Hans Peterson, MD, PhD, FEFMI, FACMI, FIMIA, FIAHSI (1928-2021), became a certified physician in Sweden in 1958 and was awarded a doctorate in Medicine in 1967 (1-4). He was an ophthalmology fellow at the Karolinska Institute, Stockholm University, and was appointed to faculty positions in Ophthalmology and Medical Informatics at the Karolinska in the late 1970’s.

Background: Mobile pharmacies are special organizational units or infrastructures that serve to supply medicines to remote communities or are stationed on ships or as such exist during war conflicts on the battlefields to provide first aid to the wounded and to provide the necessary medicines. The establishment of mobile pharmacies is regulated by the law of each state and only preparations approved by law can be found in it. There are also regulations for the good storage and warehousing of these drugs. Objective: The aim of this article was to provide an overview of the available literature on the topic “Mobile pharmacies through history”, which shows the development and progress in the structure and function of mobile pharmacies throughout history. Methods: This is an descriptive study based on the searched available literature from the on-line databases regarding to present a historical overview of mobile pharmacies during the most significant war events in Europe and the USA. Results and Discussion: Mobile pharmacies were first mentioned in Egypt and the Roman Empire, but it was not until 1500 that military and ship’s doctors began using them, and wealthy nobles had their own boxes of medicines, which they carried on long voyages. Mobile pharmacies became more and more popular, so in the 18th century, practical manuals on the use of the contents of the box began to be published. The importance of a mobile pharmacy was shown in the wars, where people, before their appearance, died due to the impossibility of providing first aid on the battlefield. The advanced medicine and pharmacy that developed on land, greatly affected the health care at the sea. The constant incidence of infectious diseases, poverty and inadequate nutrition, insecurity of navigation and long voyages are the main reasons why sailors often fell ill and were exposed to injuries at work. A situation like that required that the problem of health protection on ships gets solved in accordance with the then principles of medicine and pharmacy. Conclusion: Authors demonstrated the importance of mobile pharmacies in treating and providing medical protection on boat trips. Regarding the ship’s pharmacies, pharmacists have the role of supplying ships with medicines, conducting training for captains and ship staff, advising shipping companies and captains on equipping ship pharmacies and advising on the preparation of national regulations and national ship pharmacy supply policy.

Abstract We are witnessing an increasing frequency of illegal actions and fraud in the business of legal entities, which directly reflects on the quality of information presented in financial statements. Internal audit does not primarily deal with the audit of financial statements, but through verifying the application of accounting policies and procedures it helps to gain reasonable assurance that the financial statements are reliable and that they are presented fairly. The role of internal audit in the fraud detection process is reflected in the fraud risk assessment in the internal audit planning process, and through performing work engagements to detecting them. In this paper, we will present risk assessment techniques, which the internal auditor can apply in quantitative and qualitative assessment of fraud risk, and in identifying priority areas/audit processes. The aim of this paper is to point out the importance of the role of internal audit, through the application of techniques, tools and prescribed responsibilities for risk assessment, in the process of detecting fraud in companies that cause incalculable damage on a daily basis.

Background: Dentine hypersensitivity (DH) is a frequent clinical problem that represents a long-term painful discomfort for the patients, and for the dentists, it represents a diagnostic and therapeutic challenge. Objective: The aim of the research is to verify the effect of the treatment with diode laser SiroLaser Blue (660nm) of DH alone or in combination with different impregnating agents. Methods: Fifty patients were included in this research, separated into five groups. All the patients have been asked to define the level of dentine hypersensitivity using VAS (0-10). The first group was treated with Fluor Protector, the second group after the application of Fluor Protector has undergone irradiation with SiroLaser Blue (660nm), the third group was treated with impregnating agent Vivasens, the fourth group, after the application of impregnating agent Vivasens, has had SiroLaser Blue (660nm) irradiation. The fifth group has just been treated with SiroLaser Blue (660nm). The efficiency of the treatment was checked using VAS for every group immediately after the conducted treatment, after 7 days and 1 month. Results: Our results showed that all of the desensitizing agents used in the research alone or in combination with a diode laser (660nm) have shown a reduction of DH. The difference has been proven statistically significant in mean values by groups and examinations. Vivasens and diode laser irradiation have provided the best results in the review of mean values after the first examination and one month after the treatment of DH (p<0,05). In our research, the application of diode laser alone has not proven superior to other treatment methods that have been used in the research. Conclusion: Vivasens plus diode laser irradiation has provided the best results even after one month since the treatment of DH.

