains of 0.035 QALYs per patient and incremental costs of £ 518 (incremental cost-effectiveness ratio £14,719). Based on the one-way sensitivity analysis, the maximum achievable price at a willingness to pay threshold of £20,000 per QALY is estimated close to £900. The MAFEIP allows to quickly create early economic models, and to explore model uncertainty by performing deterministic sensitivity analysis for single parameters. However, the integration within the MAFEIP of common analytical tools such as probabilistic sensitivity analysis and Value of information would greatly contribute to its relevance for evaluating innovative technologies within and beside the EIP on AHA initiative.

Jelena Golubović, E. Heath, I. Košir, N. Ogrinc, Doris Potočnik, L. Strojnik, D. Heath

Xanthohumol (XN), isoxanthohumol (IX) and 8-prenylnaringenin (8-PN) are important prenylflavonoids present in hops with potential beneficial properties. In this study, we examined differences in the content of XN, IX and 8-PN in hops and beer produced under organic and conventional production regimes. A An ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS) method for analysing XN, IX and 8-PN in hops and beer was developed and validated, with LOQ ranging from 0.5 to 10 ng/mL. Finally, we examined 15N/14N and 12C/13C isotope ratios in the hops and beer using isotope ratio mass spectrometry (IRMS). The results show no statistically significant difference in the content of the selected prenylflavonoids between organic and conventionally produced hops and beer—in the whole sample group, as well as between the matched pairs. Stable isotope analysis indicated that only δ15N values are statistically higher in organically produced hops and beer. However, the differentiation according to the type of production could not be made solely based on the δ15N signature, but it could be used to provide supporting evidence.

E. Picano, Q. Ciampi, L. Cortigiani, Adelaide M. Arruda-Olson, C. Borguezan-Daros, J. L. de Castro e Silva Pretto, R. Cocchia, E. Bossone et al.

With stress echo (SE) 2020 study, a new standard of practice in stress imaging was developed and disseminated: the ABCDE protocol for functional testing within and beyond CAD. ABCDE protocol was the fruit of SE 2020, and is the seed of SE 2030, which is articulated in 12 projects: 1-SE in coronary artery disease (SECAD); 2-SE in diastolic heart failure (SEDIA); 3-SE in hypertrophic cardiomyopathy (SEHCA); 4-SE post-chest radiotherapy and chemotherapy (SERA); 5-Artificial intelligence SE evaluation (AI-SEE); 6-Environmental stress echocardiography and air pollution (ESTER); 7-SE in repaired Tetralogy of Fallot (SETOF); 8-SE in post-COVID-19 (SECOV); 9: Recovery by stress echo of conventionally unfit donor good hearts (RESURGE); 10-SE for mitral ischemic regurgitation (SEMIR); 11-SE in valvular heart disease (SEVA); 12-SE for coronary vasospasm (SESPASM). The study aims to recruit in the next 5 years (2021–2025) ≥10,000 patients followed for ≥5 years (up to 2030) from ≥20 quality-controlled laboratories from ≥10 countries. In this COVID-19 era of sustainable health care delivery, SE2030 will provide the evidence to finally recommend SE as the optimal and versatile imaging modality for functional testing anywhere, any time, and in any patient.

D. Manasijević, L. Balanović, I. Marković, M. Gorgievski, Uroš Stamenković, Kristina Božinović

D. Dominko, D. Starešinić, K. Biljaković, M. Đekić, A. Salčinović Fetić, K. Hrvat, M. Lozančić, J. Demšar et al.

Š. Cilović-Lagarija, Nino Hasanica, S. Musa, C. Peek-Asa

Background: Suicide is a major public health problem, with far-reaching social, emotional and economic consequences. Suicide rates are high in all age groups are particularly high in all age groups but are one of the major causes of death among younger age groups, yeilding substantial years of premature life lost. Preventing suicide is one of the major mental health challenges in the world, Objective: The aim of this study was to estimate the number and rates of suicide deaths in the Federation of Bosnia and Herzegovina (FB&H), and describe suicide characteristics by sex, age, method of suicide over the period of 2010 to 2020. Methods: This is a retrospective population-based study from the period 2010 - 2020. Data were from the FB&H mortality register, Institute for Statistics FB&H. Data on deaths by cause of death are given according to the 10th edition of the International Statistical Classification of Diseases, Injuries and Causes of Death. Suicide data were presented rates by three age group, total number, male and female, crude rates, age-specific death rates and suicide mechanism by age and gender. Results: The total number of suicides increased until 2017 to a peak of 201, then decreased to 157 for 2020. Males comprised over 70% of the suicide deaths. Over half of suicides were among those aged 30 - 64 and nearly one third among those 65 and above. However, the greatest increases were among youth aged 15 to 29, which grew from 2% to 9% of suicides over teh study period. The most common mechanisms for suicide were for hanging and firearms, both most common amond males. Poisoning was the most common mechanism among females. Conclusion: Understanding age and mechanism trends over time will help prioritize prevention strategies. Focus on mental health systems needs to ensure equal access to high-quality services in community based settings. For responses to this challenge to be effective, a comprehensive multisectoral suicide prevention strategy is needed.

