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D. Mozetič, A. Vuković, M. Avirović, Irena Seili Bekafigo, Dora Fučkar Čupić, Ksenija Jurinović, Gordana Đorđević, S. Eminović et al.

Aim: To determine the impact of the COVID-19 pandemic on the overall practice of the histopathological and cytological laboratory at the University Hospital Centre Rijeka, and on the diagnosis of the most common cancers. Methods: The numbers of histopathological and cytological reports, newly diagnosed cancers of breast, lung, colon, endometrium, and prostate, molecular tests for EGFR mutations and HPV were extracted. Two periods, from March 1 to September 30 in 2019 and 2020 were analysed and compared, as the periods before and during the COVID-19 pandemic. Results: The total number of reports was statistically significantly lower during the COVID-19 pandemic in 2020, compared to the same period in 2019 (p<0.000), histopathology by 24%, non-gynecological cytology by 20%, gynecological cytology by 13%, and Pap tests by 11%. During COVID-19 compared to the same period in 2019 the number of newly diagnosed malignant tumors was significantly reduced for colon cancers (–25%, p <0.0001). The decrease in the new cases of breast (–3%) and prostate cancer (–4%) was less pronounced while the increase was recorded for lung (+ 2%) and endometrial cancer (+ 53%). The number of HPV tests dropped significantly during the COVID-19 pandemic, by 40% (p <0.0001). Conclusions: This study confirmed the expected significant reduction in workload during the first wave of the COVID-19 pandemic in 2020, from 11% to 40%, although the number of patients with newly diagnosed cancers, except for colon, did not fall significantly. It would be important to form a joint national registry that would collect diagnostic and also therapeutic procedures, especially for oncology patients, in order to gain a more objective insight into the problems of the health system during pandemics. These data can be used to consider measures and strategies for the most adequate care, not only for COVID-19 but also for all other patients. © 2021 Hrvatski Lijecnicki Zbor. All rights reserved.

A. Mehonic, A. Kenyon

New computing technologies inspired by the brain promise fundamentally different ways to process information with extreme energy efficiency and the ability to handle the avalanche of unstructured and noisy data that we are generating at an ever-increasing rate. To realize this promise requires a brave and coordinated plan to bring together disparate research communities and to provide them with the funding, focus and support needed. We have done this in the past with digital technologies; we are in the process of doing it with quantum technologies; can we now do it for brain-inspired computing? The benefits and future prospects of neuromorphic, or bio-inspired, computing technologies are discussed, as is the need for a global, coordinated approach to funding, research and collaboration.

Muhamed Ajanović, Selma Tosum Pošković, K. Kožul, Alma Kamber-Ćesir, A. Đonlagić, M. Kacila, Lejla Kazazić

Introduction: Dentists and generally dental personnel work under the risk of being infected by patients suffering from COVID-19, who are unaware that they are infected.  The reason lies in the fact that during dental procedures, aerosol is formed with droplets that may contain the virus. Thus, it is extremely important that dental personnel complies with adequate protective measures and equipment during clinical work. The aim of this investigation was to evaluate the knowledge of COVID-19 and determine the amount of stress with dental personnel of the Faculty of Dentistry in Sarajevo, Bosnia and Herzegovina.  Methods: Health care personnel of the Faculty of Dentistry with Clinics of the University in Sarajevo have been included in the research: teaching staff, clinical doctors, dental nurses and dental technicians. The research was conducted in April 2020. It was conducted by an anonymous survey that participants filled-in. Out of 157 distributed questionnaires in paper form, 134 participants responded. The questionnaire was divided into 3 parts: 1) personal data 2) knowledge of infection COVID-19 (diagnostic methods, transmission pathways, prevention measures); 3) the amount of stress (feelings and thoughts) during epidemic COVID-19 with personnel. Results: The largest number of participants (61.97%) consider that COVID-19 may be transmitted from infected to a healthy person by inhalation of droplets generated through coughing of an infected person and by direct contact with aerosol dispersed from the mouth of the infected patient during dental treatment. The largest number of participants, 80 of them (59.7%) consider that the method of nucleic acid test is used in diagnosing COVID-19.  COVID – 19 had a significantly larger influence on females; they showed higher extent of concern for the claim „I hardly fall asleep because of thinking about it“, „I try not to talk on this topic“ and „In my mind appear pictures in relation to this.“ (p<0.05) Conclusion: Knowledge of COVID-19 and measures of protection of health care personnel at the Faculty of dentistry with Clinics in Sarajevo is satisfactory. The largest fear of participants was fear of unconsciously transmitting the infection on people close to them and that members of their families become infected with COVID-19.

