Artificial intelligence has been used in the medical field for many years finding its way in assisting medical professionals to solve complex tasks in almost every application domain. Patient care and health care costs are in the forefront of any medical system. With the emergence of electronic games (EG), originally entertaining in nature, potential was seen for their application in the medical field in terms of exploring the capabilities of educating patients in the areas of need. Design of serious games emerged with a focus on helping with the patient’s therapeutic modality. Some of the medical field serious games are part of the daily work of a medical professional. With the development of mobile devices, this type of gaming has also become available to the wider population. The aim of this research was to demonstrate the possibilities and benefits of using EG in the daily clinical work of medical professionals. This work has a descriptive character where a section of the literature is given outlining the increased research interest in using serious games as therapy enhancements. We limited ourselves to research involving patients who need medical treatment or intervention.

Air pollution is a complex mixture of toxic components that has the direct impact on human health, life quality, and the environment. In this study, meteorological variables and concentration of air pollutants are used to predict the common air quality index (CAQI) in Bjelave neighborhood, Sarajevo, BiH. CAQI prediction models were built using five popular machine learning techniques in the air pollution domain: Support Vector Regression, Random Forest, Extreme Gradient Boosting, Multiple Linear Regression and Multilayer Perceptron, using three-year period data (2016–2018). Prediction performance was measured using regression metrics: R-squared and RMSE. Ensemble technique, Random Forest method achieved the best performance results from the five evaluated machine learning methods: R2 = 0.99 and RMSE = 2.30, using the dataset when missing values were removed, and R2 = 0.99 and RMSE = 2.58 using the dataset when missing values were imputed using linear regression method.

In this paper, we consider the problem of learning a generalized Nash equilibrium (GNE) in strongly monotone games. First, we propose a novel continuous-time solution algorithm that uses regular projections and first-order information. As second main contribution, we design a data-driven variant of the former algorithm where each agent estimates their individual pseudo-gradient via zero-order information, namely, measurements of their individual cost function values, as typical of extremum seeking control. Third, we generalize our setup and results for multi-agent systems with nonlinear dynamics. Finally, we apply our algorithms to connectivity control in robotic sensor networks and distributed wind farm optimization.

Background Coronary chronic total occlusion (CTO) is characterized by the presence of collateral blood vessels which can provide additional blood supply to CTO-artery dependent myocardium. Successful CTO recanalization is followed by significant decrease in collateral donor artery blood flow and collateral derecruitment, but data on coronary hemodynamic changes in relation to myocardial function are limited. We assessed changes in coronary flow velocity reserve (CFVR) by echocardiography in collateral donor and recanalized artery following successful opening of coronary CTO. Methods Our study enrolled 31 patients (60 ± 9 years; 22 male) with CTO and viable myocardium by SPECT scheduled for percutaneous coronary intervention (PCI). Non-invasive CFVR was measured in collateral donor artery before PCI, 24 h and 6 months post-PCI, and 24 h and 6 months in recanalized artery following successful PCI of CTO. Results Collateral donor artery showed significant increase in CFVR 24 h after CTO recanalization compared to pre-PCI values (2.30 ± 0.49 vs. 2.71 ± 0.45, p  = 0.005), which remained unchanged after 6-months (2.68 ± 0.24). Baseline blood flow velocity of the collateral donor artery significantly decreased 24 h post-PCI compared to pre-PCI (0.28 ± 0.06 vs. 0.24 ± 0.04 m/s), and remained similar after 6 months, with no significant difference in maximum hyperemic blood flow velocity pre-PCI, 24 h and 6 months post-PCI. CFVR of the recanalized coronary artery 24 h post-PCI was 2.55 ± 0.35, and remained similar 6 months later (2.62 ± 0.26, p = NS). Conclusions In patients with viable myocardium, prompt and significant CFVR increase in both recanalized and collateral donor artery, was observed within 24 h after successful recanalization of CTO artery, which maintained constant during the 6 months. Trial registration ClinicalTrials.gov (Number NCT04060615 ).

In this paper, analogy of heat- or mass-transfer problem and progression of species in natural environments is used. Time-dependent spatial distributions of species in a given population (such as microbes, bacteria, viruses or herewith infected individuals etc.) are described by time-dependent convection-diffusion equation, which is widely used in analysis of a number of physical, engineering or environmental problems. In the presented example, a finite-volume method is used for its numerical solution. The source term is calibrated using the available recorded data on the species concentration development in the beginning stage. The integral results of the proposed model are compared with another, integral model (SIR) based on ordinary differential equations. Calculated spatial distributions for three different modeling cases are given.

