Introduction. Lean principles have been successfully adapted to the healthcare environment, enabling hospitals and clinics to streamline their operations and focus on value as perceived by their patients. Many healthcare facilities have implemented lean principles to improve their efficiency. The subject of this paper is the lean concept, the essence of which is implementation of methods that affect the efficiency and quality of providing health services. Our aim was to point out the necessity of applying modern concepts in healthcare. Material and Methods. The primary sources of data were obtained through research on the opinions and possibility of applying the lean concept in hospitals in Bosnia and Herzegovina. We presented the results on the effectiveness of the lean concept in hospitals that apply it. Results. After implementation of the lean concept in an Italian hospital, the results showed a positive impact on the waiting time for admission, faster discharge, and faster flow of information. The results of the research in Bosnia and Herzegovina showed that there were positive attitudes towards the effects that would be achieved by implementing the lean concept. Conclusion. The implementation of the lean concept would reduce medical waste, which would positively affect the quality of health care services.

The aim of our manuscript is to report of a successful perinatal outcome after treatment of acute polyhydramnios caused by duodenal atresia. A 34-year-old G3P1 was referred due to polyhydramnios in the 30th week of pregnancy. Ultrasound revealed polyhydramnios, amniotic fluid index (AFI) 28, and a double bubble sign that indicated duodenal atresia and dilatated oesophagus. In the 32nd week of gestation, the volume of amniotic fluid increases, AFI 35, along with symptoms of dyspnea and abdominal pain. Due to the clinical picture and the early gestational age, it was decided to perform an amnioreduction. In the 36th week of gestation cesarean section was performed. The baby was taken for exploratory laparotomy and found to have a simultaneous complete duodenal atresia and annular pancreas with associated dilated the first portion of the duodenum and the stomach. A side-to-side duodenoduodenostomy via single-layer hand-sewn anastomosis was performed over a transanastamotic feeding tube (TAFT). The postoperative course was uneventful. Amnioreduction is useful and safe in the treatment of acute polyhydramnios caused by duodenal atresia and thus has a significant role in prolonging gestation until fetal maturity.

In this paper, a novel method for the magnetic flux density estimation in the vicinity of multi-circuit overhead transmission lines is proposed. The proposed method is based on a fully connected feed-forward artificial neural network model that is trained to estimate the magnetic flux density vector components for a range of single-circuit overhead transmission lines. The proposed algorithm is able to simplify estimation process in instances when there are two or more geometrically identical circuits present in the multi-circuit overhead transmission line. In such instances, artificial neural network model is employed to estimate the magnetic flux density distribution over a considered lateral profile for only one of such circuits. The magnetic flux density estimates of the other geometrically identical circuits are derived from these results. The proposed methodology defines the resultant magnetic flux density for the multi-circuit overhead transmission line in terms of the contributions made by individual circuits. The application of the proposed magnetic flux density estimation method is demonstrated on several multi-circuit configurations of overhead transmission lines. The performance of the proposed method is compared with the Biot-Savart law based method calculation results as well as with field measurement results.

: Complexes of general formula [ Ru(bpy) 2 (L) ]CF 3 SO 3 , where bpy = 2,2′ - bipyridine, and L = Schiff bases derived from salicylaldehyde and amino acids (glycine ( 1a), cysteine (1b), methionine (1c ) and phenylalanine ( 1d )) were synthesized. Characterization based on elemental analysis, Ru content, mass, infrared and electronic spectra confirmed RuN 5 O coordination unlike 1b where coordination occurred via azomethine nitrogen and cysteine sulfur. Cyclic voltammograms, except 1b, showed several quasi- reversible redox pairs in the positive potential range, the first located at about 0.5 V, corresponding to similar heteroleptic Ru(II) bipyridyl complexes. Biological activity was tested by interactions with DNA and BSA. DNA binding constants of order 10 3 M − 1 , suggest groove binding due to bpy ligand and hydrogen bonding of the OH and CO groups from the imine moiety. In vitro BSA protein inhibition assay performed by spectrofluorimetry showed Complex : BSA binding in 1 : 1 ratio with K b of 10 4 M − 1 order. Cytotoxicity studies by MTT assay for 72 h of drug action revealed activity of 1a and 1d against breast cancer MCF- 7 cells with IC 50 values 32 ± 8 and 26 ± 1µM, respectively.

In this paper, we analyze an arbitrary heterogeneous cellular network applying stochastic geometry, and propose a modified model for assessing network spectral and energy efficiency. With this regard, we recognize that, in practice, determining Signal-to-Noise-and-Interference Ratio (SINR) as the key performance indicator, requires complex field test equipment, which might not be available or affordable. Therefore, we propose here a simple model that is based on the relatively easy measurable Bit-Error Rate (BER), whose degradation caused by various impairments is considered here as if it was due to the according additive white Gaussian noise (AWGN), thus abstracting any specific non-AWGN distortion. The proposed analytical model is verified by ns3 software network simulator, whose test results are found to match the corresponding estimated values. This indicates that both spectral and energy efficiencies of small-cell networks are higher than in larger-cell networks, even more for heterogeneous two-tier networks.

