The study investigated the influence of maturity, biomass type, and depositional settings on the distribution and relative abundance of polycyclic aromatic hydrocarbons (PAHs) for lacustrine sediments collected from depths up to 1000 m of Prebreza and Čučale stratigraphic units (the northwest part of the Toplica Basin). A recently proposed benzo[ghi]perylene/(perylene + benzo[ghi]perylene) parameter, along with commonly used Phenanthrene Alkylation Index and benzo[e]pyrene/(perylene + benzo[e]pyrene) indices, pointed out differences in maturity levels between stratigraphic units by displaying a positive linear relationship with vitrinite reflectance. However, in several immature Prebreza sediments, a substantial presence of algae and/or anoxic, mesosaline/hypersaline conditions were suitable for forming β-substituted methylphenanthrenes and 6-ring benzo[ghi]perylene. Generally, high molecular weight unsubstituted PAHs (HMWPAHs), particularly perylene, predominated Prebreza sediments. Anoxic conditions appeared to be decisive for accumulating and preserving the perylene carbon skeleton in studied stratigraphic units. Besides, more intense volcanism in the Čučale unit favored combustion processes, which prompted the accumulation of low molecular weight unsubstituted PAHs (LMWPAHs), especially phenanthrene. A general prevalence of retene over cadalene in Prebreza sediments, in which alginite and liptodetrinite predominated, implied algae as retene precursor. Selective degradation of retene or hindered demethylation of 9-methylphenanthrene under anoxic and more saline environmental settings had occurred notably in the Prebreza unit, which led to the formation of 1-methylphenanthrene and/or pimanthrene (1,7-dimethylphenanthrene). Čučale sediments with substantial amounts of vitrinite macerals or saturated diterpenoids had a predominant simonellite derived from conifers. Non-degraded and well-preserved Pinaceae conifers predominated in Prebreza sediments deposited under semi-arid climatic conditions, whereas mixed degraded/non-degraded conifers characterized Čučale sediments deposited in a wide range of climatic conditions, from semi-arid to semi-humid.

INTRODUCTION: Today, the quality of the health care is measured with the help of two parameters, patient outcomes and patient satisfaction. OBJECTIVE: The objective of this study is to investigate the level of satisfaction with health care in post-operative gyne-cology patients. METHODS: This cross-sectional study of patient satisfaction was conducted at the gynecology ward of the Department of Gynecology and Obstetrics of the University Clinical Hospital Mostar by an anonymous survey using a questionnaire designed exclusively for this study. The study included a total of 100 patients who underwent gynecological surgery. RESULTS: All preoperative and postoperative categories at the gynecology ward, including communication with gyneco-logists, anesthesiologists and nurse were rated with higher than the average score of 4. 5. The study group had a relatively short hospital stay with an average of 4. 6 days. More than 70% of patients were hospitalized for up to 6 days. Order and cle-anliness of were rated with a high average score of 4. 6; and the attitude of service staff is at high-level (average score 4. 6). CONCLUSION: High satisfaction scores represent an obligation for continuing to nurture the communication skills of the overall medical and non-medical staff. The current study is a starting point for further research on patient satisfaction at the gynecology department.

In neuroscience research, the refined analysis of rodent locomotion is complex and cumbersome, and access to the technique is limited because of the necessity for expensive equipment. In this study, we implemented a new deep learning-based open-source toolbox for Automated Limb Motion Analysis (ALMA) that requires only basic behavioral equipment and an inexpensive camera. The ALMA toolbox enables the consistent and comprehensive analyses of locomotor kinematics and paw placement and can be applied to neurological conditions affecting the brain and spinal cord. We demonstrated that the ALMA toolbox can (1) robustly track the evolution of locomotor deficits after spinal cord injury, (2) sensitively detect locomotor abnormalities after traumatic brain injury, and (3) correctly predict disease onset in a multiple sclerosis model. We, therefore, established a broadly applicable automated and standardized approach that requires minimal financial and time commitments to facilitate the comprehensive analysis of locomotion in rodent disease models. Presenting ALMA toolbox, an open source Python repository for automatic analysis of mouse locomotion using bodypart coordinates from markerless pose estimation tools. ALMA is capable of analyzing both healthy and CNS-injured mice. ALMA is also capable of predicting onset of disease in a multiple sclerosis model.

