The network edge presses an urgent need for efficient network management and orchestration (MANO), in order to efficiently cope with the wide heterogeneity in services and resources, while providing a low-latency for the hosted services. Based on ETSI standardization, the MEC platform can be managed and orchestrated by NFV MANO components. In this demo, we show how to measure the impact of the Virtualized Infrastructure Manager (VIM), which is a component of the NFV MANO, on the performance of the MANO system. In our testbed-based experimentation, we evaluated the performance in terms of time needed for a MANO system to instantiate/terminate a network service on top of the MEC platform. Open Source MANO (OSM) and Open Baton are used as MANO entities, while for the VIM environments we investigated the impact of OpenStack and Amazon Web Services (AWS) on the above-mentioned OSM, and the impact of OpenStack and Docker on Open Baton.

We present a real-time feasible Nonlinear Model Predictive Control (NMPC) scheme to control a microgrid described by a detailed Differential Algebraic Equation (DAE). Our NMPC formulation allows to consider secondary voltage and frequency control, steady-state equal load sharing, economic goals and all relevant operational constraints in a single optimization problem. The challenge is to control the fast and large dynamical system in real-time. To achieve this goal, we use the recently introduced Advanced Step Real-Time Iteration (AS-RTI) scheme and its efficient implementation in the acados software package. We present an NMPC scheme which delivers feedback in the range of milliseconds. Thereby, the controller responds efficiently to large disturbances and mismatches in the predictions and effectively controls the fast transient dynamics of the microgrid. Our NMPC approach outperforms a state-of-the-art I-controller usually used in microgrid control and shows minor deviation to a fully converged NMPC approach.

By providing storage and computational resources at the network edge, which enables hosting applications closer to the mobile users, Multi-Access Edge Computing (MEC) uses the mobile backhaul, and the network core more efficiently, thereby reducing the overall latency. Fostering the synergy between 5G and MEC brings ultra-reliable low-latency in data transmission, and paves the way towards numerous latency-sensitive automotive use cases, with the ultimate goal of enabling autonomous driving. Despite the benefits of significant latency reduction, bringing MEC platforms into 5G-based vehicular networks imposes severe challenges towards poorly scalable network management, as MEC platforms usually represent a highly heterogeneous environment. Therefore, there is a strong need to perform network management and orchestration in an automated way, which, being supported by Software Defined Networking (SDN) and Network Function Virtualization (NFV), will further decrease the latency. With recent advances in SDN, along with NFV, which aim to facilitate management automation for tackling delay issues in vehicular communications, we study the closed-loop life-cycle management of network services, and map such cycle to the Management and Orchestration (MANO) systems, such as ETSI NFV MANO. In this paper, we provide a comprehensive overview of existing MANO solutions, studying their most important features to enable network service and resource orchestration in MEC-enhanced vehicular networks. Finally, using a real testbed setup, we conduct and present an extensive performance analysis of Open Baton and Open Source MANO that are, due to their lightweight resource footprint, and compliance to ETSI standards, suitable solutions for resource and service management and orchestration within the network edge.

