Abstract Background: The relationship between different surrogates of insulin resistance and left ventricular geometry in obese children is still unclear. Objective: We sought to explore the relationship between commonly used measures of insulin sensitivity/resistance (homeostatic model assessment index, serum uric acid, and triglycerides to high-density lipoprotein cholesterol ratio) and left ventricular geometry in normotensive obese children. Methods: In this cross-sectional study, 32 normotensive obese children were examined. Transthoracic echocardiography was used to measure left ventricular mass index and relative wall thickness. Homeostasis model assessment index, serum uric acid level, and a ratio of triglycerides to high-density lipoprotein cholesterol were used as markers of the insulin resistance. Simple and partial correlation analyses (to control for the effects of body mass index) were conducted to explore relationship between studied variables and left ventricular mass index or relative wall thickness as outcome variables. Results: We found positive correlations between homeostasis model assessment index and relative wall thickness (r = 0.47, p = 0.03) which remained significant after controlling for the effect of body mass index, z-score (r = 0.48, p = 0.03). The cutoff level of homeostasis model assessment index with the optimum sensitivity (Sn) and specificity (Sp) derived from the receiver operating characteristic (ROC) curves for predicting concentric remodelling was ≥5.51 with Sn = 83.33 and Sp = 68.75. Conclusion: There is a positive relationship between homeostasis model assessment index and relative wall thickness of obese normotensive children which may help to distinguish at risk obese normotensive children for the development of concentric left ventricular remodelling.

This paper presents a novel control algorithm for variable speed wind generators (VSWG), designed to provide support to grid frequency regulation. The proposed control algorithm ensures that VSWG ‘’truly’’ emulates response of a conventional generating unit with non-reheat steam turbine (GUNRST) in the first several seconds after active power unbalance. A systematic method of analysis and synthesis of the new control algorithm is described in detail.

OBJECTIVES The physical activity level (PAL) has significantly decreased as a result of the social distancing and lockdown related to the COVID‑19 pandemic, but there is a lack of knowledge on the correlates of PAL during the pandemic. The aim of this research was to examine the influence of pre-pandemic sports participation and substance use and misuse (SUM) on PAL during the COVID‑19 pandemic. MATERIAL AND METHODS The study included 661 high-school students from Bosnia and Herzegovina (aged 15-18 years, 292 females). The investigation included 2 testing waves: before the COVID‑19 pandemic (baseline, January 2020) and during the COVID‑19 lockdown (follow-up, April 2020). The variables included PAL as measured by the Physical Activity Questionnaire for Adolescents, sports factors, and SUM. RESULTS Sports factors at baseline were positively correlated with PALs at both baseline and follow-up. Smoking tobacco negatively affected PALs at both baseline and follow-up. Alcohol consumption was positively correlated with PAL at baseline but had no effect on PAL at follow-up. CONCLUSIONS This study confirmed the importance of sports participation in maintaining PAL during challenging situations, such as the COVID‑19 lockdown. The substance-specific influence of SUM on PAL before and during the lockdown points to evident social and cultural aspects of SUM behaviors in adolescents. Further studies evidencing the cumulative effects of PAL decline during the lockdown are warranted.

Many research studies suggest that the increasing competitiveness of the global economy emphasizes the importance of identifying the drives of sustainable competitive advantage in the intangible domain. This research aims to, according to resource-based theory of the enterprise, model corporate reputation as an invisible resource of the enterprises that enables the creation of the various advantages such as customer satisfaction and gaining loyal customers that further leads to creating competitive advantage and superior business performance. The research aim is to determine the significance and intensity of the simultaneous relationships between corporate reputation, presented as a construct composed of two elements: competence and likeability, and customer satisfaction and customer loyalty. It seeks to determine the significance of the mediator customer satisfaction in the relationship between corporate reputation and customer loyalty. Research data are collected by a survey questionnaire fulfilled by 116 respondents to participate in the research on enterprises from the telecommunication sector of transition economy Republic of Srpska, Bosnia and Herzegovina. To test the proposed research model partial least squares structural equation modelling (PLS-SEM) is applied. Prior to application of the PLS-SEM certain preliminary data and sample analysis are performed. The presence of outliers and requirements of the sample size for PLS-SEM evaluation are examined. To determine whether final sample size is appropriate to conduct PLS-SEM analysis both rule of thumb and results of the analysis made by G*Power software were used. Construct likeability has nearly two times stronger direct effect on customer satisfaction compared to other element of corporate reputation called competence. Only one element of corporate reputation called likeability has significant direct effect on final target endogenous construct customer loyalty. Customer satisfaction has strong significant direct effect on customer loyalty. Beside direct effects of the latent constructs corporate reputation and customer satisfaction on customer loyalty, mediation analysis is performed to test the significance of the mediator called customer satisfaction. Research results indicate the importance of the mediator customer satisfaction in the relationship between corporate reputation and customer loyalty. According to them, both elements of corporate reputation have significant indirect effect on customer loyalty. Likewise, research results enable ranking of the exogenous factors that create and improve corporate reputation. Directing the management attention towards improving certain exogenous factors ensures the development of certain corporate reputation elements – competence and likeability, and provides efficient and effective corporate reputation management. It is revealed that corporate social responsibility, promoting products’ and services’ quality and better business performances improve competence element of corporate reputation, while corporate social responsibility and investments into raising the attractiveness of the enterprise positively influence sympathy and likeability of the enterprises from a stakeholder perspective.