Željko Stević, Çağlar Karamaşa, Ezgi Demir, Selçuk Korucuk

PurposeForests are negatively affected from rapid world population increase and industrialization that create intense pressures on natural resources and the possibility of an achieving circular economy. Forests can be considered as essential resources for providing sustainable society and meeting the requirements of future generations and circular economy. Therefore sustainable production tools as part of circular economy can be handled as one of the basic indicators for achieving circular economy. Accordingly the main purpose of this study is developing a novel rough – fuzzy multi-criteria decision-making model (MCDM) for evaluation sustainable production for forestry firms in Eastern Black Sea Region.Design/methodology/approachFor determining 18 criteria weights a novel Rough PIPRECIA (PIvot Pairwise RElative Criteria Importance Assessment) method is developed. Eight decision-makers (DMs) participated in the research, and to obtain group rough decision matrix, rough Dombi weighted geometric averaging (RNDWGA) operator has been applied. For evaluation forestry firms fuzzy MARCOS (Measurement of alternatives and ranking according to COmpromise solution) method was utilized.FindingsAfter application developed model the fourth alternative was found as the best. Sensitivity analysis and comparison were made to present the applicability of this method.Originality/valueDevelopment of novel integrated Rough PIPRECIA-Fuzzy MARCOS model with emphasis on developing new Rough PIPRECIA method.

M. D. De Herdt, Berdine van der Steen, Quincy M. van der Toom, Y. Aaboubout, S. Willems, M. Wieringa, R. J. Baatenburg de Jong, L. Looijenga et al.

Objective MET positivity is independently associated with survival in oral squamous cell carcinoma (OSCC). Since MET is a known orchestrator of invasive tumor growth, we investigated its association with LNM in early oral tongue squamous cell carcinoma (OTSCC). As it is recommended by the NCCN to use tumor depth of invasion (DOI) in making decisions on elective neck dissection (END), the results obtained for MET positivity were aligned with those for DOI > 4 mm. The cutoff value used in our institution. Methods Tumor samples from patients who underwent primary tumor resection and neck dissection between 1995 and 2013, were collected from the archives of the Leiden and Erasmus University Medical Center. Immunohistochemistry with D1C2 was performed to identify MET negative (< 10% uniform positivity) and MET positive (≥ 10% uniform positivity) cancers. ROC curve analysis and the Chi-squared test were used to investigate the association of MET positivity with LNM (pN+ and occult). Binary logistic regression was used to investigate the association of MET positivity with LNM. Results Forty-five (44.1%) of the 102 cancers were MET positive. Ninety were cN0 of which 20 were pN+ (occult metastasis). The remaining 12 cancers were cN+, of which 10 were proven pN+ and 2 were pN0. MET positivity was associated with LNM with a positive predictive value (PPV) of 44.4% and a negative predictive value (NPV) of 82.5% for pN+. For the occult group, the PPV was 36.8% and the NPV was 88.5%. Regression analysis showed that MET positivity is associated with pN+ and occult LNM (p-value < 0.05). Conclusion MET positivity is significantly associated with LNM in early OTSCC, outperforming DOI. The added value of MET positivity could be in the preoperative setting when END is being considered during the initial surgery. For cases with DOI ≤ 4 mm, MET positivity could aid in the clinical decision whether regular follow-up, watchful waiting, or END is more appropriate. Realizing that these preliminary results need to be independently validated in a larger patient cohort, we believe that MET positivity could be of added value in the decision making on END in early OTSCC.

J. Milovanović, O. Milovanović, A. Tomić Lučić, J. Djoković, T. Cvetković, S. Živanović, Ana Barjaktarević, S. Pantovic et al.