Background Immune-related diarrhoea/colitis (ir-D/C) is a common adverse event of immune checkpoint inhibitor (ICI) therapy. Guidelines recommend corticosteroid (CS) treatment; however, the average treatment duration for ir-D/C remains poorly defined. Methods All advanced melanoma patients treated with ICI therapy at the Royal Marsden Hospital between 2011 and 2016 were reviewed to identify ir-D/C cases alongside clinical variables. Results 117 any-grade ir-D/C episodes occurred in 109 (21%) patients out of a total of 519 patients treated (ipilimumab=77 episodes, anti-PD1=17 (nivolumab or pembrolizumab), ipilimumab and nivolumab=23 (ipi+nivo)) (seven patients had ir-D/C more than once on different lines of treatment) and >/=grade 3 ir-D/C occurred most frequently (63/519 patients (12%) vs 29/519 (5%) grade 1, and 25/519 (5%) grade 2). Median onset (days) of all-grade ir-D/C after starting ICI therapy was 41 for ipilimumab (IQR 24 to 59, n=77), 91 for anti-PD1 (IQR 46 to 355, n=17) and 45 for ipi+nivo (IQR 24 to 67, n=23). In 71/117 (61%) patients, ir-D/C episodes were treated with CS (17% grade 2; 79% grade 3/4): 54 being steroid-responsive; 17 being steroid-refractory and received additional anti-tumor necrosis factor (TNF) treatment. Median grade 3 ir-D/C CS duration was similar across treatments, averaging 58 days. Median overall CS duration (days) was longer in the grade 3/4 D/C steroid-refractory group (94 vs 45 days). Infection developed in 11/71 (15%) CS recipients and in 6/17 (35%) anti-TNF recipients. In 65/117 (55%) patients, ir-D/C episodes were investigated with flexible sigmoidoscopy. Of these patients, 38/65 (58%) had macroscopic colitis and 12/65 (18%) had microscopic colitis. The steroid-refractory group had more macroscopic changes, 13/17 (76%), than the steroid-responsive group, 22/41 (54%). Conclusion Rates of grade 3 ir-D/C were higher than reported in clinical trials. The 58-day median duration of CS therapy for grade 3 ir-D/C places a significant number of patients at risk of complications. We demonstrate that microscopic colitis is an important subgroup, advocating biopsies in ir-D/C even with macroscopically normal bowel.

The ongoing pandemic of SARS-CoV-2 calls for rapid and cost-effective methods to accurately identify infected individuals. The vast majority of patient samples is assessed for viral RNA presence by RT-qPCR. Our biomedical research institute, in collaboration between partner hospitals and an accredited clinical diagnostic laboratory, established a diagnostic testing pipeline that has reported on more than 40,000 RT-qPCR results since its commencement at the beginning of April 2020. However, due to ongoing demand and competition for critical resources, alternative testing strategies were sought. In this work, we present a clinically-validated standard operating procedure (SOP) for high-throughput SARS- CoV-2 detection by RT-LAMP in 25 minutes that is robust, reliable, repeatable, sensitive, specific, and inexpensive.

Long QT syndrome (LQTS) is a rare (1:2500–1:10,000) inherited disorder characterized by the onset of arrhythmogenic syncope, polymorphic ventricular tachycardia, and sudden cardiac death. The aim of this article was to describe an unexpected success with an unusual therapeutic modality of a patient diagnosed with LQTS syndrome (suspected Romano–Ward syndrome) during an 8-year period. A 59-year-old female patient was admitted to the hospital due to chest pain and nausea, and after diagnostic and therapeutical approach, a permanent dual-chamber rate-modulated (DDDR) pacemaker was implanted instead of the implantable cardioverter defibrillator (ICD). During the 8-year period, the patient remained stable, without rhythm disorder. Romano–Ward syndrome as a congenital LQTS carries a high risk of sudden cardiac death and presents an indication for ICD. In this patient, for objective reasons, this could not be performed. Implantation of a DDDR with an appropriate pharmacological therapy, including propranolol, in this case, proved to be a successful therapeutic modality.

