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We performed a retrospective cohort study, namely "Surgery and ART for Endometriomas" (SAFE) trial (Clinical Trial ID: NCT03717870), including women who underwent laparoscopic cystectomy for endometrioma before first IVF and compared their reproductive outcomes with the ones of women without endometriosis and with unexplained infertility, tubal factor or male factor infertility. We found that women who underwent previous laparoscopic cystectomy for endometrioma had higher FSH and LH levels between the 2nd and 5th day of the cycle before IVF, required higher doses of gonadotrophins for ovarian stimulation and had a lower number of retrieved oocytes compared with other types of infertility. Nevertheless, pregnancy and delivery rates remain comparable to other causes of infertility. In addition, differences in ovarian stimulation parameters between endometriosis and other types of infertility lost significance with the increase of women's age. These pieces of information can be considered useful to make adequate counselling about reproductive outcomes for infertile women with ovarian endometriomas and allow a proper decision-making approach shared with the patient.IMPACT STATEMENTWhat is already known on this subject? Although endometriomas are common findings in infertile women, whether they should be surgically removed before an in vitro fertilisation (IVF) is a long-lasting debate, and current evidence does not offer a robust background to draw firm recommendations.What do the results of this study add? Women who underwent previous laparoscopic cystectomy for endometrioma need higher doses of gonadotrophins for ovarian stimulation and have a lower number of retrieved oocytes, compared with other types of infertility. Pregnancy and delivery rates remain comparable to other causes of infertility.What are the implications of these findings for clinical practice and/or further research? These pieces of information can help to make adequate counselling about reproductive outcomes for infertile women with ovarian endometriomas and allow a proper decision-making approach shared with the patient.

This paper presents a pilot research of approaches taken by European Union (EU) Member States (MSs) in the emergency response to the COVID-19 crisis in pre-tertiary education. It includes a multi-case study of four MSs, examining their education systems’ digital readiness and “fitness for change”, as well as decision-making practices. We use the Cynefin framework of decision contexts to explore different paths in shifting from chaos to complexity. The preliminary findings of this research indicate that a factor positively influencing education systems’ response was not exclusively their digital readiness, but also “fitness” in terms of ongoing reforms and preparedness for change. The findings also suggest that MSs generally continued with their usual decision-making practices, with tendencies towards centralisation of crucial decisions, which is in line with the Cynefin framework, arguing for stronger leadership in chaotic contexts.

High-density (HD) electrodes have been introduced in research and diagnostic electromyography. Recent advances in technology offer an opportunity for using the HDEMG signal as biofeedback in stroke rehabilitation. The purpose of this case study was to test the feasibility of using two 5 × 13 electrode arrays for providing real-time HDEMG biofeedback and the preliminary outcome of combining HDEMG biofeedback with robotic wrist exercises over 4 weeks in a person who suffered a stroke 26 months earlier. The isometric wrist flexion/extension task required to keep the paretic agonist activity within variable preset limits with minimal activation of the antagonists. The participant was able to utilize the provided biofeedback interface and after eight sessions significantly decreased co-activation in the antagonist wrist extensor muscles during isometric wrist flexion. The HDEMG biofeedback seems feasible and may be used alone or in combination with robotic therapy for increasing the selectivity of muscle activation after stroke.

How language users become able to process forms they have never encountered in input is central to our understanding of language cognition. A range of models, including rule-based models, stochasti...

To investigate if second-look US using shear-wave elastography (SWE) can help to differentiate between benign and malignant changes in the postoperative breast after surgical treatment of breast carcinoma.SWE and related sonographic features were reviewed in 90 female patients with a history of surgical treatment of breast carcinoma and a suspicious lesion detected on a follow-up MRI scan. A single experienced radiologist performed all second-look US exams with SWE measurements placing a circular region of interest measuring 2 mm in diameter over the stiffest part of the lesion. Tissue samples for histopathological analysis were obtained during the same US examination via core-needle biopsy.Out of 90 lesions, 39 were proven malignant on histopathological analysis. 50 % of malignant lesions had ElStiffer lesions should be considered suspicious on second-look US in the postoperative breast and SWE can be a helpful tool in identifying malignant lesions, especially if this is related to restricted diffusion on MRI exam. Lesion stiffness, however, should not be considered as an independent predictor of lesion malignancy in the postoperative breast, because of benign changes that can appear stiff on SWE, as well as carcinoma recurrences that may appear soft.ZIEL: Es soll untersucht werden, ob der Second-Look-US mittels Scherwellen-Elastografie (SWE) nützlich ist, um zwischen benignen und malignen Veränderungen in der postoperativen Brust nach der operativen Therapie des Mammakarzinoms zu differenzieren.SWE und die damit verbundenen sonografischen Merkmale wurden bei 90 Patientinnen mit Anamnese einer operativen Therapie des Mammakarzinoms und einer bei der MRT-Nachuntersuchung entdeckten verdächtigen Läsion überprüft. Ein einziger erfahrener Radiologe führte alle Second-Look-US-Untersuchungen mit SWE-Messungen durch, indem er eine kreisförmige Region of Interest von 2 mm Durchmesser über dem steifsten Teil der Läsion legte. Gewebeproben für die histopathologische Untersuchung wurden dabei durch Stanzbiopsie entnommen.Von 90 Läsionen erwiesen sich 39 als maligne in der histopathologischen Untersuchung. Von den malignen Läsionen zeigten 50 % ElSteifere Läsionen in der postoperativen Brust sollten im Second-Look-Ultraschall als suspekt angesehen werden. SWE kann eine hilfreiche Methode zur Identifizierung maligner Läsionen sein, insbesondere im Zusammenhang mit einer eingeschränkten Diffusion in der MRT-Untersuchung. Die Steifigkeit der Läsion sollte jedoch nicht als unabhängiger Prädiktor für die Läsionsmalignität in der postoperativen Brust angesehen werden, da in der SWE benigne Veränderungen steif, Karzinomrezidive hingegen weich erscheinen können.

The ultimate goal of each production process is to optimize all the subprocesses leading to the high quality final product. Within the printing process, dot gain is identified as one of the most important variables to control because of the extremely negative impact to middle tone contrast and the overall reproduction. Dot gain consists of two components, mechanical and optical dot gain, as a result of two different contributions. This article proposes a model for separately analyzing components of dot gain for electrophotography prints using gradient method, where the impact of printing technique and paper type will be examined. It is shown that mechanical dot gain for electrophotography prints can be satisfactorily approximated with Gaussian, whilst optical dot gain is once again confirmed to have the form of a Lorentzian.