A. H. Andersen, S. Santurette, M. Pedersen, E. Alickovic, L. Fiedler, Jesper Jensen, T. Behrens

Abstract Hearing aids continue to acquire increasingly sophisticated sound-processing features beyond basic amplification. On the one hand, these have the potential to add user benefit and allow for personalization. On the other hand, if such features are to benefit according to their potential, they require clinicians to be acquainted with both the underlying technologies and the specific fitting handles made available by the individual hearing aid manufacturers. Ensuring benefit from hearing aids in typical daily listening environments requires that the hearing aids handle sounds that interfere with communication, generically referred to as “noise.” With this aim, considerable efforts from both academia and industry have led to increasingly advanced algorithms that handle noise, typically using the principles of directional processing and postfiltering. This article provides an overview of the techniques used for noise reduction in modern hearing aids. First, classical techniques are covered as they are used in modern hearing aids. The discussion then shifts to how deep learning, a subfield of artificial intelligence, provides a radically different way of solving the noise problem. Finally, the results of several experiments are used to showcase the benefits of recent algorithmic advances in terms of signal-to-noise ratio, speech intelligibility, selective attention, and listening effort.

I. Hlapčić, Marija Grdić Rajković, A. Čeri, S. Dabelić, S. Popović-Grle, Margareta Radić Antolić, J. Knežević, A. Försti et al.

Heat shock protein 70 (Hsp70) engages Toll-like receptors (TLR) 2 and 4 when found in the extracellular compartment and contributes to inflammation in chronic obstructive pulmonary disease (COPD). Since there is growing evidence for the genetic risk factors for COPD, the gene expression of HSP70, TLR2 and TLR4 was determined, as well as the association between HSP70, TLR2 and TLR4 single nucleotide polymorphisms, (SNPs) and COPD. The gene expression was assessed in peripheral blood cells of 137 COPD patients and 95 controls by a quantitative polymerase chain reaction (qPCR), while a total of nine SNPs were genotyped by TaqMan allelic discrimination real-time PCR. HSP70 and TLR2 gene expression was increased in COPD patients compared to the controls, regardless of the disease severity and smoking status of participants. The rs6457452 SNP of HSP70 was associated with COPD, indicating the protective role of the T allele (OR = 0.46, 95% CI = 0.24–0.89, p = 0.022). Furthermore, COPD C/T heterozygotes showed a decreased HSP70 mRNA level compared to COPD C/C homozygotes. In conclusion, HSP70 and TLR2 may have a role in the pathogenesis of COPD, and the HSP70 rs6457452 variant might influence the genetic susceptibility to COPD in the Croatian population.

D. Kremer, E. Stabentheiner, F. Bogunić, D. Ballian, E. Eleftheriadou, D. Stešević, V. Matevski, V. Ranđelović et al.

A study of the trichomes types and distribution and pollen morphology was carried out in nine Micromeria taxa (M. cristata ssp. cristata, M. cristata ssp. kosaninii, M. croatica, M. graeca ssp. graeca, M. graeca ssp. fruticulosa, M. juliana, M. kerneri, M. longipedunculata and M. microphylla) and five closely related Clinopodium species (C. dalmaticum, C. frivaldszkyanum, C. pulegium, C. serpyllifolium and C. thymifolium) from the Lamiaceae family of the Balkan Peninsula. By scanning electron microscope, non-glandular trichomes, peltate and capitate trichomes were observed on the calyx, leaves and stem of the studied species. Two subtypes of capitate trichomes were observed in Micromeria species: subtype 1 (consisting of a basal epidermal cell and an elliptically shaped head cell) and subtype 2 (consisting of a basal epidermal cell, two to three stalk cells and a round head cell). In Clinopodium species, three types of capitate trichomes were observed: subtype 1, subtype 3 (consisting of a basal epidermal cell, a short peduncle cell, and a single round head cell), and subtype 4 (consisting of a basal epidermal cell, a stalk cell, and an elongated head cell). These results support the recent transfer of Micromeria species from the section Pseudomelissa to the genus Clinopodium.