Using tissue microarrays it was shown that membranous C-terminal MET immunoreactivity and ectodomain (ECD) shedding are associated with poor prognosis in oral cancer. Seen the potential diagnostic value, extrapolation of these results to whole tissue sections was investigated. Since MET orchestrates epithelial to mesenchymal transition (EMT), results were benchmarked to loss of E-cadherin; a readout for EMT known to be associated with poor prognosis. C-terminal MET, N-terminal MET, and E-cadherin immunoreactivities were examined on formalin-fixed paraffin-embedded parallel sections of 203 oral cancers using antibody clones D1C2, A2H2-3 and NCH-38. Inter- and intra-antibody relations were examined using a novel scoring system, nonparametric distribution and median tests. Survival analyses were used to examine the prognostic value of the observed immunoreactivities. Assessment of the three clones revealed MET protein status (no, decoy, transmembranous C-terminal positive), ECD shedding and EMT. For C-terminal MET positive cancers, D1C2 immunoreactivity is independently associated with poor overall survival (OS; HR=2.40; 95% CI, 1.25 to 4.61 and P=0.008) and disease free survival (DFS; HR=1.83; 95% CI 1.07 - 3.14; P=0.027). For both survival measures, this is also the case for ECD shedding (43.4% with HR=2.30; 95% CI, 1.38 to 3.83 and P=0.001 versus HR=1.87; 95% CI 1.19 - 2.92; P=0.006) and loss of E-cadherin (55.3% with HR=2.21; 95% CI, 1.30 to 3.77 and P=0.004 versus HR=1.90; 95% CI 1.20 - 3.01; P=0.007). The developed scoring system accounts for MET protein status, ECD shedding, EMT, and is prognostically informative. These findings may contribute to development of companion diagnostics for MET-based targeted therapy.

BACKGROUND Adenotonsillectomy is one of the most common pediatric surgical procedures. Postoperative voice changes are a very common concern among patient's parents. Therefore, the aim of this study is to analyze acoustic voice parameters after adenotonsillectomy, tonsillectomy, and adenoidectomy in pediatric patients in a tertiary referral academic center. PATIENTS AND METHODS All pediatric patients undergoing an adenotonsillectomy, tonsillectomy or adenoidectomy in a single center from 2002 to 2018 were included in the study. Change of fundamental frequency, jitter, shimmer, and harmonic-noise ratio at first, seventh and 30th postoperative day compared to preoperative values were the primary outcome parameters. Statistical analysis was performed using repeated measures analysis of variance model. RESULTS A total of 1258 patients were included in the study. The mean age of patients at the time of surgery was 8.3 years (range 3.0-18.0 years). Around 698 were male (55.5%) and 560 female (44.5%). The values of fundamental frequency increased significantly after the first and seventh postoperative day (P = 0.001 both) but normalized 1 month after surgery (P = 0.962). At the first postoperative month, values of jitter and shimmer decreased significantly (P = 0.005 and P = 0.002, respectively). Measurements of harmonic-noise ratio revealed a significant increase 30 days after surgery (P = 0.004). CONCLUSION Statistically significant differences in objective voice parameters within the first postoperative month after tonsillectomy, adenoidectomy, and adenotonsillectomy were observed. The fundamental frequency returned to normal 1 month after surgery. These findings can contribute in soothing the concerns of parents regarding postoperative voice changes.

Firearms injuries are a major public health problem in Kosovo. Injuries from firearms injuries are those caused by any firearm (cartridge, Cannonball) and from the special properties war, mine explosive grenades, and other subjects. Epidemiology of the use of firearms in males ranges corresponding 1.9 per 100,000 population, while for women 0.3 per 100,000 inhabitants The most common injuries are caused by weapons fire, rarely with special tools of war, Causes with firearms injuries blamed mental health problems, domestic violence, disparities in family, social cases, use of drugs and alcohol Preventing injuries and deaths by firearms is one of the most complex issues at the country in recent years. Management and Access Principles, Access, Evaluation of Emergency Medical Care at Three Levels of Care based on EMS Standard. It is important to take a step, contributing significantly to the reduction of premature deaths, diseases, and disability. Careful medical certificates should be given for carrying weapons, assessing the psychophysical and social aspects. The Kosovo Police should control nightclubs, schools and universities, respecting, implementing legal and institutional mechanisms, educating communities through brushes, lectures, media, and social networks, as well as international cooperation. The significant number of injuries with disabilities and deaths should be prevented through national preventive strategies and the need to provide emergency medical care for the rapid transport of firearm victims to the emergency clinic for definitive treatment. Educational efforts are trying to promote safer use of firearms, but they have not led to a significant reduction in the number of victims.

The process of patient referral system at the level of health care is a comprehensive institutional framework with responsible, well-defined competencies, as a network of cooperation with the general goal of maintaining health, treatment, stabilization, transport and medical care up to in the complete recovery of the sick. The process of patient referral system in most countries in Europe and in the world is a challenge for most developing and developed countries. The mechanisms of the referral system function at different national, regional and municipal levels based on national laws and policies and work on the basis of efficient lines of communication by creating clear and simple steps and procedures described. The referral system in Kosovo is disorganized, chaotic, the Ministry of Health must have a national document of the referral system for patients at the health level, and before that all health care professionals are educated, trained on the way of the referral system, which cases must be sent from the primary, secondary and tertiary level. At the national level, the National Coordinating Council with a national plan of the patient referral system can convey the quality; help the health care professionals based on the current health legislation, the harmonization of unique standardized protocols with follow-up guidelines. Patients at the country level.