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Introduction: Postoperative infections after ureteroscopy are common and potentially devastating complications. National and international guidelines recommend treatment of symptomatic positive urine cultures prior to operation, but how to manage patients with asymptomatic colonization remains unclear. In clinical practice, there is wide variation in the choice and duration of antibiotics for these patients. To examine how preoperative antibiotic duration impacts postoperative infection rate, we evaluated our institutional practices and outcomes. Materials and Methods: Our prospectively collected database was queried for patients undergoing ureteroscopy between 2015 and 2023. Preoperative urine culture results and antibiotic duration/choice were abstracted. Patients included for study were those with a high risk of urinary colonization defined as those with history of neurological insult, bowel diversion, indwelling suprapubic catheter or foley, or a stent/nephrostomy. Our primary outcome was postoperative infection, defined by urinary tract infection (UTI), pyelonephritis, systemic inflammatory response syndrome (SIRS), or fever within 30 days of operation. Results: A total of 405 patients met our inclusion criteria. Preoperative prophylactic antibiotics were not utilized in 68% of the study cohort, while 11% received less than 3 days or 3–10 days of prophylaxis and the remaining 10% received more than 10 days. The overall rate of UTI or pyelonephritis was 9%, and the SIRS or sepsis rate was 5%. Although receipt of preoperative prophylactic antibiotics of any duration was not predictive of postoperative infectious complications on multivariable analysis, women were associated with a 4.135 (OR: 1.768–9.669, p = 0.001) increased odds of UTI/pyelonephritis compared with men. Conclusions: In high-risk patients, the duration of preoperative antibiotics prior to ureteroscopy did not reduce postoperative infectious complication rates. Women were the only clinical feature associated with increased risk of UTI/pyelonephritis. Further research is needed to identify alternative interventions to prevent postoperative infectious complications. [ABSTRACT FROM AUTHOR]

Cannabis use disorder (CUD) is the most frequent reason for psychiatric inpatient substance use disorder (SUD) treatment among 15–19-year-olds in Germany. Despite effective treatment programs, relapse rates remain high. Thus, existing multi-component programs (TAU) need to be enhanced with SUD-specific elements. Mindfulness-based interventions (MBI) seem promising as they can positively influence SUD-related behaviors (e. g. craving). Given limited research in adolescents, this randomized controlled trial investigated the extent to which MBI-based group therapy (Mind it!) as an add-on treatment to TAU led to fewer cannabis use days after 6 months in 84 adolescent inpatients with CUD. Additionally, craving, severity of CUD, and changes in mindfulness were monitored (pre-, post-, and follow-up (FU) assessments). The results revealed a significant reduction in cannabis use days in both groups at 6-month FU (d = − 0.72 and = − 0.75). Although minor additional benefits of Mind it! were evident post-treatment, specifically reduction of craving and SUD severity, by the 6-month mark, TAU exhibited a more substantial decrease in SUD severity (d = 0.78), and reward craving (d = 0.28) compared to Mind it!. Regarding self-regulation skills (mindfulness), Mind it! demonstrated superiority over TAU after 6-month FU (d = 0.27). Therapists judged the MBI as feasible. (Serious) adverse events were unrelated to Mind it!. There was a systematic dropout among Mind it! participants. Primarily, the results emphasize the effectiveness of TAU in reducing cannabis use. MBI also seem feasible for youth, but results remain inconsistent and unstable over time. Importantly, enhanced adherence to reduce dropouts is needed. Trial registration: German Clinical Trials Register, DRKS00014041. Registered on 17 April 2018. [ABSTRACT FROM AUTHOR]