Background: During the plateletpheresis procedure the number of thrombocytes in the donor’s blood significantly decreases, and the levels of the hematocrit, hemoglobin, and leukocyte diminish as well. Influence of the cell separator is one of the factors that affects the levels of HCT, Hgb and WBC. Objective: In this study, the goal was to determine the value difference of HCT, Hgb, WBC, and platelets after the platelet pheresis process between performance on Fenwal AMICUS and on COBE Spectra LRS Methods: The criteria for participation: male in the age range of 25-45. We have formed two groups: group I–180 separation were performed on 60 participants were the values of hematocrits, concentration of hemoglobin and number of leukocytes ware established before and after separation using the single-needle intermitent flow cell separation (SN-IFCS) on the Fenwal AMICUS device. Group II – presented 180 separation that were performed on 60 participants, were the values of hematocrits, concentration of hemoglobin and number of leukocytes ware established before and after separation using double-needle continuous flow cell separation (SN-IFCS) on the COBE Spectra LRS. device. To confirm the statistical differences we have used Student t-test for independent or dependent samples, as well as Mann-Whitney U test as non-parametric alternative. To compare differences between the values of four parameters (P1-P2) from two groups (using two devices–Fenwal AMICUS and Fresenius Com Tec) we have performed the ANOVA variance analyze. The possibility of errors were accepted for α<0,05, and the difference between groups as statistical relevant were accepted for p<0,05. Results Statistically significant lower values were noted for all researched parameters after separation on both devices (Fenwal AMICUS and COBE Spectra LRS). Comparing the parameters of hematocrit, leukocytes and hemoglobin’s, we found a statistical significant difference in the decrease of the parameter’s value after separation, there was a significant decrease change in using COBE Spectra LRS cell separator compared to using Fenwal AMICUS cell separator with the same procedure. For the platelets (Plt) there was no statistical significant difference (p> 0,05-α=0,05), between average level obtained using either Fenwal AMICUS or COBE Spectra LRS. Conclusion: The type of cell separator had the influence on the decrease value of the observed parameters.

Background: Family medicine is defined as continuous, comprehensive medical care of the patient in the context of the family and the community. Continuous patient care includes prevention, diagnosis and treatment of acute and chronic diseases and palliative care. Caring for individuals during different diseases and stages in the life cycle, understanding the role of the family in disease and using community resources makes family medicine unique among medical disciplines. With the development of new technologies, there was a need for changes in the work and introduction of the Health Information System, in all areas of medicine, including family medicine. Objective: The objectives of this study are to analyze CHIS functions in family medicine, analyze CHIS data reports, complaints, and suggestions for improvement, and then, based on the results of these analyses, to offer recommendations for future development of the CHIS family medicine module. Methods: This article represents a qualitative, interpretative case study of the implementation of the CHIS in family medicine in Public Institution Health Centre of Sarajevo Canton conducted by a group of physicians using three primary data sources: medical experts’ analysis of the CHIS content, reports available in the CHIS about the number and type of services, analysis of written medical doctor and nurse complaints, and suggestions for improving the CHIS. Although qualitative data analysis predominated, quantitative data analysis was also employed. Results and Discussion: It is crucial that healthcare professionals who utilize HIS have the opportunity to provide feedback on the system and suggest modifications. The main results show that CHI is widely used in family medicine and that employees in this department provide purposeful suggestions to improve CHI, as well as that a good cooperation between the software company and the user exist. Experts in software should view these suggestions as useful information and adopt them to enhance the system so as to increase customer satisfaction and enhance the quality of health care. Health informatics as a separate scientific discipline began to be effective in academic institutions at the end of the 70’s by the presentation of actual accomplishments in this area in under and postgraduate education at biomedical faculties. The Central Health Information System (CHIS) in Sarajevo Canton was implemented in 2014 but was not fully integrated and was incompletely used at certain levels of health care. Conclusion: Thanks to the agility of the company rapid implementation of new software modules enabled the organizational transformation of the Sarajevo Canton health network.

This paper investigates the allocation model, the flexibility, and the scalability of fully distributed communication architectures for metering systems in smart grids. Smart metering infrastructure aggregates data from Smart Meters (SMs) and sends the collected data to the fog or the cloud data centres to be stored and analysed. The system needs to be scalable and reliable and to respond to increased demand with minimal cost. The problem is to find the optimal distribution of application data among devices, data centres or clouds. The need for support computing at marginal resources, which can be hosted within the building itself or shared within the construction of the complex, has become important over recent years. The resource allocation model is presented to optimize the cost of the resources in the communications and relevance parts of computing (the data processing cost). The fog helps cloud computing connectivity on the edge network. This paper explains how calculation/analysis can be performed closer to the data collection site to complement the analysis that would be undertaken at the data centre. Results for a range of typical scenarios are presented to show the effectiveness of the proposed method.

Background: For many years, pharmacy and medicine were inseparable sciences, so everything that was done in the field of medicine, that is, treatment, can be related to pharmacy. The history of pharmacy therefore also includes the history of medicine, at least until the 13th century, when pharmacy was officially separated from medicine. Objective: The aim of this study was: to describe the books and monographs that are available on the Internet, which deal with the study of the history of Pharmacy; and to show pharmaceutical history museums around the world and their unique collections of pharmaceutical artifacts. Methods: During the preparation of this paper, a descriptive method of analysis from the available literature was used. The analysis of available literature included professional books, monographs, articles and other literature available on online browsers. Results and Discussion: Today there are a large number of societies, academies, associations and foundations dealing with the history of pharmacy. Also, a lot of books, monographs and scientific papers published in on-line databases. The goal of each organization is the research of historical facts in the field of pharmacy and medicine that will be shared with professionals, but also persons who are not from the profession (doctors, librarians, archaeologists, archivists). A large number of museums have been opened for the history of pharmacy, and almost every developed country has such a museum. Such museums represent a national treasure, because they preserve the valuables of pharmacy from the territory of the country, as well as the world.

<jats:p />

<jats:p />

<jats:p />

<jats:p />