Shear wave elastography (SWE) is a type of ultrasound elastography with which the elastic properties of breast tissues can be quantitatively assessed. The purpose of this study was to determine the impact of different regions of interest (ROI) and lesion size on the performance of SWE in differentiating malignant breast lesions. The study included 150 female patients with histopathologically confirmed malignant breast lesions. Minimal (Emin), mean (Emean), maximal (Emax) elastic modulus and elasticity ratio (e-ratio) values were measured using a circular ROI size of 2, 4 and 6 mm diameters and the lesions were divided into large (diameter ≥ 15 mm) and small (diameter < 15 mm). Highest Emin, Emean and e-ratio values and lowest variability were observed when using the 2 mm ROI. Emax values did not differ between different ROI sizes. Larger lesions had significantly higher Emean and Emax values, but there was no difference in e-ratio values between lesions of different sizes. In conclusion, when measuring the Emin, Emean and e-ratio of malignant breast lesions using SWE the smallest possible ROI size should be used regardless of lesion size. ROI size has no impact on Emax values while lesion size has no impact on e-ratio values.

Patient: Male, 28-year-old Final Diagnosis: Giant cell bone tumor • osteoclastoma Symptoms: Wrist swelling and pain Medication: — Clinical Procedure: Radiology imaging • orthopaedic surgery Specialty: Orthopedics and Traumatology • Radiology Objective: Rare disease Background: Giant cell tumor is a rare tumor of mesenchymal origin. According to World Health Organization classification, it is considered a benign tumor with locally aggressive characteristics and the capacity to metastasize. The tumor typically occurs in the epiphyseal regions, most often of long bones after the completion of bone growth. The disease is characterized by severe pain and swelling of the affected area. Tumor growth is expansive but relatively slow. The tumor rarely metastasizes, but when it does, the lungs are primarily affected. Case Report: A 28-year-old man, otherwise healthy, presented with pain in the right wrist joint, limited range of motion, and spindle-shaped thickening/swelling in the same area, which he had noticed several months earlier. After a comprehensive diagnostic evaluation (wrist X-ray, computed tomography, magnetic resonance imaging, ultrasound-guided biopsy, and histopathological analysis), he was diagnosed with giant cell tumor of the right ulna. The tumor was surgically removed with good recovery, and the patient continued to be seen thereafter in regular followup. Conclusions: The wide range of benign and malignant differential diagnostic entities requires a detailed diagnostic approach and comprehensive assessment, using different radiological modalities, as was done in this case. The final diagnosis was confirmed by histopathological analysis of core biopsy material.

Aims To achieve better treatment decisions, type 2 diabetes patients need to be empowered also through knowledge increase. The aim of this study was to evaluate and compare the level of knowledge and overall perceptions of type 2 diabetes within the elderly diabetic patients before and after the National Diabetes Prevention and Care Development Programme 2010–2020. Methods Diabetes knowledge test was used in two cross-sectional studies in 2011 and 2020 where the samples of type 2 diabetes patients 65+ were surveyed. Besides descriptive statistics, non-parametric tests and general linear model were used to compare the level of knowledge. Results The comparison reveals that in the last decade the general knowledge about diabetes has not significantly changed (U = 16942, p = 0.809). The average scores in 2011 and 2020 were 7.98 ± 2.41 and 7.96 ± 2.36 respectively. The average level of knowledge has slightly worsened for patients in the age group 80+, while it remained approximately the same in the other three age groups (65−69, 70−74, 75−79). Conclusions Our study has shown that despite the National Diabetes Prevention and Care Development Programme the knowledge of elderly diabetic patients in Slovenia remained at the same level or worsened.

Hydronephrosis associated with kidney malrotation can be a surgical challenge. We present the case of a 3.5 y.o.-boy presenting with left pyelo-ureteric obstruction caused by kidney hyperrotation (270°) resulting in recurring urinary tract infection. After complete radiological work-up, we opted for a primary laparoscopic ureterocalicostomy, which allowed for complete resolution of the pelvic dilatation. Kidney malrotation can present with a wide variation in anatomic features. Radiological work-up is the cornerstone of surgical strategy planning. Laparoscopic ureterocalicostomy is a useful primary option in unusual anatomical situations.

Multidisciplinary research of surface geodynamic processes is important for understanding mechanisms that lead to sudden release of accumulated strain energy, i.e. earthquakes. It requires development of an original scientific approach which combines data from various geosciences such as geodesy, geology and seismology. This implies that each geoscience contributes to a better understanding by providing specific direct or indirect information on activity (spatial movements) and properties of seismogenic sources (faults). In recent years, new and accessible sources and types of geoinformation have greatly enhanced, enabling a more comprehensive investigation of ongoing geodynamic activity on faults and, therefore, improve our ability to develop approaches to assess and mitigate the seismic hazard and risk within the earthquake-prone areas. In this paper, we seek to identify the geoinformation required to improve the current knowledge on regional and local geodynamic processes in the Republic of Croatia. Focusing on the complementarity of geodetic, geological and seismological data, we discuss possible sources of the diverse sets of site-specific geospatial data. Examples include: ground/surface movement observations with Global Navigational Satellite Systems (GNSS) and Satellite Radar Interferometry (InSAR); data about historical and instrumental seismicity (e.g. focal mechanism solutions, number of earthquakes, b-value, etc.); fault location, fault geometrical properties and information on their neotectonic activity, paleoseismological data, etc. Challenges regarding the integrated use of these data, such as heterogeneity of data sources, access protocols, metadata standards, data quality, up-to-dateness, and other limitations are also addressed.

