Abstract We performed simulations of Rayleigh-Benard convection (RBC) for very high Ra number, 10 9 , 10 12 , 10 13 , 10 14 and 10 16 , thus beyond the reach of classical LES, by using an elliptic-relaxation hybrid RANS-LES (ER-HRL) model paired with a compound wall treatment that allows much coarser mesh resolution in the near wall region. The standard switching criterion used in the hybrid RANS-LES modeling based on wall distance is modified and linked to the local turbulence properties in order to sustain the modeled turbulence production in the RBC configuration. The proposed hybrid model successfully predicts the main integral and mean flow features at Ra = 10 9 for which experimental and LES data exists. The Nusselt number obtained is closely following the power law correlation based on 0.307 exponent up to Ra = 10 13 . For higher Ra number, the Nusselt number displays a Ra -scaling behaviour that is consistent with the so-called ultimate regime, where Nu ≈ Ra 1 / 2 . Furthermore, unlike LES, the ER-HRL model provides generally good results even when using a very coarse mesh at high Ra number. The instantaneous three-dimensional fields reveal interesting features of the Rayleigh-Benard convection at very high Ra number such as a strong correlation between instantaneous pressure and temperature fields, a major similarity of the flow structures in the near-wall region to those present in the impinging jet, existence of the superstructures and their tendency to cluster and localise with increasing Ra number. The simulations are performed with an in–house unstructured finite-volume code T-Flows, using second-order-accuracy discretisation schemes for space and time.
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.
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.
OBJECTIVE The aim of our study was to determine the etiological factors, treatment and outcome of patients with non-variceal bleeding from upper gastrointestinal tract. MATERIALS AND METHODS This study enrolled 200 patients admitted to Sarajevo University Clinical Center with signs and symptoms of upper gastrointestinal bleeding, from January 2019 to July 2020. All patients had undergone gastroscopy, confirming the cause of gastrointestinal bleeding. Clinical and laboratory data were collected retrospectively, including previous non-steroid antiinflammatory drugs (NSAIDs) and anticoagulant therapy, comorbidities, risk factors, as well as endoscopic findings, laboratory findings, treatment and clinical follow-up. RESULTS The majority of patients were men (59%) with an average age of 53±6 years. Duodenal and gastric ulcers were the most common cause, followed by other etiologies. In our study, previous NSAIDs therapy had been registered in 29.5% of patients, anticoagulants in 8%, and proton pump inhibitors (PPI) in 2.9% of patients. Endoscopic intervention was required in 34% of patients. The need for transfusion occurred in 44.5% of cases. Rebleeding during hospitalization was observed in 7.5% of patients, mortality in 1.5% and surgery in 3% of patients. CONCLUSION The patients admitted to our hospital with symptoms of acute nonvariceal upper gastrointestinal bleeding were elderly, predominantly males, with significant comorbidities and a higher incidence of NSAID use. Gastroprotection is underutilized during NSAID treatment in patients with other coexisting risk factors, with a low rate of concomitant use of PPI during NSAIDs therapy. Endoscopic therapy, together with PPI, significantly reduces rebleeding rates, mortality and the number of emergency surgical interventions.
Although absolute jump heights should be considered an important factor in judging the performance requirements of volleyball players, limited data is available on age-appropriate categories. The purpose of this study is to determine the differences in specific anthropometric characteristics and jumping performance variables in under−19 female volleyball players in relation to playing position and performance level. The sample of subjects consisted of 354 players who prepared for the U19 Women’s Volleyball European Championship 2020 (17.4 ± 0.8 years, 1.81 ± 0.07 m, 67.5 ± 7.1 kg). Playing positions analyzed were setters (n = 55), opposites (n = 37), middle blockers (n = 82), outside hitters (n = 137), and liberos (n = 43). The results showed player position differences in every performance level group in variables of body height, spike, and block jump. Observed differences are a consequence of highly specific tasks of different positions in the composition of the team. Players of different performance levels are significantly different, with athletes of higher-ranked teams achieving better results. The acquired data could be useful for the selection and profiling of young volleyball players.
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.