Aim To analyse the resolution of chest X-ray findings in relation to laboratory parameters in patients infected with acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a two- month followup. Analysis of chest X-ray findings in the first few months after the disease is the main goal of our work. Methods Out of the total of 343 patients chest X-ray findings were followed in 269 patients. Patients were divided into groups according to the severity of findings. D-dimer, inflammatory markers, blood cell count, neutrophil lymphocyte ratio (NLR) were analysed. Chest X-ray was analysed during the hospitalization on the day of admission, on the third, the seventh and the fourteenth day (scoring method was used). After discharge chest X-ray was performed in a two-week follow-up, then after one and two months, and after three months if necessary. Results Incomplete chest X-ray resolution was identified in 24 (39.34%) patients with severe, 27 (22.31 %) patients with moderate and in three (3.91%) patients with mild findings. Statistical significance was established in overall score by comparison between all groups (p<0.001), and in the moderate compared to the mild group (p=0.0051). The difference of NLR in the severe compared to the moderate group was observed (p=0.0021) and in the severe group compared to the mild group (p=0.00013). Conclusion Chest X-ray findings persisted mostly in the severe group followed by the moderate and mild ones. Long-term followup is necessary for the appropriate treatment and prevention of fibrosis, and reduction of symptoms.

Aim To present the regulations governing the operation of pharmacies in Bosnia and Herzegovina over the Austro-Hungarian rule (1878-1918). Methods Qualitative secondary data analysis was used. Results The Austro-Hungarian government had found poor population's health, insufficient health facilities and qualified staff. For a long time, population was treated by old methods of medicine and pharmacy, and directed to folk doctors, healers and herbalists. As early as 1879, orders requesting mandatory possession of a university diploma to practice pharmacy and medicine, thus taking the initial steps to combat quackery. The production and dispensing of medicines became the exclusive competence of pharmacists. The Law on Pharmacies adopted in 1907 comprehensively regulated the apothecary activity. Pharmacy Gremium was founded, the first association of pharmacists with the task of protecting professional interests. All types of quackery were explicitly forbidden to pharmacy staff. Apothecary activity was regulated as a craft, not as a health activity. During this period, pharmacy became a regulated profession with educated and qualified personnel. The number of public pharmacies and qualified staff was growing. In 1878 only one graduated pharmacist was found, while in 1910 in 47 pharmacies there were 79 pharmacy staff. At the end of 1918, the masters of pharmacy were the owners of 48 pharmacies, in 38 cities. Conclusion All enacted regulations contributed to the development and improvement of the apothecary activity over the observed period, and laid the foundations for the future development of the profession.

D. Jović, M. Biscevic, M. Milisavljevic, Zoran Aleksić, M. Jakovljević, Nevena Tešović, Mićo Kremenović

Aim To measure a calibre of radial and ulnar septocutaneous perforators at the anterior forearm, and to count its number in proximal, middle and distal thirds. Methods The study was conducted on 50 fresh amputated forearms (trauma, tumours) in the period between January 2012 and December 2021. Forearms were collected from several hospitals in Belgrade, and analysed at the Institute of Anatomy, Medical School, University of Belgrade, Serbia. Injection of ink-gelatin and fine dissection of autopsy material was performed on 30 forearms, and corrosion method with injecting methyl methacrylate for 3D analysis on the other 20 forearms. Results A mean calibre of septocutaneous perforators on the radial artery was 0.53±0.46 mm (0.2-0.85). Averagely, there were 8.1 radial artery septocutaneous perforators - two perforators on the proximal third, 3.7 on the middle third, and 2.7 on the distal third. The mean calibre of ulnar artery perforators was 0.65±0.35 mm (0.18-1.8). The average number of septocutaneous perforators of the ulnar artery was 5.6; 1.2 on the proximal third, two on the middle third, and 2.2 on distal third. Conclusion Determination of the origin, calibre and spreading directions of the arterial septocutaneous perforators on the anterior forearm provide quantification of data about arborisation of radial and ulnar septocutaneous perforators at the anterior forearm. Clinical relevance of those anatomical data is in defining of safe locations and dimensions of forearm fasciocutaneous flaps in plastic surgery.

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