Cartographic symbols on crisis maps serve as the means of depicting information about the position, properties, and/or numerical values of objects, phenomena or actions specific to crisis mapping. The aim of symbology for many crisis cartographic visualisations are simple, clear, aesthetically pleasing symbols that can be easily used and understood by a wide range of crisis map users. If they are incomprehensible, illegible, ambiguous, unclassified, and random, if they lack hierarchical organisation and other characteristics which are important when designing a cartographic symbol set, they can fail to deliver the intended message. In addition to effective graphic design, cartographic symbol sets for crisis mapping are facing additional challenges, including consideration of their availability (sharing and promotion, dissemination and promulgation) and standardisation (ensuring the general and repeatable use of map symbols). To determine the extent of these challenges and to assess the current state of the cartographic symbology for crisis mapping we have compiled and compared the prominent examples of symbol sets that were promoted in the cartographic scientific and crisis mapping community in recent years. We pay particular attention to those sets that have gone through a new, reviewed or extended edition. We research whether the latest changes incorporated follow the recognised challenges posed to the crisis mapping symbology.

Backround: Guidelines for economic analyses of health care technologies require local input data for reimbursement decisions in the countries of Central and Eastern Europe (CEE). The aim of this study was to systematically review and analyse the available empirical studies using the EQ-5D instrument as a measure of the health-related quality of life (HRQoL) in patients with neurological diseases. Methods: A systematic literature search was performed up to 1st April 2018 to identify relevant studies in eight selected CEE countries. Original articles reporting on studies of neurological diseases using the EQ-5D instrument were analysed. Results: Thirty-six articles, describing the results of 38 samples of patients and a total of 13,005 patients were included in the review. Most studies were from Hungary (44.4%) and none from Romania or Slovakia. EQ-5D utility scores were reported in 33 (91.7%) articles. In multiple sclerosis (MS) being the most represented disease, the average utility scores ranged from 0.49 in Austria to 0.80 in Poland with a weighted average of 0.69. EQ VAS scores for MS ranged from 39 in Czech Republic to 72.0 in Poland, with weighted average of 59.1. MS patients, together with epilepsy and essential tremor patients, estimated their HRQoL among the highest. Conclusions: EQ-5D research activity in neurology has been increasing through the years in studied CEE countries. There are clinical areas with the significant social burden, such as a migraine or meningitis, that are completely lacking data, other areas, such as stroke or epilepsy, with very scarce data.

Background/Aim. Neuropathy represents the most frequent complication in the patients with diabetes mellitus (DM). Symmetric distal sensorimotor polyneuropathy (DSP), which represents the most frequent type of diabetic neuropathy, is present in 30% of hospitalized diabetic patients. The aim of our study was to compare the effects of physical therapy (PT) and alpha-lipoic acid (ALA) supplementation on pain reduction and quality of life improvement in the DSP patients. Methods. The study was performed on 60 adult patients with DM type 2 and DSP. The patients were randomly divided into 2 groups: group A (n = 30) was treated by PT and group B (n = 30) was treated by ALA. The study lasted 6 months during which 3 diagnostictherapeutic cycles were performed. To asses their pain before and after every of 3 cycles, we used visual analog scale (VAS). We also evaluated quality of life before the 1st and after the 3rd cycle with the European Quality of Life Questionnaire (EQ-5D-3L). To analyze results between groups we used mixed between-within subjects ANOVA and statistical significance was set on p < 0.05. Results. Pain intensity showed statistically significant influence of both PT and ALA (? = 0.028; p < 0.001). A statistically significant difference between the effects of those two therapy modalities was observed (F = 4.78; p < 0.05): PT reduced pain to the greater extent than ALA. A statistically significant improvement was found in the domain of pain/discomfort both in the group A (? = 0.54, p < 0.001) and group B (? = 0.57, p < 0.001), as well as anxiety/depression (group A: ? = 0.32, p = 0.008; group B: ? = 0.22, p < 0.019) and EQ-VAS (both groups, p < 0.05). Conclusion. Our research showed that physical therapy had a greater influence in pain reduction than alpha-lipoic acid in the patients with DSP.

Digital competences should be considered in teacher education and professional development. The Technological Pedagogical Content Knowledge (TPACK) framework represents the knowledge required by teachers in order to successfully integrate technology into the teaching process. The Survey of Pre-service Teachers’ Knowledge of Teaching and Technology (SPTKTT) is one of the inventories developed to measure the TPACK framework. The aim of this study is to validate the SPTKTT inventory in the context of the Croatian education system by the use of exploratory and confirmatory factor analysis. Results showed that the new context structure of the SPTKTT inventory consists of nine factors, while confirmatory factor analysis established that the two Content Knowledge factors can actually be unified. This can be explained by differing content organization in education systems. There were also differences in the distribution of some of the remaining factors. Internal consistency of the inventory shows high reliability.

Introduction/Objective. Pain, stiffness and limited mobility are the main factors that lead to difficulties in performing daily activities and are also responsible for the decline in the quality of life in people with knee osteoarthritis (OA). The aim of this study was to evaluate the functional capacity and health related quality of life (HRQoL) compared to pain in patients with knee OA, as well as to determine the correlation between these three clinical variables. Methods. The study involved 931 patients diagnosed with knee OA. In all patients, pain was evaluated by a short form of the McGill pain questionnaire (SF-MPQ), functional status was assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC), while life quality was evaluated using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Results. The average age of patients was 61.21 ? 4.62 years, while 71.3% of them were women. The quality of life in patients with knee OA and all pain parameters contained in the SF-MPQ were highly statistically positively associated (p ? 0.01). In addition, the physical functioning was mostly affected by emotional pain (rho = -0.585). A high statistical correlation (p ? 0.01) was noted between stiffness and physical functioning from the WOMAC questionnaire and all of the parameters from the SF-MPQ. The physical functioning from the WOMAC questionnaire had the strongest correlation with total pain incorporated into the McGill questionnaire (rho = 0.530). Conclusion. Knee pain has a significant impact on functional capacity and HRQoL in patients with knee OA. Therefore, one of the main therapy goals for OA of the knee should be to reduce the pain in the affected knee, which can help to improve the functionality and HRQoL of these patients.