Linear regression analysis is one the most common methods for weather-normalizing energy data, where energy versus degree-days is plotted, quantifying the impacts of outside temperature on buildings’ energy use. However, this approach solely considers dry-bulb temperature, while other climate variables are ignored. In addition, depending on buildings’ internal loads, weather impact can be less influential, making the linear regression method not applicable for energy data normalization in internally driven buildings (such as research laboratory buildings, healthcare facilities, etc.). In this study, several existing buildings from different categories, all located on the University of Massachusetts Amherst campus and exposed to the same weather conditions in a heating-dominated climate, were analyzed. For all cases, regression of monthly steam use on heating degree-days and floor-area normalized steam data were used, investigating applicability of the former when the latter changes. It was found that internal loads can skew steam consumption, depending on the building functionality, making the effect of degree-days negligible. For laboratory-type buildings, besides heating and domestic hot water production, steam is also used for scientific experiments. Here, daily occupancy percentage, even during weekends and holidays, was higher than that of other buildings, indicating the intensity of scientific experiments performed. This significantly impacted steam consumption, resulting in higher floor-area-normalized steam usage. In these cases, steam use did not provide an outstanding correlation to heating degree-days. Whereas, for cases with other functionality-types and lower floor-area normalized steam, coefficients of determination in regressions were high. This study concludes that even for buildings located in the same climate, depending on how building functionality and occupancy schedule influence floor-area normalized steam use, multivariate linear regression can provide more accurate analysis, rather than simple linear regression of steam on heating degree-days.

Antimicrobial resistance (AMR) is a high priority across countries as it increases morbidity, mortality and costs. Concerns with AMR have resulted in multiple initiatives internationally, nationally and regionally to enhance appropriate antibiotic utilization across sectors to reduce AMR, with the overuse of antibiotics exacerbated by the COVID-19 pandemic. Effectively tackling AMR is crucial for all countries. Principally a narrative review of ongoing activities across sectors was undertaken to improve antimicrobial use and address issues with vaccines including COVID-19. Point prevalence surveys have been successful in hospitals to identify areas for quality improvement programs, principally centering on antimicrobial stewardship programs. These include reducing prolonged antibiotic use to prevent surgical site infections. Multiple activities centering on education have been successful in reducing inappropriate prescribing and dispensing of antimicrobials in ambulatory care for essentially viral infections such as acute respiratory infections. It is imperative to develop new quality indicators for ambulatory care given current concerns, and instigate programs with clear public health messaging to reduce misinformation, essential for pandemics. Regular access to effective treatments is needed to reduce resistance to treatments for HIV, malaria and tuberculosis. Key stakeholder groups can instigate multiple initiatives to reduce AMR. These need to be followed up.

Abstract The enzymes of the cytochrome P450 superfamily play a critical role in phase I drug metabolism. Among them, CYP2C9 and CYP2C19 are clinically important, as they can mediate severe toxicity, therapy failure, and increased susceptibility to cancer and other diseases caused by chemicals. The aim of this study was to determine the prevalence of pharmacologically most important allelic variants of the CYP2C9 and CYP2C19 genes in the general population of the Republic of Srpska (Bosnia and Herzegovina) and to compare them with other populations. For this purpose we determined the genotype profile and allele frequency of 216 randomly selected healthy volunteers using real-time polymerase chain reaction (RT-PCR). The prevalence of the CYP2C9 *2 and *3 alleles was 13.6 and 7.4 %, respectively. Based on these frequencies, of the 216 participants four (1.86 %) were predicted to be poor metabolisers, 78 (36.11 %) intermediate, and the remaining 134 (62.03 %) normal metabolisers. Based on the prevalence of CYP2C19 *2 and *17 variants – 16.2 and 20.4 %, respectively – nine (4.17 %) were predicted to be poor, 57 (26.39 %) rapid, and nine (4.17 %) ultra-rapid metabolisers. We found no significant differences in allele frequencies in our population and populations from other European countries. These findings suggest that genetically determined phenotypes of CYP2C9 and CYP2C19 should be taken into consideration to minimise individual risk and improve benefits of drug therapy in the Republic of Srpska.

SUMMARY The aim of this cross-sectional study was to investigate the occurrence of chromosomal abnormalities through the frequency of micronuclei and other genomic damage markers in patients with chronic generalized periodontitis and without periodontal disease. Micronucleus assay was performed in exfoliated gingival epithelial cells of 35 patients with generalized chronic periodontitis and 30 control subjects with healthy periodontium. Full mouth clinical examination was performed to define periodontal condition. The mean number of cells with micronuclei observed in chronic periodontitis and control groups was 1.8 (±1.49) and 2.0 (±1.34), respectively. Differences between the groups were not significant (p=0.574). Compared to control subjects, patients with chronic periodontitis showed a significant increase in the number of binucleated cells (p≤0.001) and number of cells with nucleoplasmic bridges (p=0.042). Study results indicated that chronic periodontitis was not associated with higher occurrence of chromosomal damage in gingival cells compared to individuals with healthy periodontium.