Introduction: The head-up tilt table test is noninvasive diagnostic procedure, which is used in the diagnosis of syncope. Syncope presents a benign short-term disorder of cerebral circulation with the sudden loss of consciousness and muscle tone. Aim: The aim is to present not only the role and importance of orthostatic tests in the daily clinical practice of pediatric cardiology, neuropediatrics but also pediatrics in general. Patients and Methods: This study has retrospective descriptive character and included the period from April 1997 to June 2020, during which the registration and analysis of orthostatic stability tests (head-up/tilt table test, tilt table test) was performed. Medical documentation of outpatient and hospitalized patients on the Paediatric Clinic of Clinical Center University of Sarajevo (Register of Tilt Table Test) was used. Results: During this period, 1029 tests were registered and analyzed. Modification test (head-up) was performed in 132 (12.8%) patients, and since 2008, classic tilt table test was performed in 897 (87.1%) patients. Patients were 6.5–19 years old, with a predominance of female patients 611 (59.4%). There were 519 (50.4%) patients who were 15–19 years old and 510 (49.6%) patients who were under 15 years of age. Indications were syncope or suspected syncope in 671 (65.2%) patients, cardiovascular etiology (arrhythmias, chest pain, congenital heart defects [CHDs], surgically corrected CHDs, hypotension, and hypertension) in 195 (19%) patients, neuropediatric pathology (epilepsia, suspected epilepsia, headache, vertigo) in 101 (9.8%) patients, and other indications in 62 (6.03%) patients. From the total number of tests, 862 were first tests (83.4%) and 167 were control tests (16.3%). The positive test was found in 538 (52.3%) patients, most often vasovagal syncope (473 patients or 87.9%). Conclusion: Tilt table test is a reliable diagnostic tool in examining the etiology of syncope, primarily vasovagal, and is an extremely important method primarily in cardiopediatric and neuropediatric daily diagnostics.

Background: Cochlear dysfunction can arise not only from various factors such as ear diseases but also from systemic disorders of the body. The occurrence of otologic symptoms such as hearing loss, dizziness, and tinnitus can be due to cardiovascular disorders. Therefore, current understandings in the field of the diagnosis and therapy of cardiovascular diseases (CVDs) should include, among others, evidence of otologic disorders. Objective: The aim of this study is to determine the association between risk factors for CVD and cochlear dysfunction. Methods: The cross-sectional study included 128 participants with major CVD risk factors who underwent auditory function examination (pure tone audiometry). Results: There were 52 women (40.6%) and 76 men (59.4%) in total. The mean age of the participants was 58 years (a range of 28–83 years). The mean age among participants with hearing loss was 60 (±10.88), whereas the mean age among participants that had normal hearing thresholds was 54 (±12.18). Sensorineural hearing loss (SNHL) was measured in 59% of participants, of most frequent mild degree hearing loss. The prevalence of SNHL was higher in participants with arterial hypertension (P < 0.001, OR = 5.881, 95% CI 2.694–12.837) and the most common among them was moderate degree hearing impairment (38%). There is also a statistically significant association of SNHL with dyslipidemia and elevated body mass index (P < 0.001, [OR]: 4.118, 95% [CI]: 1.873–9.053 and P< 0.001, [OR]: 1.517, 95% [CI]: 1.237–1.859 ) with moderate and profound hearing loss. Conclusion: Based on the data obtained, it seems that the presence of major cardiovascular risk factors was a significant predictor for cochlear dysfunction.

Background: Hereditary transthyretin amyloidosis (hATTR) is an autosomal dominantly inherited disorder caused by an accumulation of amyloid fibrils in tissues due to mutations in the transthyretin (TTR) gene. The prevalence of hATTR is still unclear and likely underestimated in many countries. In order to apply new therapies in a targeted manner, early diagnosis and knowledge of phenotype-genotype correlations are mandatory. This study aimed to assess the prevalence and phenotypic spectrum of hATTR in Austria. Methods: Within the period of 2014–2019, patients with ATTR-associated cardiomyopathy and/or unexplained progressive polyneuropathies were screened for mutations in the TTR gene. Results: We identified 43 cases from 22 families carrying 10 different TTR missense mutations and confirmed two mutational hot spots at c.323A>G (p.His108Arg) and c.337G>C (p.Val113Leu). Two further patients with late onset ATTR carried TTR variants of unknown significance. The majority of patients initially presented with heart failure symptoms that were subsequently accompanied by progressive polyneuropathy in most cases. A total of 55% had a history of carpal tunnel syndrome before the onset of other organ manifestations. Conclusions: Our study underlined the relevance of hATTR in the pathogenesis of amyloid-driven cardiomyopathy and axonal polyneuropathy and indicated considerable genetic heterogeneity of this disease in the Austrian population. The estimated prevalence of hATTR in Austria based on this study is 1:200,000 but a potentially higher number of unknown cases must be taken into account. With respect to new therapeutic approaches, we strongly propose genetic testing of the TTR gene in an extended cohort of patients with unexplained heart failure and progressive polyneuropathy.