In current guidelines, thiopurines are still recommended as first-line maintenance therapy for patients with Crohn’s disease (CD). Due to their lack of immunogenicity, oral administration route and low costs, thiopurines are an attractive first-line treatment option. However, in recent studies the position of thiopurine monotherapy in CD has been questioned as a result of relatively lower overall effectiveness rates compared to ulcerative colitis. Real-world long-term effectiveness data substantiating the use and position of thiopurines in CD management remain sparse. We assessed long-term effectiveness of thiopurine monotherapy in CD using the population-based IBD South-Limburg (IBDSL) cohort. All CD patients in the IBDSL cohort starting thiopurine monotherapy as first-line maintenance therapy between 1991–2014 were included. Thiopurine monotherapy was defined effective if either: (1) no escalation to biological treatment, (2) no course of corticosteroids, (3) no resective surgery or, (4) no hospitalization for active disease was required whilst on thiopurine treatment. Patients with early treatment discontinuation (i.e. <3 months) were identified, including reason of discontinuation. Long-term effectiveness was assessed adjusting for differences in follow-up between patients using Kaplan-Meier analysis. Potential risk factors for therapy failure were identified using Cox regression. In total, 643/1162 (55.3%) CD patients (median follow-up: 8.5 years IQR 5.0–13.2) received first-line thiopurine monotherapy after a median of 9.7 months (IQR 3.2–31.3) after diagnosis. Therapy was discontinued within three months in 164 patients (25.5%), mainly due to adverse events [Figure 1]. Thiopurine monotherapy was effective for the duration of treatment in 229/479 (35.6%) patients, corresponding to estimated effectiveness rates of 62.9%, 43.9% and 31.2% after 1, 5 and 10 years, respectively [Figure 1–2]. No significant difference in effectiveness was observed after stratifying for era of thiopurine initiation (pre-biological (1991–1998) vs. biological (>1999) era, p=0.84). Factors associated with thiopurine failure were stricturing disease (aHR 1.41, 95%CI 1.01–1.96) and upper GI involvement (aHR 1.52, 95%CI 1.02–2.28) at diagnosis. During follow-up, 40/229 patients with a durable response discontinued treatment due to quiescent disease. Of these, 35 patients (87.5%) remained without treatment 24 months after discontinuation. Real-world data from this population-based study demonstrate that thiopurine monotherapy remains an effective and durable first-line treatment option for CD, even in the biological era. These results should be considered in the ongoing discussion regarding the position of thiopurine therapy.

Immunomodulators and biologicals are cornerstones in the current management of Inflammatory Bowel Disease (IBD), but are associated with increased risk of infections. Post-marketing surveillance studies are important to assess the risk for infectious side effects in real-world populations, yet mainly focus on severe infections. Data on mild and moderate infections in IBD patients are scarce, primarily since self-limiting infections and infections treated by the general practitioner are not systematically captured in surveillance registries. Mild and moderate infections take longer to clear in immunosuppressed patients, have a large impact on (work) disability and quality of life, and potentially precede severe infections. In the current study, we aimed to develop and implement a remote monitoring tool for real-world assessment of infections in IBD patients. Through a structured iterative process with input from IBD specialists, nurse practitioners, and a comprehensive literature review, a 7-item Questionnaire comprising 15 different types of infections (covering e.g. upper/lower respiratory tract; urinary tract; eye; and skin infections) was developed to measure Patient-Reported Infections (PRIQ) with a recall period of 3 months. Infection severity was defined as either mild (self-limiting or requiring topical/local treatment), moderate (requiring oral antibiotic, antiviral or antifungal drugs) or severe (requiring hospitalization and/or IV treatment). To ascertain comprehensiveness and comprehensibility in the intended study population prior to implementation, in three rounds a total of 36 randomly selected IBD patients visiting the outpatient clinic were interviewed individually until saturation was reached. Overall, patient understanding of the PRIQ was good and cognitive interviews did not result in reduction of questionnaire-items. Analysis of feedback from interviews resulted in addition of definitions to certain response options (e.g. definition for antivirals) and minor linguistic adjustments to further improve patient understanding. A total of three patients (8.3%) raised concerns on the recall period of 3 months, which after expert consensus, did not result in alteration of the recall period. Next, the PRIQ was digitized and implemented in myIBDcoach, an established telemedicine platform for management of IBD. We developed a remote monitoring tool (PRIQ) to assess patient-reported infections in IBD and ascertained patient understanding through cognitive interviewing. A prospective multicentre study using the myIBDcoach platform is ongoing to validate the PRIQ and subsequently report the risk of mild and moderate infections across different treatment regimens in IBD patients (NCT04151420).