ABSTRACT Optimal vitamin D status is very important for reflecting not only bone but overall woman’s health. The aim of the study was to determine pharmacokinetic variability of 25-hydroxy vitamin D, to reveal and quantify the most significant factors that affect its variability in the population of healthy non-menopausal women using the population pharmacokinetic (PopPK) approach. The study population consisted of 74 healthy reproductive women aged from 35 to 50 years, without the use of any supplement. A population pharmacokinetics analysis was conducted using a nonlinear mixed-effects model software. A total of 35 factors were assessed: demographic, clinical, biochemical data and lifestyle factors. The average age and bodyweight of our participants were 40.11 ± 4.35 years 65.30 ± 6.80 kg, respectively. The observed mean serum concentration of 25-hydroxy vitamin D was 26.51 ± 13.49 ng/mL with a wide range of 6.97 to 59.89 ng/mL. Development final PopPK model of the clearance of 25-hydroxy vitamin D showed that only the average daily dose of vitamin D intake from food had a significant influence, with a magnitude of its effects of 0.00401. These results could help when individualizing vitamin D intake in the form of supplements, especially during the wintertime, in healthy reproductive women.

Semir Mehović, S. Janković, Z. Tafi

Introduction: Type 2 diabetes mellitus is a chronic disease that is causing enormous economic and social costs. It is characterized by many microvascular and macrovascular complications, such as heart attack, stroke, retinopathy, nephropathy, neuropathy, etc. Such complications can cause severe limitations and decrease the quality of life. The objective of this study was to assess the effect of type 2 diabetes mellitus on the quality of life using the EQ-5D-5L questionnaire, taking into account cardiovascular complications (heart attack, hospitalization due to angina pectoris, stroke, hospitalization due to heart insufficiency, transient ischemic attack, coronary revascularisation), complications of diabetes (microalbuminuria, renal failure, retinopathy, and neuropathy), and demographic characteristics (age, gender, body mass index, height, and weight).Materials and Methods: This cross-sectional study included 484 participants with type 2 diabetes mellitus. Quality of life was estimated by the EuroQol instrument EQ-5D-5L and visual analogue scale (VAS). The following complications related to type 2 diabetes were taken into account: heart attack, hospitalization due to angina pectoris, stroke, hospitalization due to heart insufficiency, transient ischemic attack, coronary revascularization, microalbuminuria, renal insufficiency, retinopathy, and neuropathy.Results: The mean value of the EQ index was 0.895, with the value of -0.59 as the lowest, and 1.0 as the highest quality of life of the study patients. Multivariate linear regression model showed that heart attack, hospitalization due to unstable angina pectoris, retinopathy, and neuropathy significantly decreased the quality of life of the study participants (p<0.05). Spearman's correlation showed that there was a significant correlation between age, height, duration of type 2 diabetes, body mass index, and the EQ index (p<0.001).Conclusion: The results suggest that type 2 diabetes complications, such as heart attack, neuropathy, retinopathy, and hospitalization due to unstable angina pectoris significantly decrease the quality of life of type 2 diabetes mellitus patients (T2DM).

Jasminka Hasić Telalović, S. Pillozzi, Rachele Fabbri, A. Laffi, D. Lavacchi, Virginia Rossi, Lorenzo Dreoni, F. Spada et al.

The application of machine learning (ML) techniques could facilitate the identification of predictive biomarkers of somatostatin analog (SSA) efficacy in patients with neuroendocrine tumors (NETs). We collected data from 74 patients with a pancreatic or gastrointestinal NET who received SSA as first-line therapy. We developed three classification models to predict whether the patient would experience a progressive disease (PD) after 12 or 18 months based on clinic-pathological factors at the baseline. The dataset included 70 samples and 15 features. We initially developed three classification models with accuracy ranging from 55% to 70%. We then compared ten different ML algorithms. In all but one case, the performance of the Multinomial Naïve Bayes algorithm (80%) was the highest. The support vector machine classifier (SVC) had a higher performance for the recall metric of the progression-free outcome (97% vs. 94%). Overall, for the first time, we documented that the factors that mainly influenced progression-free survival (PFS) included age, the number of metastatic sites and the primary site. In addition, the following factors were also isolated as important: adverse events G3–G4, sex, Ki67, metastatic site (liver), functioning NET, the primary site and the stage. In patients with advanced NETs, ML provides a predictive model that could potentially be used to differentiate prognostic groups and to identify patients for whom SSA therapy as a single agent may not be sufficient to achieve a long-lasting PFS.