Recent catastrophic consequences of coronavirus pandemic stimulate some deeper analysis of present level of globalization, particularly connected with public health problems One definition of globalization may be that it is the integration of capital, technology, and information across national borders in a way that is creating a single global market and, to some degree, a global village Besides economic, it includes many different processes such as development of communications systems, the increase in human mobility, the integration of trade and investment across boundaries, the spread of democracy and human rights, the increasing role of nongovernmental organizations in international politics, the growing concern about global epidemics, and ecological matters such as climate change that are happening at the same time and in many cases reinforcing one another Up till now, in June 2020, there have been over 20,000 published scientific papers on Coronavirus Disease-2019 (COVID-19), which is an unprecedented level of interest in any topic in the entire history of science Besides the described effect of remdesivir on reducing the length of the illness and the announced research on the effect of dexamethasone on reducing the mortality rate, science has not offered any other news on medication effectiveness so far After the vaccine’s effectiveness in developing antibodies and protecting from COVID-19 is proven, then its safety will need to be proven Vaccines have to be harmless and their only effect on the organism should be the developing of permanent immunity to the novel coronavirus However, never have we in history, as humanity, had planned to simultaneously vaccinate 4 or 5 billion people Most of us welcomed positive globalization process, but with the recent pandemic of corona disease, we are introducing negative part of globalization with many unpredictable developments Indeed, globalization is both inevitable and usually desirable and contains advantageous and disadvantageous issues It is a source of both hope and of apprehension and is an accelerating process in flow of information, technology, goods and services, and production means Globalization has a complex influence on perinatal health The bonds that link perinatologists together transcend geographic, political, religious, and lingual differences, resulting in a globalization that optimizes perinatal care

Purpose: To report a rare occurrence of ocular dirofilariasis in Bosnia and Herzegovina and provide a short overview on clinical characteristics and treatment options for ocular dirofilariasis. Methods: A 75-year-old woman was admitted to the University Clinical Centre Tuzla with pain and redness in her left eye. A live, white, coiled, and active worm was noticed in subconjunctival space of bulbar conjunctiva. Results: After successful surgical extraction, the parasite was identified as the adult form of Dirofilaria repens. There were no signs of intraocular or systemic inflammation. Conclusion: Ophthalmologists should have in mind a possible infestation, especially in cases with repeated inflammatory reactions and swelling of the ocular region, which does not respond to conventional therapy.

Volatile constituents of Satureja montana L. collected from a natural habitat in the southern region of Bosnia and Herzegovina were isolated by steam distillation and headspace sampling. The relative abundance of volatile compounds from the air-dried fragrant plant was analysed by GC-MS using two columns of different polarity. A total of 28 compounds were identified, constituting 93.5% of the essential oil composition. The GC pattern of headspace was different from that prepared by steam distillation. The former consisted of 14 compounds that made up 84.1% of the components identified. Both samples were dominated by oxygenated monoterpenes ranging from 55.2% for headspace of the plant material to 75.5% for the steam-distilled oil. Eleven alcohols represented the most diverse chemical class in the volatile oil (71.8%), as well as seven alcohols detected in the headspace (57.3%). GC-MS analysis of the volatiles indicates that S. montana belongs to linalool chemotype with its relative content of 38.7% for the essential oil and 23.7% for the headspace. With linalool as the most abundant constituent, the other major components were -terpineol (14.7%) in the essential oil, and cis-sabinene hydrate (21.8%) and p-cymene (17.9%) in the headspace sample. The results prove that the combined approach in the extraction of volatile compounds is reliable for the analysis of the aroma of complex herbal samples.