With the rapid advances in IoT, edge and cloud computing solutions, it is critical to educate and train students in computer science and engineering in various aspects of IoT-edge-cloud (IoT-E-C) system architecture implementations. We outline the design and development of an undergraduate laboratory course that sets the goal of implementing various interfaces and communication protocols to connect IoT, edge and cloud computing systems and evaluating their performance. The lab setup is modular and based on open source tools. In the IoT context, it consists of low-cost processing platforms with various sensors and actuators. In the edge and cloud computing context, we implement and deploy single board computers and Firebase cloud solutions, respectively. The modular lab setup allows students to engineer and integrate various communication protocol solutions, including MQTT, COAP and HTTP. In addition to the system implementation, students can evaluate and benchmark the performance of the entire system.

Recipient effector T cells differentiate into functional tissue-resident memory T cells, causing graft rejection after kidney transplantation. Memories of rejection Long-term graft survival after organ transplantation can be hindered by immune-mediated allograft rejection; thus, understanding these immune responses is crucial to developing new transplant-supporting therapies. Tissue-resident memory T cells (TRM), a subset of memory T cells that reside in barrier tissues and do not recirculate, are detectable in transplanted organs, but it is unclear if they contribute to allograft rejection. Abou-Daya et al. created a mouse model of T cell–mediated kidney transplant rejection, showing that adoptively transferred, kidney antigen–specific effector T cells differentiated into functional, nonrecirculating antigen-specific TRM in the transplanted kidneys. These kidney antigen–specific TRM induced allograft rejection. These data suggest that TRM in transplanted allografts can contribute to rejection and that targeting alloreactive TRM might improve long-term graft survival in transplant recipients. Tissue-resident memory T cells (TRM) contained at sites of previous infection provide local protection against reinfection. Whether they form and function in organ transplants where cognate antigen persists is unclear. This is a key question in transplantation as T cells are detected long term in allografts, but it is not known whether they are exhausted or are functional memory T cells. Using a mouse model of kidney transplantation, we showed that antigen-specific and polyclonal effector T cells differentiated in the graft into TRM and subsequently caused allograft rejection. TRM identity was established by surface phenotype, transcriptional profile, and inability to recirculate in parabiosis and retransplantation experiments. Graft TRM proliferated locally, produced interferon-γ upon restimulation, and their in vivo depletion attenuated rejection. The vast majority of antigen-specific and polyclonal TRM lacked phenotypic and transcriptional exhaustion markers. Single-cell analysis of graft T cells early and late after transplantation identified a transcriptional program associated with transition to the tissue-resident state that could serve as a platform for the discovery of therapeutic targets. Thus, recipient effector T cells differentiate into functional graft TRM that maintain rejection locally. Targeting these TRM could improve renal transplant outcomes.

Abstract Our study aimed to develop and validate a reliable instrument that can measure the quality of life (QOL) of patients with cervical cancer living in a developing country, such as the Central Balkan country, Serbia. Our study was cross-sectional for assessing the reliability and validity of a questionnaire. Balkan questionnaire for QOL of patients with cervical cancer showed satisfactory reliability and temporal stability. When the investigators rated the questionnaire, Cronbach’s alpha was 0.971 at the beginning, and one month later it was 0.967. When the questionnaire was rated by patients themselves, Cronbach’s alpha was 0.972. The questionnaire should be considered as an addition to the existing armamentarium for measuring the quality of life in patients with cervical cancer.

In this article, we empirically analyze European Collateralized Loan Obligations (CLOs) in the aftermath of the financial crisis. As Regulation introduced the so-called risk retention rule, originally designed to align interests between issuers and investors, we analyze the implications and effects of the risk retention rule on managed cash CLOs (arbitrage deals). Although the market suffered severely during the period after the rule was introduced, an alignment of interests between issuers and investors does not necessarily seem to have been attained. Here, we examine the implications of risk retention on asset pricing and find that CLO manager experience, credit rating and issuance amount are important factors that significantly influence pricing expectations of CLO investors. However, the form in which the CLO manager retains the risk does not seem to play a role.