Ivona Čarapina Zovko, Jakov Milić, Filip Bartolomeo Vucemilovic, Nika Jemrić, Petra Sulić, Matea Turudić, Dominic Vidović, Dorotea Jelovica et al.

Introduction: Clance Impostor Phenomenon Scale (CIPS) is the most common and psychometrically sound instrument used to measure the impostor phenomenon. The aim of this study was to translate and make a cultural adaptation of the CIPS from English into Croatian. Materials and Methods: The translation process included two independent forward translations, combination of the forward translations into one single translation, back-translation, back-translation review, pre-piloting and drafting of the final translation after several revisions and minor adjustments by a professional reviewer. Results: We noticed no semantic differences when comparing the original and the back-translated versions of the CIPS. Thus, the final translation was only slightly changed in comparison with the first version. Conclusions: The version of the CIPS which was translated and culturally adapted into Croatian represents a reliable translation ready to be used in Croatia and Bosnia and Herzegovina.

A. Jakovljević, T. S. Jakovljevic, H. Duncan, V. Nagendrababu, J. Jaćimović, A. Aminoshariae, Jelena Milasin, P. Dummer

BACKGROUND The association between adverse pregnancy outcomes (APOs) and maternal apical periodontitis remains unclear as it has not been examined rigorously or reviewed systematically. OBJECTIVE To systematically review and critically evaluate the available evidence on the association of maternal apical periodontitis with several APOs. METHODS A literature search was conducted using the following electronic databases: Clarivate Analytics' Web of Science, Scopus, PubMed, and Cochrane Database of Systematic Reviews (CDSR), from inception to 25 February 2021, with no language restrictions. Observational studies including longitudinal clinical trials, cohort, case-control, and cross-sectional studies of prospective and retrospective design were included. Articles with duplicate or overlapping results, abstract-only papers, case reports, case series, animal studies and reviews were excluded. Two independent reviewers were involved in study selection, data extraction and appraising the included studies; disagreements were resolved by a third reviewer. The Newcastle-Ottawa Scale (NOS) and the adapted form of the NOS were used to assess the quality for case-control and cross-sectional studies, respectively. RESULTS Two case-control and one cross-sectional study were included in the current review. The included studies were published between 2015 and 2017, with a total of 1187 participating individuals with an approximate age range of 15 to 40 years. As the included studies reported different outcomes, the heterogeneity of data prevented the use of a meta-analysis. The overall quality of the evidence was "Fair" for two out of three included studies, while one study was categorised as "Good". DISCUSSION Two out of three included primary studies had a substantial number of methodological inconsistencies and flaws, and caution should be exercised in interpreting the results of this systematic review because several important covariates were not considered in the original investigations. CONCLUSION Based on a limited volume and "Fair" and "Good" quality of evidence, a positive association between maternal apical periodontitis and APOs was observed. However, more "Good" quality clinical studies are needed to confirm the results of the current review.

multilateral policy spaces. Let us not forget that on the twentieth anniversary of UNSCR 1325 last year, Russia proposed a draft resolution to the UNSC that, if passed, would have seriously diluted the hard-won advances of the past two decades. The resistance to the agenda, notably by antifeminist regional and transnational coalitions, is certainly one of the most serious threats that the WPS community is facing today. In the form of a conversation between Joy Onyesoh, Madeleine Rees, and Catia Cecilia Confortini – all affiliated with the Women’s International League for Peace and Freedom (WILPF) – the last chapter tackles the question of co-optation and how feminist advocacy has a role to play in confronting this challenge. To conclude, while this cutting-edge volume fulfills its promise, the “new directions” referred to in the title could have been more explicitly defined and discussed; its contributions could have been more clearly highlighted with the addition of a conclusion bringing together the insights of the 14 chapters. New Directions in Women, Peace and Security nonetheless offers a remarkable and accessible overview of the current theoretical debates in the field, as well as the future research avenues and policy challenges of the constantly evolving WPS agenda.

Amar Aganovic, G. Cao, Tomáš Fečer, B. Ljungqvist, B. Lytsy, Andreas Radtke, Berit Reinmüller, R. Traversari

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