Drawing from four electoral models for the election of Bosniak and Croat representatives to the collective Presidency of Bosnia and Herzegovina, this article proposes a set of favorable conditions for the application of territorial distribution requirements in deeply divided societies. It shows that it is possible to deliver stable consociational outcomes using territorial distributive requirements for bi-national polities. Territorial distributive requirements result in stable democracy only under appropriate consociational conditions for the election of multi-person presidencies in dyadic societies with a demographic imbalance of power, whereas centripetal techniques prevent minority groups from choosing their most-preferred representatives. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study is to determine whether response to preoperative lidocaine or corticosteroid intra-articular hip injections can predict 2-year postoperative outcomes in patients undergoing arthroscopic management of femoroacetabular impingement syndrome (FAIS). Methods: We performed a retrospective analysis of a prospective cohort consisting of patients who received a preoperative corticosteroid or lidocaine intra-articular hip injection and subsequently underwent hip arthroscopy for treatment of FAIS between 2014-2020. Patients were classified by injection received and labeled as "responders" if the injection provided pain relief. Lidocaine and corticosteroid cohorts were matched using 1:1 matching for age, BMI, and sex. Patient reported outcome (PRO) measurements including the Hip Disability and Osteoarthritis Outcome Score (HOOS), 12-item Short-Form Survey mental (SF-12 MCS) and physical component survey (SF-12 PCS), and visual analog scale (VAS) Pain were completed both preoperatively and 2-years postoperatively. Mean differences in preoperative and 2-year postoperative scores were calculated as was the percentage of patients achieving a mean clinically important difference (MCID). Floor and ceiling effects of PROs were also evaluated with 15% of patients achieving a maximum or minimum survey score deemed as significant. Results: Our cohort included 110 patients (55 lidocaine, 55 corticosteroid) with no significant differences in preoperative demographic variables (Table 1). Both cohorts demonstrated significant 2-year postoperative score improvements across all PROs, except SF-12 MCS, which was unchanged. Lidocaine non-responders demonstrated greater 2-year mean difference in all PROs, except for SF-12 MCS, when compared to lidocaine responders (Table 2). Lidocaine non-responders also achieved MCID at higher rates than responders in both HOOS Pain & VAS Pain (Table 3). There was no difference in percentage of patients achieving MCID or mean difference in PROs between corticosteroid responders and non-responders. Ceiling and floor effects were seen in 2-year postoperative PROs of a combined lidocaine & corticosteroid responder cohort. [Ceiling: HOOS ADL (34.6%) HOOS Pain (21.0%) HOOS Sport (28.4%); Floor: VAS Pain (34.6%)] Conclusions: Preoperative intra-articular hip injection response did not predict 2-year postoperative outcomes after hip arthroscopy for FAIS. Results from this study suggest that preoperative injection response should not be used in isolation to predict outcomes after arthroscopic treatment of FAIS. [ABSTRACT FROM AUTHOR]

Background: The pre-analytical phase, which includes all preparatory actions to the analytical procedure, is part of the process during which there is the greatest possibility of laboratory errors. This study was conducted to investigate the frequency and types of laboratory errors during work in the clinical laboratory as well as the frequency and types of laboratory errors in the pre-analytical phase of laboratory work. Methods: The retrospective, descriptive study covered the period from 01/01/2016 to 12/31/2016 within which the presence of 5 different indicators of quality of work, i.e., pre-analytical errors, was monitored: improperly drawn blood, coagulated blood sample, hemolyzed blood sample, improperly marked referral for analysis, and insufficient sample for analysis. Results: The most common error in the pre-analytical phase of our study was "coagulated sample", followed by: "improperly drawn blood", "improperly marked referral", "insufficient sample for analysis", and "hemolyzed sample". Using the chi-squared test, a statistically significant difference was found in the frequency of occurrence of certain types of indicators in different departments (p < 0.005). Conclusions: Reduction of these errors can be achieved through analyzing and correcting the reasons for them, education, and by joint action of experts and international organizations, continual training of staff as well as to following the adopted guidelines and standards. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes (T2D) is associated with coronary microvascular dysfunction, which is thought to contribute to compromised diastolic function, ultimately culminating in heart failure with preserved ejection fraction (HFpEF). The molecular mechanisms remain incompletely understood, and no early diagnostics are available. We sought to gain insight into biomarkers and potential mechanisms of microvascular dysfunction in obese mouse (db/db) and lean rat (Goto-Kakizaki) pre-clinical models of T2D-associated diastolic dysfunction. Methods: The microRNA (miRNA) content of circulating extracellular vesicles (EVs) was assessed in T2D models to identify biomarkers of coronary microvascular dysfunction/rarefaction. The potential source of circulating EV-encapsulated miRNAs was determined, and the mechanisms of induction and the function of candidate miRNAs were assessed in endothelial cells (ECs). Results: We found an increase in miR-30d-5p and miR-30e-5p in circulating EVs that coincided with indices of coronary microvascular EC dysfunction (i.e., markers of oxidative stress, DNA damage/senescence) and rarefaction, and preceded echocardiographic evidence of diastolic dysfunction. These miRNAs may serve as biomarkers of coronary microvascular dysfunction as they are upregulated in ECs of the left ventricle of the heart, but not other organs, in db/db mice. Furthermore, the miR-30 family is secreted in EVs from senescent ECs in culture, and ECs with senescent-like characteristics are present in the db/db heart. Assessment of miR-30 target pathways revealed a network of genes involved in fatty acid biosynthesis and metabolism. Over-expression of miR-30e in cultured ECs increased fatty acid β-oxidation and the production of reactive oxygen species and lipid peroxidation, while inhibiting the miR-30 family decreased fatty acid β-oxidation. Additionally, miR-30e over-expression synergized with fatty acid exposure to down-regulate the expression of eNOS, a key regulator of microvascular and cardiomyocyte function. Finally, knock-down of the miR-30 family in db/db mice decreased markers of oxidative stress and DNA damage/senescence in the microvascular endothelium. Conclusions: MiR-30d/e represent early biomarkers and potential therapeutic targets that are indicative of the development of diastolic dysfunction and may reflect altered EC fatty acid metabolism and microvascular dysfunction in the diabetic heart. [ABSTRACT FROM AUTHOR]