Although homeostasis is a commonly accepted concept, there is incontrovertible evidence that biological processes and functions are variable and that variability occurs in cycles. In order to explain and understand dysregulation, which has not been embraced by homeostatic principles, the allostatic model has emerged as the first serious challenge to homeostasis, going beyond its homeostatic roots. Circadian rhythm is the predominant variation in the body, and it is a pattern according to which many physiological and pathological events occur. As there is strong experimental and clinical evidence that blood pressure fluctuations undergo circadian rhythm, there is equally strong evidence that targeted time therapy for hypertension provides a better outcome of the disease. The research has gone even further throughout the development and approval process for the use of pulsatile drug release systems, which can be considered as an option for an even more convenient dosage regimen of the medicines needed.

Abstract In patients with pulmonary embolism (PE), the D-Dimer assay is commonly utilized as part of the diagnostic workup, but data on D-Dimer for early risk stratification and short-term mortality prediction are limited. The purpose of this study was to determine D-Dimer levels as a predictive biomarker of PE outcomes in younger (<50 years of age) compared to older patients. We conducted retrospective analysis for 930 patients diagnosed with PE between 2015 and 2019 as part of the Serbian University Multicenter Pulmonary Embolism Registry (SUPER).All patients had D-Dimer levels measured within 24 hours of hospital admission. The primary outcome was mortality at 30 days or during hospitalization. Patients were categorized into two groups based on age (≤ 50 and >50 years of age). Younger patients constituted 20.5% of the study cohort. Regarding all-cause mortality, 5.2% (10/191)of patients died in group under the 50 years of age; the short-term all-causemortality was 12.4% (92/739) in older group.We have found that there was significant difference in plasma D-Dimer level between patients ≤ 50 years of age and older group (>50), p= 0.006.D-Dimer plasma level had good predictive value for the primary outcome in younger patients (c-statistics 0.710; 95% CI, 0.640-0.773; p<0.031). The optimal cutoff level for D-Dimer to predict PE-cause death in patients aged > 50 years was found to be 8.8 mg/l FEU(c-statistics 0,580; 95% CI 0.544-0.616; p=0.049). In younger PE patients, D-Dimer levels have good prognostic performance for 30-day all-cause mortalityand concentrations above 6.3 mg/l FEU are associated with increased risk of death. D-Dimer in patients aged over 50 years does not have predictive ability for all-caused short-term mortality. The relationship between D-Dimer and age in patients with PE may need further evaluation.

We aimed to explore factors for optimizing antimicrobial treatment in emergency departments. A single-day point prevalence survey was conducted on January 18, 2020, in 53 referral/tertiary hospitals in 22 countries. 1957 (17%) of 11557 patients presenting to EDs had infections. The mean qSOFA score was 0.37 ± 0.74. Sepsis (qSOFA ≥ 2) was recorded in 218 (11.1%) patients. The mean qSOFA score was significantly higher in low-middle (1.48 ± 0.963) compared to upper-middle (0.17 ± 0.482) and high-income (0.36 ± 0.714) countries ( P < 0.001). Eight (3.7%) patients with sepsis were treated as outpatients. The most common diagnoses were upper-respiratory (n = 877, 43.3%), lower-respiratory (n = 316, 16.1%), and lower-urinary (n = 201, 10.3%) infections. 1085 (55.4%) patients received antibiotics. The most-commonly used antibiotics were beta-lactam (BL) and BL inhibitors (n = 307, 15.7%), third-generation cephalosporins (n = 251, 12.8%), and quinolones (n = 204, 10.5%). Irrational antibiotic use and inappropriate hospitalization decisions seemed possible. Patients were more septic in countries with limited resources. Hence, a better organizational scheme is required.

In this work, we reinterpret ATLAS and CMS dijet resonance searches to set robust constraints on all hypothetical tree-level scalar and vector mediators with masses up to 5 TeV, assuming a diquark or a quark-antiquark coupling with an arbitrary flavor composition. To illustrate the application of these general results, we quantify the permissible size of new physics in B¯q→Dq∗+πK\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\overline{B}}_q\to {D}_q^{\left(\ast \right)+}\left\{\pi, K\right\} $$\end{document} consistent with the absence of signal in dijet resonance searches. Along the way, we perform a full SMEFT analysis of the aforementioned non-leptonic B meson decays at leading-order in αs. Our findings uncover a pressing tension between the new physics explanations of recently reported anomalies in these decays and the dijet resonant searches. The high-pT constraints are crucial to drain the parameter space consistent with the low-pT flavor physics data.