For many decades English language was dominant in international scientific communications, but during the last decade it threatens to become the only language for communicating medical science at international level. The aim of this article was to make an overview of publication practices in regard to language of publication of MEDLINE-referenced articles from European countries in year 2020. Scientific publications referenced in MEDLINE database during year 2020 were chosen for analysis. The inclusion criteria were publications affiliated with one of European countries, published in either English or national languages of those countries. The countries with less than 100.000 inhabitants were excluded from the study. Only 11 of 38 European countries had any number of medical publications in national language that were referenced in MEDLINE; the authors from twenty-seven European countries completely stopped publishing in national language at international journals. While economic strenght of a country was strongly correlated with number of international publications per 100.000 inhabitants, the correlation with international papers published in national languages was much less pronounced. Researchers from majority of European countries are publishing their studies predominantly or only in international medical journals printed in English language. Additional efforts should be made in the future to promote publishing in national languages.

Stroke remains one of the leading causes of death and disability in Europe. The European Stroke Action Plan (ESAP) defines four main targets for the years 2018 to 2030. The COVID-19 pandemic forced the use of innovative technologies and created pressure to improve internet networks. Moreover, 5G internet network will be helpful for the transfer and collecting of extremely big databases. Nowadays, the speed of internet connection is a limiting factor for robotic systems, which can be controlled and commanded potentially from various places in the world. Innovative technologies can be implemented for acute stroke patient management soon. Artificial intelligence (AI) and robotics are used increasingly often without the exception of medicine. Their implementation can be achieved in every level of stroke care. In this article, all steps of stroke health care processes are discussed in terms of how to improve them (including prehospital diagnosis, consultation, transfer of the patient, diagnosis, techniques of the treatment as well as rehabilitation and usage of AI). New ethical problems have also been discovered. Everything must be aligned to the concept of “time is brain”.

In this paper we will look at the one system of ODE and analyze it. We aim to determine the points of equilibrium; examine their character and establish the existence of a bifurcation for the corresponding parameter value. A detailed analysis of local stability was performed for all values of the given parameter. For a certain value of the parameter, the existence of supercritical Hopf bifurcation of the observed system of differential equations has been proved. Also, the existence of a limit cycle that is always stable has been proved.

D2D is a promising paradigm of the 5G network offering a beneficial infrastructure and allowing different applications such as social applications, advertising services, or those supporting mutual connectivity of heterogenous objects, as well as those offering support in cases of natural disasters. Compared to conventional network communication, communication achieved by D2D technology shows a lower degree of security. It is necessary to modify existing security mechanisms and new solutions to be adapted to the application of D2D in the fifth generation network, which will raise the level of security in terms of authenticity verification, ensuring service availability and maintaining integrity.

The greater the number of devices on a network, the higher load in the network, the more chance of a collision occurring, and the longer it takes to transmit a message. The size of load can be identified by measuring the network occupancy, hence it is desirable to minimize the latter. In this paper, we present an approach for network occupancy minimization by optimizing the packing process while satisfying multiple constraints. We formulate the minimization problem as a bin packing problem and we implement a modification of the Best-Fit Decreasing algorithm to find the optimal solution. The approach considers grouping signals that are sent to different destinations in the same package. The analysis is done on a medium-sized plant model, and different topologies are tested. The results show that the proposed solution lowers the network occupancy compared to a reference case.

Owing to its superlative carrier mobility and atomic thinness, graphene exhibits great promise for interconnects in future nanoelectronic integrated circuits. Chemical vapor deposition (CVD), the most popular method for wafer-scale growth of graphene, produces monolayers that are polycrystalline, where misoriented grains are separated by extended grain boundaries (GBs). Theoretical models of GB resistivity focused on small sections of an extended GB, assuming it to be a straight line, and predicted a strong dependence of resistivity on misorientation angle. In contrast, measurements produced values in a much narrower range and without a pronounced angle dependence. Here we study electron transport across rough GBs, which are composed of short straight segments connected together into an extended GB. We found that, due to the zig-zag nature of rough GBs, there always exist a few segments that divide the crystallographic angle between two grains symmetrically and provide a highly conductive path for the current to flow across the GBs. The presence of highly conductive segments produces resistivity between 102 to 104 Ω μm regardless of misorientation angle. An extended GB with large roughness and small correlation length has small resistivity on the order of 103 Ω μm, even for highly mismatched asymmetric GBs. The effective slope of the GB, given by the ratio of roughness and lateral correlation length, is an effective universal quantifier for GB resistivity. Our results demonstrate that the probability of finding conductive segments diminishes in short GBs, which could cause a large variation in the resistivity of narrow ribbons etched from polycrystalline graphene. We also uncover spreading resistance due to the current bending in the grains to flow through the conductive segments of the GB and show that it scales linearly with the grain resistance. Our results will be crucial for designing graphene-based interconnects for future integrated circuits.