In this paper, we demonstrate the result of certain machine-learning methods like support vector machine (SVM), naive Bayes (NB), decision tree (DT), k-nearest neighbor (KNN), artificial neural network (ANN), and AdaBoost algorithms for various performance characteristics to predict human body constituencies. Ayurveda-dosha studies have been used for a long time, but the quantitative reliability measurement of these diagnostic methods still lags. The careful and appropriate analysis leads to an effective treatment to predict human body constituencies. From an observation of the results, it is shown that the AdaBoost algorithm with hyperparameter tuning provides enhanced accuracy and recall (0.97), precision and F-score (0.96), and lower RSME values (0.64). The experimental results reveal that the improved model (which is based on ensemble-learning methods) significantly outperforms traditional methods. According to the findings, advancements in the proposed algorithms could give machine learning a promising future. [ABSTRACT FROM AUTHOR]

Background: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. To decrease the high case fatality rates and morbidity for sepsis and septic shock, there is a need to increase the accuracy of early detection of suspected sepsis in prehospital and emergency department settings. This may be achieved by developing risk prediction decision support systems based on artificial intelligence. Methods: The overall aim of this scoping review is to summarize the literature on existing methods for early detection of sepsis using artificial intelligence. The review will be performed using the framework formulated by Arksey and O'Malley and further developed by Levac and colleagues. To identify primary studies and reviews that are suitable to answer our research questions, a comprehensive literature collection will be compiled by searching several sources. Constrictions regarding time and language will have to be implemented. Therefore, only studies published between 1 January 1990 and 31 December 2020 will be taken into consideration, and foreign language publications will not be considered, i.e., only papers with full text in English will be included. Databases/web search engines that will be used are PubMed, Web of Science Platform, Scopus, IEEE Xplore, Google Scholar, Cochrane Library, and ACM Digital Library. Furthermore, clinical studies that have completed patient recruitment and reported results found in the database ClinicalTrials.gov will be considered. The term artificial intelligence is viewed broadly, and a wide range of machine learning and mathematical models suitable as base for decision support will be evaluated. Two members of the team will test the framework on a sample of included studies to ensure that the coding framework is suitable and can be consistently applied. Analysis of collected data will provide a descriptive summary and thematic analysis. The reported results will convey knowledge about the state of current research and innovation for using artificial intelligence to detect sepsis in early phases of the medical care chain. Ethics and dissemination: The methodology used here is based on the use of publicly available information and does not need ethical approval. It aims at aiding further research towards digital solutions for disease detection and health innovation. Results will be extracted into a review report for submission to a peer-reviewed scientific journal. Results will be shared with relevant local and national authorities and disseminated in additional appropriate formats such as conferences, lectures, and press releases. [ABSTRACT FROM AUTHOR]

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Introduction: Willis arterial circle (circulus arteriosus cerebri Willisi) is the most important part of the collateral circulatory system of the brain. It functions in normal and pathological situations such as valvular mechanism and thus allows optimal blood supply of all parts of the brain tissue, which reduces the risk of transient ischemic attack (TIA) and stroke. The main pre-requisite for the normal function of the circle is its completeness and the lack of hypoplastic vessels. Materials and Methods: In this research, we used 100 angiograms of carotid system shown by serial angiography by Seldinger taken from the archives of the Department of Radiology, Clinical Center University of Sarajevo. For morphometric analysis of blood vessels, we used specially designed software program ELLIPSE (ViDiTo, Zoltan Tomoris, Kosice, Slovak Republic, tomori@saske.sk. In this way, it was possible to more easily store and analyze angiograms that were used for morphometric analysis. Results: In our study, larger diameters of blood vessels in Willis circle were observed in the younger subjects compared to older except the diameter of the internal carotid artery, which was about 0.2 to 0.3 mm larger in the older subjects. In both age groups among males, we recorded larger diameters of the internal carotid artery and segment before the circle of the posterior cerebral artery in relation to the female population, while the rear communicating artery in females was 0.1 mm wider in diameter compared to men in category of younger respondents. [ABSTRACT FROM AUTHOR]