Abstract At the end of December 2019, first identified cases of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) started emerging. Ever since the emergence of the first case of infection with SARS-CoV-2 or COVID-19, it became the hottest research topic of numerous studies, in which scientists are trying to understand the path of infection, transmission, replication and viral action, all in order of finding a potential cure or vaccine applying various fundamental principles and methodologies. Using in silico method via AutoDock Vina 1.1.2., we analysed the binding affinity of six selected compounds from grapefruit seed extract (GSE) (narirutin, naringin, naringenin, limonin, ascorbic acid and citric acid) to SARS-CoV-2 main protease Mpro (PDB ID: 6Y84), using acetoside, remdesivir and gallic acid as a positive controls of binding affinity. Results showed highest affinity (rmsd l.b. 0.000; rmsd u.b. 0.000) for narirutin (-10.5), then for naringin (-10.1), acetoside (-10.0), limonin (-9.9), remdesivir (-9.6), naringenin (-8.2), ascorbic acid (-6.7), citric acid (-6.4) and gallic acid (-6.4), all expressed in kcal/mol. Our findings suggest that selected compounds from grapefruit seed extract represent potential inhibitors of SARS-CoV-2 Mpro, but further research is needed as well as preclinical and clinical trials for final confirmation of inhibitory functionality of these compounds.

Possibilities to use unmanned aerial vehicles (UAVs) are rapidly growing. With the development of battery technologies, communication, navigation, surveillance, and autonomous systems in general, many UAVs are expected to operate at relatively low altitudes. Thus, the problem of UAV noise impact on human health and well-being will be more pronounced. In this paper, we conducted noise measurements of two UAVs of different performance (quadrotor and hexarotor) in flying up and down, hovering, and overflight procedures. Respondents of good hearing who were confirmed by audiogram measurement and had participated in the survey during UAV noise measurement gave their subjective assessments on the UAV noise perception. UAV noise measurements and subjective respondents’ assessments were analysed and related. UAV noise analysis showed that the parameters measured at the same measurement point for the hexarotor were higher than those for the quadrotor in flying up and down and flying-over procedures. Low frequency noise was present in the noise spectrum of both drones. Participants were able to distinguish between the noise of UAVs and had a generally more negative experience with the hexarotor. Regardless of the noise perception, more than 80% of the respondents believe there are more pros than cons for UAV introduction into everyday life.

Background: Multisystem inflammatory syndrome in children (MIS-C) was recognized during the 2020 pandemic of SARS-CoV-2. Because of the relative rarity current knowledge is limited, especially in the European Caucasian population. Objectives: To report the epidemiology, clinical and laboratory characteristics of patients with MIS-C in a nationwide cohort study in Slovenia. Methods: This is a nationwide prospective cohort study of all consecutive patients with MIS-C, admitted from the beginning of epidemics to 31st December 2020 to University Medical Centre Ljubljana, Slovenia, the only tertiary care pediatric rheumatology center in the country. The inclusion criteria were meeting the CDC criteria for MIS-C. Infection with SARS-CoV-2 was confirmed in all patients by positive antibodies for SARS-CoV-2. Data were collected from the patients' medical records. Data on the COVID-19 epidemics in Slovenia were collected from National Institute of Public Health. Population data were provided by the Statistical Office of the Republic of Slovenia. Results: Twenty-three patients with MIS-C were diagnosed nationwide in Slovenia, all of them in the second wave of epidemics from 14th September to 31st December 2020. All patients were Caucasian and the estimated prevalence of MIS-C was 5.8/100 000 persons younger than 19 years of age. Detailed analyses were available in 20 patients of which 14 were boys (70 %), median age was 12.4 years (4 months to 17.7 years). Two patients (10 %) were treated in the intensive care unit and none of the patients died. Troponin was elevated in 15/20 (75 %) patients during the disease course, and 7/15 (47 %) of these had normal troponin level at admission. The serum level of troponin closely followed the serum level of CRP. Six out of 20 (30 %) patients had elevated pancreatic enzymes in the second week of the disease after treatment was already given,and one patient developed asymptomatic acute pancreatitis with serum lipase level reaching the maximum of 25μkat/L. All patients had elevated levels of D-dimer with no signs of thrombosis. Five patients (5/20;25 %) had pleural effusions and five patients (5/20, 25 %) had ascites. Half of the patients (10/20;50 %) had hepatosplenomegaly and eight (8/20;40 %) had mesenterial lymphadenopathy. Three patients (3/20;15 %) had radiologic signs of cholecystitis. Two patients had thickened lung parenchyma. All patients received IVIG and systemic glucocorticosteroids. Because of resistant or organ threatening disease 4 patients (4/20, 20%) received high dose methylprednisolone pulse therapy. Biologic therapy with anakinra was started in 2 patients. Nineteen patients (19/20, 95%) received acetylsalicylic acid and prophylactic anticoagulation was prescribed in 15/20 (75%) of patients. The mean follow up was 50 days (14 -122). At the last follow-up visit all patients had normal laboratory parameters of inflammation, troponin, pro-BNP, d-dimer values and normal heart function. Conclusion: A very high incidence of MIS-C, estimated 5.8/100 000 persons under the age of 19 with a predominantly cardiac involvement but very good outcome was noted in European Caucasian population in a nationwide cohort study in Slovenia. Attention to newly described pancreatic involvement should be raised.