BACKGROUND The capability of diffusion-weighted imaging (DWI) for morphological analysis of breast lesions is underexplored. PURPOSE To evaluate the utility of DWI for assessment of morphological features of breast cancer by comparing DWI and dynamic contrast-enhanced (DCE) MRI findings to determine intermethod and interobserver agreement. STUDY TYPE Retrospective. POPULATION Seventy-eight women with pathohistologically proven breast cancer. FIELD STRENGTH/SEQUENCE 1.5T. DWI and DCE images. ASSESSMENT Diffusion-weighted and DCE images were placed in two separate case sets. Three radiologists, blinded to all other information, independently evaluated each case set on two separate occasions. Lesions were interpreted according to the fifth edition of the ACR BI-RADS lexicon. STATISTICAL ANALYSIS Kappa (κ) statistics were calculated in order to assess intermethod and interobserver agreement. RESULTS For values that attained statistical significance (P < 0.05), intermethod agreement ranged from fair (κ = 0.22) for nonmass internal patterns to significant (κ = 0.8) for lesion type. On DWI, interobserver agreement varied from fair (κ = 0.34) for mass shape to significant (κ = 0.75) for lesion type. On DCE MRI, interobserver agreement varied from fair (κ = 0.27) for irregular vs. spiculated mass margin to perfect (κ = 1) for circumscribed vs. noncircumscribed mass margin. DATA CONCLUSION On the whole, there was moderate intermethod agreement. The values of interobserver agreement were mostly similar between DWI and DCE MRI. This suggests that DWI is applicable for morphological assessment of breast cancer, notwithstanding substantially inferior spatial resolution compared to DCE MRI. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;49:1381-1390.

Objectives: Electromygraphic (EMG) biofeedback has been successfully applied in stroke survivors for a few decades. Recently high-density (HD) electrodes were introduced in research and diagnostic EMG. The application of such electrodes may increase the reliability and selectivity, but requires information reduction for real-time biofeedback. We tested whether the use of the proposed feedback is feasible in minimization of inappropriate co-activation of wrist flexors/extensors controlled by the wrist rehabilitation robot. Methods: The EMG of wrist flexors and extensors muscles has been assessed by arrays of 5 x 13 electrodes, reduced to 1 x 4 information matrix and provided as real-time biofeedback during wrist movement controlled by the robot. The designed task required to keep the contribution of agonist muscles within predefined limits. A feasibility study with a single patient with stroke was conducted to examine force tracking and reduction of activity of antagonists wrist muscles in 4 weeks. Results: Force tracking signal and cumulative forecast errors decreased in 4 trials. The RMS activity of antagonist muscles significantly decreased (Kruskal Wallis, c2 = 3.330*10-9) during wrist flexion in the 4th week of trials. The participant was able to follow the reduced HDEMG biofeedback.Conclusions: The outcomes show that the surface HDEMG biofeedback has a potential to decrease the co-activation of antagonist muscles, wrist flexion in particular. Additionally the combination of force tracking and robot assisted biofeedback training may recover selective hand function in stroke survivors who would less likely to develop contractures. Trial registration: The study is not a clinical trial. While human subjects are involved, they do not participate in a full rehabilitation intervention, and no health outcomes are examined.

OBJECTIVE Fractures in children are common and account for 10% to 25% of injuries in children with considerable effects on activity restriction and subsequent high socioeconomically impact. Eighty percent of all fractures in children occur at the upper extremity. The article investigates the epidemiology and fracture pattern of the upper extremity within a pediatric population consulting a tertiary referral hospital in Switzerland. METHODS Study population included all patients younger than 18 years presenting with an upper extremity fracture. Recorded data were age, sex, side, season of the year, mechanism, type of fracture, and applied treatment. RESULTS Fractures of the upper extremities represented 76% with a mean age of 9 years and 7 months. Compared with girls, boys had a risk ratio of 1.35 (1.14-1.6) of having a traumatic injury. The radius, with 298 fractures (37%), was the most injured bone. Overall simple fall from his or her height and soccer represented the main injury mechanisms accounting for 26% and 9%, respectively. Eighty-six percent of fractures were treated by cast with or without closed reduction, 11% (92) by closed reduction and pinning or elastic stable intramedullary, and only 3% of fractures were treated by open reduction and internal fixation. CONCLUSIONS Eighty-six percent of all fractures could be treated by conservative methods. Only 17% need surgical treatments by orthopedic surgeons. This shows how important it is to train residents in pediatrics for the treatment of upper limb fractures in children.

Recently, the employability of higher education graduates has been a topic of interest within many policy documents and scientific studies. Given the lack of comprehensive research identifying the implications of this issue for practice, this article presents a maturity model to support graduates’ early careers within higher education institutions (HEIs). The model is developed using a five-step approach, following the design science paradigm and exploiting four case studies across Europe. The final maturity model contains 65 practices within four key process areas—13 within strategic planning, 26 within curriculum design and delivery, 16 within student support, and 10 within the provision of extracurricular activities. In addition, a description of capability assessment criteria at the five maturity levels for each practice is provided. The model presented in this article can be used by HEIs as a tool to assess the maturity of their practices that contribute to graduates’ employability.

The computer-generated hologram (CGH) has wide use in many fields but often comes at a high cost due to complex proprietary equipment. For this research, we developed a new robust computational method, and applied and tested common computer-to-film (CtF) technology to create affordable and high-resolution prints of CGHs that can be used primarily in security printing. The proposed method also allows for quick authentication with no need for a complex optical setup, while offering high-level security analysis through a simple yet robust system. Beyond the computational method, we based our research on testing material, protocol, and the optical measuring setup and derived an all-in-one, highly defined, conclusive, usable method capable of making every CGH unique.

The development of Slovenian poetry after 1950 can be understood as a process of prosaisation and aesthetic inversion, and the writing of poetry in free verse as poetry in prose. Since many literary historians attribute the invention of free verse to Walt Whitman, the paper strives to research on what creative principles the American poet has founded his collection Leaves of Grass . Many contemporary American poets consider themselves to be Whitman’s successors, and the paper explores how the beatnik Lawrence Ferlinghetti understands this notion. In the first half of the twentieth century, Walt Whitman has influenced Oton Župancic and Anton Podbevsek, and in the second half until today, directly through the translations of his poetry in Slovenian language and indirectly through beat poets, many contemporary Slovenian authors. That is why, considering also other influences, the development of free verse in Slovenia can be partly perceived as the continuation of Whitman’s tradition. The paper examines the creative solutions found by Andrej Brvar, Esad Babacic, and Uros Zupan.