BACKGROUND The relation of gait quality to real-life mobility among older adults is poorly understood. This study examined the association between gait quality, consisting of step variability, smoothness, regularity, symmetry and gait speed with the Life-Space Assessment (LSA). METHODS In community-dwelling older adults (N=232, age 77.5±6.6, 65% females), gait quality was derived from: a) an instrumented walkway: gait speed, variability and walk-ratio; and b) accelerometer: signal variability, smoothness, regularity, symmetry, and time-frequency spatiotemporal variables during 6-minute walk. In addition to collecting LSA scores, cognitive functioning, walking-confidence, and falls were recorded. Spearman correlations (speed as covariate) and Random Forest Regression were used to assess associations between gait quality and LSA, and Gaussian-mixture modeling (GMM) was used to cluster participants. RESULTS Spearman correlations of ρp=0.11 (signal amplitude variability ML), ρp=0.15, ρp=-0.13 (symmetry AP-V, ML-AP), ρp=0.16 (power V) and ρ=0.26 (speed), all p<0.05 and marginally related, ρp=-0.12 (regularity V), ρp=0.11 (smoothness AP) and ρp=-0.11 (step-time variability), p<0.1 were obtained. The cross-validated Random Forest model indicated good fit LSA prediction error of 17.77; gait and cognition were greater contributors than age and gender. GMM indicated two clusters. Group-1(N=189) had better gait quality than Group-2(N=43): greater smoothness AP (2.94±0.75 vs 2.30±0.71); greater similarity AP-V (0.58±0.13 vs 0.40±0.19); lower regularity V (0.83±0.08 vs 0.87±0.10); greater power V (1.86±0.18 vs 0.97±1.84); greater speed (1.09±0.16 vs 1.00±0.16 m/s); lower step time CoV (3.70±1.09 vs 5.09±2.37) and better LSA (76±18 vs 67±18), padjusted<0.004. CONCLUSIONS Gait quality measures taken in the clinic are associated with real-life mobility in the community.

BACKGROUND falls and fall-related injuries are common in older adults, have negative effects both on quality of life and functional independence and are associated with increased morbidity, mortality and health care costs. Current clinical approaches and advice from falls guidelines vary substantially between countries and settings, warranting a standardised approach. At the first World Congress on Falls and Postural Instability in Kuala Lumpur, Malaysia, in December 2019, a worldwide task force of experts in falls in older adults, committed to achieving a global consensus on updating clinical practice guidelines for falls prevention and management by incorporating current and emerging evidence in falls research. Moreover, the importance of taking a person-centred approach and including perspectives from patients, caregivers and other stakeholders was recognised as important components of this endeavour. Finally, the need to specifically include recent developments in e-health was acknowledged, as well as the importance of addressing differences between settings and including developing countries. METHODS a steering committee was assembled and 10 working Groups were created to provide preliminary evidence-based recommendations. A cross-cutting theme on patient's perspective was also created. In addition, a worldwide multidisciplinary group of experts and stakeholders, to review the proposed recommendations and to participate in a Delphi process to achieve consensus for the final recommendations, was brought together. CONCLUSION in this New Horizons article, the global challenges in falls prevention are depicted, the goals of the worldwide task force are summarised and the conceptual framework for development of a global falls prevention and management guideline is presented.

Patients with cancer are currently prioritized in coronavirus disease 2019 (COVID-19) vaccination programs globally, which includes administration of mRNA vaccines. Cytokine release syndrome (CRS) has not been reported with mRNA vaccines and is an extremely rare immune-related adverse event of immune checkpoint inhibitors. We present a case of CRS that occurred 5 d after vaccination with BTN162b2 (tozinameran)—the Pfizer-BioNTech mRNA COVID-19 vaccine—in a patient with colorectal cancer on long-standing anti-PD-1 monotherapy. The CRS was evidenced by raised inflammatory markers, thrombocytopenia, elevated cytokine levels (IFN-γ/IL-2R/IL-18/IL-16/IL-10) and steroid responsiveness. The close temporal association of vaccination and diagnosis of CRS in this case suggests that CRS was a vaccine-related adverse event; with anti-PD1 blockade as a potential contributor. Overall, further prospective pharmacovigillence data are needed in patients with cancer, but the benefit–risk profile remains strongly in favor of COVID-19 vaccination in this population. A rare case of cytokine release syndrome in a patient on anti-PD-1 blockade that was likely related to BNT162b2 vaccination supports prospective monitoring of patients with cancer after COVID-19 vaccine administration.