Aim To evaluate satisfaction of mothers who gave birth at term with received hospital care and to find areas for improvement at a tertiary hospital. Methods A cross-sectional study at the Department of Obstetrics & Gynaecology at the University Clinical Hospital Mostar was conducted by an anonymous survey using a questionnaire designed exclusively for this study. A total of 100 mothers were included in the study. Results Satisfaction with midwives' communication and their approach to the women during their stay in the delivery room was rated significantly higher (4.7±0.6) when compared to obstetricians-gynaecologists (4.5±0.8) (p=0.02). Midwives were rated better in providing breastfeeding information (4.5±0.8) than for the speed of arrival after a call bell (average grade 4.2±1.0). Respondents were least satisfied with the hygiene (toilet, shower and rooms) and the quality of food (average grades 3.8±1.1 and 3.9±1.0, respectively). Mothers with previous experience in childbirth at the same hospital rated current stay with a similar level of satisfaction. Conclusion Good communication skills of medical and non-medical staff are a recommended step to maintain mothers' childbirth satisfaction, while improvement in quality of nutrition and hygiene should be mandatory.
Background: Haematochesia (Lower Gastrointestinal Bleeding (LGIB) is the most common reason for endoscopic examination. Generaly it is caused by hemorrhoids and diverticular disease, but other anorectal conditions can also lead to LGIB. Recurrent bleeding may result in secondary iron deficiency anemia. Colonoscopy is the primary diagnostic option for establishing a diagnosis of colonic bleeding. Objective: This study aimed to analyze symptoms and endoscopic finding (specialy hemorrhoids) who may be sources of LGIB.Second goal of this study is to estimate time from onset of symptoms to performance of a colonoscopy. Methods: A retrospective study included 603 adult patients who underwent colonoscopy in General Hospital “Sv. Apostol Luka“, Doboj, Bosnia and Herzegovina, between 1.1.2020 and 31.12.2020. Results: Average age of the examined population was 62±13,3years. According to the gender they were mostly men. To be exact,by percentage it was 53.7% of men and 46,3% of women, or by number: 324 men and 279 women. The most common indications for colonoscopy were LGIB (48,8%), abdominal pain and irregular stool. Most frequent endoscopic findings were hemorrhoids 42%. Normal findings had almost one third of all examinated patients. Combined findings-presence of more clinical entities in one patient were presented in 95 cases. In the group with hemorrhoids were almost two thirds of males, but there was no gender difference noted in between group with LGIB and without LGIB. More than half patients were older than 61 years. Anemia was presented in almost 20% of cases. Significantly it is higher frequency of abdominal pain, irregular stool and weight loss observed on the group without LGIB. Also, significantly more frequently patients with LGIB underwent colonoscopy in 0-30 days when compared with patients without LGIB (p=0,016). Conclusion: In patients with haematochezia, taking a careful medical history is mandatory. Hemorrhoids, diverticular disease and colorectal cancers are the most common causes of bleeding. Patients with LGIB and abdominal pain were previously examined with colonoscopy. Completely colonoscopy is advocated to detect probable proximal lesions.
Aim To identify predictive factors related with noninvasive ventilation (NIV) failure that are not based on the patient's respiratory status or acid base gas analyses in COVID-19 critically ill patients, and to create a predictive model of NIV failure. Methods A total of 73 COVID-19 critically ill patients who developed acute respiratory failure and underwent NIV were divided into two groups: Group 1, patients who required endotracheal intubation and invasive mechanical ventilation after NIV and Group 2, patients with successful weaning from NIV. Demographic data, clinical symptoms and signs, clinical index and scores, duration indicators and laboratory data were analysed. Predictive factors of NIV failure were assessed using univariate and multivariate regression analyses followed by the receiver operating characteristic (ROC) curve. Results In the Group 1 (NIV failure) there were 54 (73.97%) patients. Predictive factors for NIV failure were: the presence of dyspnoea on the day of admission at hospital (p<0.05; sensitivity 44.40%; specificity 84.20%), higher radiographic assessment of lung oedema score (RALES) on the day of starting NIV (p<0.009; sensitivity 70.40%; specificity 73.75%), higher length of NIV (p<0.014; sensitivity 48%; specificity 84.10%) and higher urea on the day of starting NIV (p<0.004; sensitivity 70.44%; specificity 73.72%) Conclusion NIV treatment in COVID-19 critically ill patients has a high failure rate. In addition to respiratory parameters, dyspnoea, higher RALES, higher length of NIV and increased urea value could predict NIV failure. These factors should be considered in treatment decision making.