The purpose of this study is to analyse and present the causes of the differences in crude utilization rate in cardiac implantation electronic devices, specifically pacemakers and automatic implantable cardioverter-defibrillators, across 5 European countries, with a specific emphasis on Slovenia.Based on the results of the analysis of the uptake of cardiac implantation electronic devices across countries studied in MedtecHTA project, the targeted interviews were conducted to explain the factors that impact the differences and explain data in Slovenia.The reasons for the differences in crude utilization rate across 5 European countries were multiple: the first group of differences refers to the coding system and linkages between coding and financing of health care. The second group of reasons can be qualitatively ascribed to the economic situation, financial situation in health care, and its impact on decision-making. The last reason is the non-existence of the golden rule for optimal crude utilisation rate.It is evident that the differences in the uptake of cardiac implantation electronic devices among the countries are of organisational nature: they refer to the system of coding, the importance attached to correct coding practices, the link between coding and financing of health care as well as the availability of private clinics and private insurance. According to the interviews, the economic development of the country also impacts those differences, whereas the differences in clinical practice and guidelines are claimed not to play a role in the explanation of the differences.Namen raziskave je analizirati in predstaviti vzroke za razlike v stopnji izkoriščenosti in uporabe srčnih spodbujevalnikov in avtomatskih vsadnih srčnih defibrilatorjev med petimi evropskimi državami s poudarkom na Sloveniji.Na osnovi rezultatov analize uporabe in izkoriščenosti vsadnih srčnih elektronskih naprav med državami v okviru projekta MedtecHTA smo izvedli targetirane osebne intervjuje, s katerimi smo želeli razložiti faktorje, ki vplivajo na razlike v stopnji uporabe, in s katerimi bi lahko razložili razlike v slovenskih podatkih.Razlike v stopnji uporabe med petimi evropskimi državami so posledica več faktorjev. V prvo skupino spadata predvsem sistem kodiranja in povezanost med kodiranjem in financiranjem zdravstvenih storitev. Drug razlog je ekonomski razvoj gospodarstva, ki vpliva na finančno situacijo v zdravstvu in na sprejemanje odločitev o financiranju. Ne nazadnje pa je treba omeniti tudi dejstvo, da ni zlatega pravila o optimalni stopnji uporabe izbranih pripomočkov.Iz podatkov je razvidno, da so razlogi za razlike v uporabi izbranih pripomočkov med državami posledica organizacijskih odločitev: sistem kodiranja, pomen, ki ga pravilnemu kodiranju pripisuje medicinsko osebje, povezava med kodiranjem in financiranjem ter organizacija sistema v smislu stopnje privatizacije zdravstva in zasebnega zavarovanja. V intervjujih se je izkazalo tudi, da ima stopnja gospodarskega razvoja vpliv na razlike, zagotovljeno pa je bilo, da razlike v klinični praksi in smernicah ne igrajo vloge v obrazložitvi ugotovljenih razlik.

Hip osteoarthritis (OA) is a degenerative, progressive musculoskeletal system disease in adult individuals. Both genders demonstrate a similar prevalence at 11.5% for men and 11.6% for women. During the initial stage of hip OA, conservative treatments may significantly decrease pain, provide functional improvement and enhance health related quality of life (HRQoL).The aims of the study were to evaluate the quality of life of patients with hip osteoarthritis and to estimate the impact of a comprehensive rehabilitation intervention on their HRQoL.This was a prospective, observational study of 50 consecutive patients with hip osteoarthritis who were referred to an outpatient rehabilitation intervention. To assess their HRQoL before and after rehabilitation, we used the SF-36 and the Lequesne index for hip OA.The mean age was 61.7±8.3 years, and 56% of the patients were women. After rehabilitation, the SF-36 RE and RP subscales and the Lequesne pain subscale showed the most significant improvement, although all of the SF-36 and Lequesne domains showed significant improvement. Before rehabilitation, the Lequesne ADL subscale was most correlated with the SF-36 PF subscale (rho=−0.908). After rehabilitation, the total Lequesne score was highly correlated with the SF-36 PF subscale (rho=−0.895). Age, education and the duration of disease were significantly correlated with all of the Lequesne subscales before and after rehabilitation.This study showed that patients with hip osteoarthritis had a substantially low HRQoL, but all health dimensions showed statistically significant improvements after outpatient rehabilitation intervention.

Summary Fear of needles can significantly limit professional and social functioning of a person, and is highly prevalent in general population (4%). The aim of our study was to reveal risk factors that are associated with fear of needles among healthy university students of medicine and pharmacy. The study was of a cross-sectional type. In total, 301 students of medicine or pharmacy (82% female and 18% male) attending from 1st to 5th year of study were surveyed at the Faculty of Medical Sciences, University of Kragujevac, Serbia. The students were surveyed using a questionnaires (scales) for assessing the fear of needless, a visual analog scale for self-assessment intensity of the fear of needless, and a general questionnaire with questions about socio-demographic characteristics of the participants. Using a score on the scales as out-come variables, multiple regressions were employed to reveal factors that may influence the fear of needles. Average values of Blood/Injection Fear Scale, Injection Phobia Scale-Anxiety and Medical Avoidance Survey scores were 7.89 ± 9.48, 4.46 ± 5.18 and 89.95 ± 12.73, respectively. The following factors affected significantly the score of the scales: course of study, chronic disease in the family, fear of a dentist, smell of the room phobia, sound phobia, score on the Beck’s anxiety scale and fear of a situation when medical staff give an injection. The presence of chronic disease in the family was a protective factor, while the other six factors were contributing to the fear of needles. Fear of needles is more prevalent among the students of pharmacy than among the students of medicine. It is less frequent among students with chronic disease in their family, while fear of dentist, smell of the room phobia, sound phobia, general anxiety and fear from the situation when medical staff give an injection are all factors that predispose students of medicine or pharmacy to develop fear of needles.