Juvenile systemic sclerosis (jSSc) is a rare disease with a prevalence of around 3 in 1,000,000 children. To better capture the clinical manifestations of jSSc the juvenile systemic sclerosis inception cohort (jSScC) has been prospectively enrolling patients with predetermined clinical variables over the past 12 years. One of the goals is to study the demographic, clinical features, and physician and patient reported outcome differences between those with juvenile limited cutaneous (lc) compared to diffuse cutaneous (dc) disease subtypes, to determine if characteristics are similar or different between dc and lc jSSc.Evaluation of the baseline clinical characteristics of jSSc patients in the jSScC. Compare clinical phenotype between diffuse (dcjSSc) and limited cutaneous (lcjSSc) subtypes.Demographic, physical examination, organ system evaluation, autoantibody profile, treatment, and patient and physician reported outcome variables were evaluated from the jSSc Inception cohort and summary statistics applied using chi-square test and Mann Whitney U-test comparing lcjSSc and dcjSSc subtypes.At the time of data extraction, 175 jSSc patients were enrolled in the cohort, 81% were Caucasian and 81% female. Diffuse cutaneous jSSc subtype predominated (73%). Mean disease duration was 3.1 year (±2.7). Mean age at Raynaud´s was 10 years (+3.8) and mean age of first non-Raynaud´s was 10.2 years (±3.8). Significant differences were found between dcjSSc versus lcjSSc, regarding several clinical characteristics. Patients with diffuse cutaneous subtype had significantly higher modified Rodnan skin score (p=0.001), presence of sclerodactyly (p=0.02), presence of Gottron’s papules (p=0.003), presence of telangiectasia (p=0.001), history of digital tip ulceration (p=0.01), and frequency of elevated CK value (p=0.04). Cardiac involvement was significantly higher in limited cutaneous jSSc subtype (p=0.02). Diffuse cutaneous jSSc patients had significantly worse scores for Physician Global Assessment of disease activity (38 vs 25; p=0.002) and disease damage (34 vs 19; p=0.008).Table 1.Comparison of demographic data and significant differences between dcjSSc and lcjSSc at time of inclusionWhole CohortN=175Diffuse SubtypeN=128Limited SubtypeN=47P valueFemale to Male Ratio4.3:1 (142/33)4.1:1 (103/25)4.8:1 (39/8)0.829Cutaneous subtypeDiffuse subtype73% (128)1280Limited subtype27% (47)047Mean Disease duration (years)3.1 (± 2.7)3.3 (± 2.9)2.6 (± 2.2)0.135Mean age of onset of Raynaud´s (years)10.0 (± 3.8)17 non-Raynaud9.8 (± 3.6)10 non-Raynaud10.6 (± 4.3)7 non-Raynaud0.219Mean age of onset of non-Raynaud´s (years)10.2 (± 3.9)10.0 (± 3.7)10.9 (± 4.3)0.173Disease modifying drugs88% (154)89% (114)85% (40)0.446CutaneousMean modified Rodnan skin score14.3 (0-51)17.4 (0-51)6.1 (0-24)0.001Gottron Papules27% (46/171)33% (41/124)11% (5)0.003Sclerodactyly78% (126/162)82% (98/119)65% (28/43)0.020Laboratory valuesElevated CK25% (30/122)30% (26/88)12% (4/34)0.041VascularTelangiectasia36% (56/154)44% (49/111)16% (7/43)0.001History of ulceration53% (91/173)61% (77/127)30% (14/46)0.001CardiacCardiac Involvement6% (10)2% (3)15% (7)0.002Patient Related OutcomesPhysician global disease activity(0-100) min -max35(0-90) n=14138(0-90) n=10825(0-80) n=330.002Physician global disease damage(0-100) min -max31(0-85) n=14034(0-85) n=10819(0-60) n=320.008Results from this large international cohort of jSSc patients demonstrate significant differences between dcjSSc and lcjSSc patients. According to the general organ involvement and physician global scores, the dcjSSc patients had significantly more severe disease. These observations strengthen our previous findings of the unique organ pattern of pediatric patients.Supported by the “Joachim Herz Stiftung”None declared.