Objective: In recent years regional anesthesia has gained great popularity. However, like any other medical procedure, the regional anesthesia carries certain risk of unintended intraneural injection and consequential neurological complications. Studies in animals have suggested that intraneural application of local anesthetics may cause mechanical injury. Previous studies, however, have used small animal models and clinically irrelevant injection speed or equipment. In this study we used equipment and injection methods in common clinical use to study the consequences and pressure dynamics of intraneural injection. Our hypothesis is that an intraneural injection is heralded by higher injection pressure and leads to neurologic impairment in pigs. Materials and Methods: Ten pigs of mixed breed (21-26 kg, 4-6 months old) were studied. After general anesthesia, the sciatic nerves (n = 20) were exposed bilaterally. Under direct vision, a 25-gauge insulated nerve block needle was placed either intraneurally (n = 10) or perineurally (n = 10), and 4 ml of preservative-free lidocaine 2% was injected using an automated infusion pump (15 ml/min). Injection pressure data were acquired using an in-line manometer coupled to a computer via an analog-to-digital conversion board. After injection, the animals were awakened and subjected to serial neurologic examinations during next 7 days. Results: All perineural injections resulted in injection pressures below 40 kPa. In contrast, intraneural injections resulted in significantly higher peak pressures (P < 0.01). In seven (70%) intraneural injections, the injections pressures were over 140 kPa (140-350 kPa). Neurologic function returned to baseline within 24 hours in all sciatic nerve receiving perineural injections. In contrast, residual neurologic impairment was present in seven sciatic nerves after intraneural injection and was associated with injection pressures >140 kPa. Conclusion: High injection pressure (>140 kPa) predicts intraneural injection and consequential neurologic deficit. As long as the injection pressure is low, injection into poorly compliant tissue can be avoided and neurological complication can be prevented. [ABSTRACT FROM AUTHOR]

Poly(ℇ-caprolactone) (PCL), a biodegradable and biocompatible aliphatic polyester has a great potential as a drug carrying material in controlled drug delivery/release systems. The most simple and economical way to tailor the release profile of active substances from biodegradable polymer matrix is by the addition of the second polymeric component in the polymer matrix, i.e. by blending. This study describes the preparation and characterization of a carbamazepine-loaded microspheres by the use of PCL blended with poly(ethylene oxide) as a drug carrying material. By the use of two-component hydrophilic/hydrophobic polymer blend as a microspheres' matrix material, release profile of the drug can be modified and dictated. The microspheres prepared by classical oil-in-water emulsion solvent evaporation technique were characterized with respect to particle size and morphology, polymer matrix composition, encapsulation efficiency, physical state of the drug and in vitro release behaviour. It was presented that the release profile can be modified by the presence and the amount of hydrophilic component in the starting formulation of microspheres. [ABSTRACT FROM AUTHOR]

After gaining the independence at the Congress of Berlin in 1878, relations between Montenegro and the Ottoman Empire were on a relatively high level. They were especially good during the reign of Prince Nikola and Sultan Abdulhamid the Second, mostly due to their mutual friendship. Such relations resulted in two visits of Prince Nikola to Istanbul, in 1883 and 1899. The second visit was widely commented in Istanbul daily newspapers. One of them was Malumat, which on several occasions published articles regarding the Prince's visit. This paper intends to provide an overview of Malumat's reporting on the Prince Nikola's visit to Istanbul in 1899. [ABSTRACT FROM AUTHOR]

As part of the commemorative issue “60 Years of the Historical Institute of Montenegro 1948-2008,” this article surveys documents of the Ottoman Empire mentioning the Montenegrin village of Zloglavlje.

A series of aliphatic poly(ether–ester)s based on flexible poly(tetramethylene oxide) (PTMO) and hard poly (butylene succinate) (PBS) segments were synthesized by the catalyzed two‐step transesterification reaction of dimethyl succinate, 1,4‐butanediol, and α,ω‐hydroxy‐terminated PTMO (Mn = 1000 g/mol) in the bulk. The content of soft PTMO segments in the polymer chains was varied from 10 to 50 mass %. The effect of the introduction of the soft segments on the structure, thermal, and physical properties, as well as on the biodegradation properties was investigated. The composition and structure of the aliphatic segmented copolyesters were determined by 1H NMR spectroscopy. The molecular weights of the polyesters were verified by viscometry of dilute solutions and polymer melts. The thermal properties were investigated using DSC. The degree of crystallinity was determined by means of DSC and WAXS. Biodegradation of the synthesized copolyesters, estimated in enzymatic degradation tests on polymer films in phosphate buffer solution with Candida rugosa lipase at 37°C, was compared with hydrolytic degradation in the buffer solution. Viscosity measurements confirmed that there was no change in molecular weight of the copolyesters leading to the conclusion that the degradation mechanism of poly(ester–ether)s based on PTMO segments occurs through the surface erosion. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci, 2007 [ABSTRACT FROM AUTHOR]