Background/Aim. Acute pancreatitis is an inflammatory condition having the significant mortality rate in the case of severe forms of the disease. The aim of this study was to investigate putative factors of increased mortality in patients with acute pancreatitis with contradictory prior evidence, and to reveal factors that were insufficiently explored previously. Methods. This prospective cohort study with nested case/control design included all adult patients treated for acute pancreatitis in the Clinical Center of Kragujevac, Serbia, during the 3-year period (from October 2011 to December 2014). The cases (n = 19) were patients who died, while the controls (n = 113) were patients who survived. The associations between putative risk factors and the study outcomes were tested by univariate and multivariate logistic regressions, and expressed as crude and adjusted odds ratios (OR) with corresponding 95% confidence intervals (CI). Results. Significant association with the lethal outcome in acute pancreatitis was found for advanced age (adjusted OR 1.12, 95%CI 1.02?1.23), presence of significant comorbidities (adjusted OR 10.62, 95%CI 1.01?111.39), higher interleukin- 8 (IL-8) value on third day from onset of symptoms (adjusted OR 1.05, 95%CI 1.02?1.08), use of tramadol and/or morphine (adjusted OR 47.34, 95%CI 3.21?699.08), the Bedside index for severity in acute pancreatitis (BISAP) score ? 3 in the first 24 hours (adjusted OR 48.11, 95%CI 3.14?736.29), and prophylactic use of antibiotics (adjusted OR 0.07, 95%CI 0.01?0.85). Conclusion. Advanced age, significant comorbidities, use of tramadol and/or morphine and more severe disease as assessed by BISAP score can increase the risk of death in acute pancreatitis, while prophylactic use of antibiotics may have a protective role.

Objective To our knowledge this is the first study presenting descriptive EQ-5D health profile and VAS scores for orthopedic patients in Slovenia. Furthermore, EQ-5D-3L population norms for Slovenia are presented. The aims of this study are (1) to provide population norms for EQ-5D-3L in Slovenia according to age and sex and (2) to compare different groups of orthopaedic patients’ health state among themselves as well as to the general population. Methods Data on orthopedic patients' preoperative health status assessment were recorded (n = 1118). The health status of 4 groups of orthopedic patients was analyzed and compared using EQ VAS and the EQ-5D descriptive profile. The results were compared with Slovenian population norms, which were calculated using the EQ-5D valuation set database from year 2000 (n = 708). Results As expected, a higher proportion of patients than the general population report problems on all dimensions. The opposite is true only for mobility and anxiety/depression dimension for shoulder surgery patients. Hip endoscopy patients have the lowest health-related quality of life (HRQoL) out of all patient groups using EQ VAS and EQ-5D descriptive profiles. Conclusion The population norms presented will be useful for many researchers trying to compare HRQoL among various patient groups or the general population. Separate use of the descriptive profile of the EQ-5D is informative when assessing HRQoL in orthopedic patients and is in line with VAS values. The results can support further studies on health needs assessment as well as decisions on funds allocation among groups of orthopedic patients.

BACKGROUND Differential diagnosis of soft tissue swelling on exposed body parts in the young athlete is large and mostly includes benign self-limiting conditions, once underlying lesion to the bone, the cartilage, and the ligaments is excluded. Morel-Lavallee lesion represents a rare soft tissue injury requiring prompt intervention to ensure favorable outcome. CASES A 10-year-old boy presented with 2-week-old swelling of the medial side of the knee without recent traumatic event. Unawareness of Morel-Lavallee lesion in the differential diagnosis led to delayed diagnosis and treatment. A 16-year-old boy came to our pediatric tertiary care center with a similar presentation and history. Timely intervention allowed for favorable outcome and early return to play. CONCLUSIONS Morel-Lavallee lesion is a rare entity in the pediatric population, although underreporting due to unfamiliarity with the diagnosis is highly probable. Raising awareness among professionals in charge of young athletes should allow for better reporting as well as for elaboration of a standardized treatment plan, including rapid intervention and early return to play.

Background In patients with extreme alveolar ridge atrophy, where mandibular height is less than 10 mm, it is challenging to achieve stable and well functioning complete denture. In such cases, it is not possible to insert standard size or even short dental implants without complicated bone augmentation procedures. Due to small width of MDIs, patients do not need demanding surgical procedures and hence are well accepted by elderly patients or those with deteriorating general health status. Aim/Hypothesis Aim was to test the behavior of dental implants being both, slim and short (short MDIs) for complete overdenture (OD) retention by digital image correlation (DIC), and afterward, in clinical trial, to rehabilitate patients with less than 10 mm of mandibular height by means short MDIs OD retention. Material and Methods Based on CBCT scans of patients with extremely atrophied mandible (interforaminal height < 10 mm), 6 models of an average extremely atrophied mandible were virtually built and 3D printed. In each model 4 short MDIs (length 6 or 8 mm, width 2 or 2.5 mm) were inserted interforaminally and CoCr reinforced ODs were loaded with 150 N on denture molar region bilaterally, unilaterally and the on anterior region. Precise measurement of strain and displacement was conducted using the Digital Image Correlation Method (ARAMIS software v6.2.0 + GOM‐ Optical Measuring Techniques), which approved the protocol. Patients (D or E classification according to Leckholm and Zarb) received 4 short MDIs by a flapless surgical technique. MDIs were early loaded using matrices with O‐rings mounted in mandibular ODs. Marginal bone loss (MBL), technical complications, OHIP‐EDENT and the chewing function questionnaire (CFQ) were assessed prior treatment, after OD delivery and after 2‐ years in function. Results Strain values on all models ranged from 0.45% to 0.92% with the highest displacement and strain values observed around MDIs and on the zone of bone‐denture contact. Analysis of the major strain fields demonstrated that the strains of the mandibular bone were the result of vertical displacements of the ODs. DIC showed in all loading stages identical spreading direction with the maximum strain value within the denture‐bone complex. In clinical trial 20 patients received 4 short MDIs and respective ODs. Two implants fractured during insertion and 4 failed after placement. All other implants were stable, without biological complications. MBL was 0.26 ± 0.35 mm with 95% survival rate and 8 O‐ring replacements. The OHIP‐EDENT and the CFQ scores significantly decreased after treatment (P > 0.05) and did not change significantly through the 2‐ years of observation (P > 0.05). Conclusion and Clinical Implications DIC is a novel method in dentistry providing high precision and accurate repeatability. Measurements on 3D printed models demonstrated low strain and displacement values around short MDIs and in mandible, which enabled proceeding with clinical trials. Within the limitations of this study, insertion of 4 short MDIs (length 6 or 8 mm) in extremely atrophied mandibles for retention of mandibular ODs showed encouraging results in the first two years of function. Acknowledgement‐ HRZZ