Aim To analyse demographic data, clinical symptoms and signs, laboratory data and comorbidities in patients with COVID-19 pneumonia admitted to the intensive care unit (ICU), mechanically ventilated with fatal outcome. Methods Medical records of 92 patients were retrospectively analysed. Demographic data, clinical symptoms and comorbidities were collected on the day of hospital admission. Clinical signs and laboratory data were collected on the day of hospital admission (T1), on the day of starting non-invasive ventilation (T2), and on the day of starting invasive ventilation (T3). Results Average age of the patients was 60.05 years. Patients over 50 years of age, 71 (77.1%) (p=0.000), and males, 62 (67.4%; p=0.001) were predominant. The most common patient symptoms were exhaustion, myalgia, dyspnoea and cough. Hyperthermia was recorded on the day of hospital admission. Tachycardia, hyperglycaemia, hypoxemia were recorded at all observed study times. The most common comorbidity was hypertension arterialis with a very strong correlation with fatal outcome, followed by diabetes mellitus and chronic heart disease that were moderately correlated with fatal outcome. Conclusion The treatment of COVID-19 patients in ICU with mechanical ventilation has a high failure rate. Demographic data, clinical symptoms and signs as well as accompanying comorbidities can be a significant component in making decisions about diagnostic-therapeutic procedures.
AbstractCoanda-effect screens exclude coarse and fine debris from a variety of water intakes. Water overflows an inclined wedge-wire screen with tilted wires that shear high velocity flow from the ...
Aim To explore patient's awareness and appliance of the fasting state requirements for blood sampling. Methods This observational survey was performed at the Department of Medical Biochemistry and Immunology Diagnostics, Cantonal Hospital Zenica, from June to July 2019. An anonymous questionnaire was conducted on 200 consecutive outpatients older than 18, who were admitted to the laboratory for routine blood testing. Results A total of 134 (67%) patients were informed that they needed to be at fasting to perform laboratory tests. Patients were mostly informed by a requesting physician or a nurse, 68 (50.8%), and by other patients, members of the family and friends, 58 (43.3%); only seven (5.2%) patients were informed in the laboratory. A total of 75 (37.5%) patients arrived to the laboratory properly prepared. Conclusion Most patients were not well informed about fasting state requirements for blood sampling and consequently they were not adequately prepared for laboratory tests. Laboratory should establish updated fasting recommendations available to patients and healthcare professionals, and conduct continuing education of patients and health care staff.
Aim To investigate the relationship between preoperative level of serum albumin in patients with colorectal cancer (CRC), stage of CRC and postoperative complications. Methods This cross-sectional retrospective study was conducted at the Clinic for General and Abdominal Surgery of the University Clinical Centre Sarajevo (UCCS). A total of 107 patients surgically treated for CRC in the period between 2013 and 2018 were enrolled in this study and divided into two groups: with hypoalbuminemia (group A) and without hypoalbuminemia (group B). Results The average level of albumin in group A was 29 (25-32) g/L versus 39 (37-41) g/L in group B (p<0.05). The average length of hospital stay in group A was 18 (13-25) days, and in group B 14.5 (12-21) days. Patients with hypoalbuminemia (group A) had wound dehiscence more often and more re-interventions compared to group B (p<0.05). Binary logistic regression found that serum protein, albumin and globulin levels were not statistically significant in the prediction of CRC stadium or postoperative complications (p>0.05). Conclusion Study results show that preoperatively measured levels of serum albumin are not associated with the stage of colorectal cancer and cannot serve as predictors for postoperative complications.
Abstract Digital workplace transformation goes beyond the adoption or non-adoption of technologies – it has far deeper effects in the context of re-designing a workplace. Future digital work implies not only a change of tools used in work activities, but it also often changes the very nature of the working activities and processes. Psychological needs of employees are important in this context: the need for autonomy, competence, and relatedness which affect the employees' motivation to accept the future workplace. More specifically, if employees have expectations that digital environment will enable them to accomplish better performance, bigger satisfaction and personal well-being more easily, they will be more motivated to support digital transformation. Thus, in our study we aim to investigate whether employee involvement, well-being and support to digital work foster digital transformation of the workplace. In doing so, we close the existing gap in literature and confirm that interpersonal relatedness in digital work environment has a significant influence on employees' performance and well-being. This, in turn, increases employees’ intentions to support digital workplace transformation. We believe this study will help pre-digital organizations to rethink their strategies according to employee involvement to respond to the challenges of digital transformation. The study also encourages scholars to investigate whether and how those factors are shaped differently due to COVID-19 pandemic context.
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