Background: Common cold and influenza result in an increased number of primary care consultations, significant work/school absences and cause a socio-economic burden. Laypeople’s perceptions and knowledge regarding common cold and influenza prevention is poorly understood and under-researched. Objectives: Our study explores laypeople’s knowledge of prevention of common cold and influenza across three European countries. Furthermore, it investigates if there is any distinction between prevention activities focussing on reasons impacting the attitude towards influenza vaccination as well as investigating cross-country variation. Methods: In total, 85 semi-structured individual interviews were performed across three European countries (Austria n = 31, Belgium n = 30, Croatia n = 24). Qualitative thematic content analysis was performed. Results: Most participants across all three countries made no distinction between the prevention of the common cold and influenza and referenced the same preventative measures for both conditions. They mainly expressed negative attitudes towards influenza vaccination possibly effective but only intended for high-risk groups (bedridden/older people, chronic patients or health workers). There were very few cross-country differences in results. Conclusion: The perception of health risk of contracting influenza and a primary healthcare physicians’ recommendation played an important role in shaping participants’ decisions towards vaccination. Primary healthcare physicians are invited to assess and if necessary adjust inappropriate prevention behaviour through their everyday patient consultations as well as add to the knowledge about influenza severity and influenza vaccination benefits to their patients.

The triceps surae muscle group has a very important role in supporting human posture and gait and is thus particularly interesting in the context of healthy aging and independent locomotion of older people. Despite plenty of research on age-related changes in human limb muscles, the underlying mechanisms are still not completely understood and there is no common consensus on the effects of aging in triceps surae muscles and their causes. Furthermore, a few recent research papers published results that seem to contradict the previous research and open new questions about the mechanisms of muscle adaptation to aging-related changes in human body.In this study, we used the decomposition of high-density surface electromyograms to analyze motor unit firing rates in triceps surae muscles of young and older subjects during isometric plantar flexion. When compared to the young subjects, the motor unit firing rates of older subjects were significantly higher in gastrocnemii muscles and significantly lower in soleus muscle. The presented results demonstrate that the age-related changes in triceps surae are muscle specific. They also demonstrate the feasibility of using high-density surface EMG to non-invasively track age-related changes in motor unit behavior.

Shear wave sonoelastography is a valuable additional technique in differentiation between benign and malignant breast lesions. In this paper, a hypothesis of the potential role of this additional ultrasound technique as a very useful tool in differentiation of a medullary breast cancer subtype is proposed. Medullary breast cancer is a rare subtype, difficult for diagnosing, due to its benign radiologic features that can mislead to the wrong conclusion. After analyzing the results of nine patients diagnosed with medullary breast cancer and in comparison with two control groups (invasive ductal cancer of no specific type and fibroadenoma), we concluded that this breast cancer subtype shows specific elastography features based on qualitative and quantitative values.

Breast sonoelastography is a relatively novel ultrasound (US) method that enables estimation of tissue stiffness to estimate the elasticity of normal breast tissue and seek to correlate it with well-known breast cancer risk factors. Two hundred women of different age were included in the study and completed a questionnaire about personal, familiar, and reproductive history. Glandular and fatty tissue elasticity in all breast quadrants was measured by shear wave elastography (SWE). Mean elastographic values of breast tissue were calculated and compared to personal history risk factors. Elasticity of normal glandular tissue (66.4 kilopascals (kPa)) was higher than fatty tissue (26.1 kPa) in all breast quadrants and in both breasts. Lower outer quadrant (LOQ) had the lowest elasticity values of both parenchyma and fat. Higher elasticity values of breast tissue were confirmed in the left breast than in the right breast. Glandular and fat tissue elasticity negatively correlated with body mass index (BMI). Women with mastodynia had higher glandular elastographic values compared to subjects without breast pain. Nuliparity was also associated with higher elasticity of glandular breast tissue. The results of this study are promising and could, over time, contribute to a better understanding of glandular breast tissue elasticity as a potential risk factor for breast cancer.

Cartographic symbols on crisis maps serve as means of depicting information about the position, properties, and/or numerical values of objects, phenomena or actions specific to crisis mapping. Many crisis cartographic visualisations require simple, clear, categorised and visually organised symbols that can be easily read and understood by a wide range of crisis map users. Cartographic symbol sets for crisis mapping depend on effective graphic design, good availability (sharing and promotion, dissemination and promulgation) and standardisation (ensuring the general and repeatable use of map symbols). In this research, our aim was to examine the extent of these challenges in current cartographic symbology for crisis mapping. Through a comparative study of prominent symbol sets, we analysed efforts invested so far and proposed future directions. The results of this study may be of assistance in understanding less unified or coherent symbologies currently in use, or in revising or amplifying existing sets for future publication.

In this study we investigated gait measurement with wearable sensor for subjects with and without multiple sclerosis (MS) and evaluation gait function.The gait function was measured with Avatar sensors system in 3 patients with MS and in 3 healthy subjects without MS. The system consists of a main sensor node and three additional fixtures. Each sensor node is wearing three-axial accelerometer and two-axis gyroscope. Cross-correlation analysis with the walk signal was applied.Coefficient values from cross-correlation are determined for all 6 subjects. Then for a new unknown subject the cross-correlation was applied and the mean value cross-correlation for healthy subjects was 0.0477, while in MS subjects this value was 0.0207. A proven validation for this small training system has shown the evidence for different gait analysis for MS and healthy subjects.This small study opens a new avenue for clinical diagnosis of potential MS subjects while wearable sensor can provide an objective framework for assessing gait abnormality. The measured data can provide better understanding on the progression of the disease and response to treatment.

It has been several years since Massive Open Online Courses (MOOC) have entered the higher education environment and many forms have emerged from this new way of acquiring knowledge. Teachers have been incorporating MOOCs with more or less success in a traditional classroom setting to support various learning preferences, introduce this new way of learning to students, and to make learning available to those who might not be able to follow traditional instructions. This paper researches a blended learning model where a MOOC has been integrated in a traditional classroom. A learning outcomes based approach was implemented, that supported a balanced student workload. Qualitative approach was used to analyse students’ learning diaries. Based on this research, benefits of integrating a MOOC with classroom based teaching were identified, as well as barriers that can hinder the successful implementation. Recommendations for teachers are provided.

The paper deals with influential factors of an organization’s environment in the initial phase of diffusion of innovations (DOI) within the organization. A qualitative research was carried out with two expert groups: one for the diffusion of e-learning as an innovation in a higher education institution and the other for the diffusion of the Building Information Modelling (BIM) in a Construction Industry. The research disclosed 20 common factors. The internal environment group covers management support, the attitude towards innovation, strategic planning and communication, motivation and expertize of employers, available resources and IT maturity level of an organization. The group of business environment factors consists of competitors, clients and partners, supply and demand balance on the specific market for goods and services. In the social environment group, three factors are recognized on the national level and two on the global levels. The holistic model combines the theory of DOI and the concept of absorption capacity.

Using the appropriate methodology for strategic decision-making in higher education is crucial to make effective decisions. In this paper, the analytic network process (ANP), one of the most suitable decision-making methods in terms of higher education issues, is presented and evaluated from the position of the user. After recognising some characteristics of the ANP that can be improved, the main objective of this research was to develop a new method based on the characteristics of the ANP and social network analysis (SNA). The research methodology used in this paper is the design science research process (DSRP), which is often used to design new artefacts, such as models, methods and methodologies. The main phases of this approach include problem identification, objectives of a solution, design and development, demonstration of the artefact, evaluation and dissemination. By using the DSRP, a new decision-making method is designed and proposed. The new method has two components that are based on the ANP and SNA. The first component is related to determining the importance of criteria with respect to the goal of decision-making. The second component is related to modelling influences/dependencies between criteria, and identifying criteria that strongly influence others, as well as criteria that others depend on. A measure that describes how strong a particular criterion is in terms of influences/dependencies is based on the centrality degree, one of the most fundamental centrality measures. In this paper, the new method, which was evaluated on several cases, is demonstrated with example of evaluating scientists, and a comparison of the new method’s results and the ANP method’s results is presented.

Introduction: Bronchopulmonary sequestration may cause prenatal pleural effusion (PE) or even hydrops. This case describes a fetus presenting with severe PE, which prenatally waned completely under steroid treatment, yet surprisingly reappeared rapidly after birth, requiring early surgical intervention. Case description: A male fetus was diagnosed with left bronchopulmonary sequestration and severe PE. After 3 courses of prenatal steroid therapy for each recurrence of PE from 27 weeks of gestation we observed a complete regression of PE prenatally. Yet, PE recurred 18 hours after birth and persisted after repeated drainages and steroid therapy. Early total resection of the extra-lobar bronchopulmonary sequestration was performed and led to complete recovery without recurrence of PE. Conclusion: This report underlines that in cases of bronchopulmonary sequestration presenting with prenatal PE needing fetal intervention, even if full regression of PE is observed before birth, there might be a need for surgical excision during the neonatal period.

In this paper we present the results of an empirical study into the cognitive reality of existing classifications of modality using Polish data. We analyzed random samples of 250 independent observations for the 7 most frequent modal words (moc ‘can’, mozna ‘it is possible’, musiec ‘must’, nalezy ‘it is necessary’, powinien ‘should’, trzeba ‘it is required’, wolno ‘it is allowed’), extracted from the National Corpus of Polish. Observations were annotated for modal type according to four different classifications of modality, as well as for morphological, syntactic and semantic properties using the Behavioral Profiling approach. Multiple correspondence analysis and (polytomous) regression models were used to determine how well modal type and usage align. These corpus-based findings were validated experimentally. In a forced choice task, ‘naive’ native speakers were exposed to definitions and prototypical examples of modal types or functions and then labeled a number of authentic corpus sentences accordingly. In the sorting task, naive native speakers sorted authentic corpus sentences into semantically coherent groups. In this article we discuss the results of our empirical study as well as the issues involved in building usage-based accounts on traditional linguistic classifications.

Acute pancreatitis represents an acute nonbacterial inflammation of the pancreas caused by a premature and ectopic activation of pancreatic digestive enzymes. Two of the most important genes in pancreatic autodigestion, PRSS1 and SPINK1, were implicated in the earliest discoveries of the genetic background of pancreatitis. However, the distribution of their variations displays interethnic variability, which could significantly affect the magnitude of their proposed effects on this disease worldwide. The aim of the present study was to investigate the distribution of the most important functional variations of PRSS1 (86A>T and 365G>A) and SPINK1 (101A>G), and their influence on the clinical course of acute pancreatitis in Serbian patients. The study enrolled 81 subjects, the severity of disease course was determined using the Atlanta Classification system, and the genotyping was conducted using a PCR-RFLP method. PRSS1 86A>T and 365G>A SNPs were not observed in the study population, while SPINK1 101A>G was present with the frequency of 0.62% (95% CI: 0.00, 3.83%). Due to extremely low frequencies or absences of examined variations, the proposed effect of these SNPs on the severity of acute pancreatitis could not be confirmed. The results do not support routine genotyping of either PRSS1 or SPINK1 in Serbs.

Acute necrotizing pancreatitis (ANP) is a severe form of acute pancreatitis that is associated with high morbidity and mortality. Thus, an adequate initial treatment of patients who present with acute pancreatitis (AP) based on correct interpretation of early detected laboratory and clinical abnormalities may have a significant positive impact on the disease course. The aim of the study was to determine patient- and initial treatment-related risk factors for the development of acute necrotizing pancreatitis. For the purpose of this study a case-control design was chosen, including adult patients treated for AP in the surgical Intensive Care Unit (sICU) of Clinical Center of Kragujevac, from January 2006 to January 2011. The cases (n=63) were patients who developed ANP, while the controls (n=63) were patients with AP without the presence of pancreatic necrosis. The controls were randomly selected from a study sample after matching with the cases by age and sex. Significant association with the development of ANP was found for the presence of comorbidity (adjusted OR 6.614 95%CI 1.185-36.963), and the use of somatostatin (adjusted OR 7.460, 95%CI 1.162-47.833) and furosemide (adjusted OR 2710.57, 95%CI 1.996-56.035) started immediately upon admission to the sICU. This study suggests that comorbidities, particularly the presence of serious cardio-vascular disease, can increase the risk for development of acute necrotizing pancreatitis. The probability for the development of ANP could be reduced by the avoidance of the initial use of loop diuretics and somatostatin.

We recorded high-density surface electromyograms (hdEMG) of gastrocnemii muscles in young and older healthy subjects performing isometric plantar flexion at 30 % of maximum voluntary contractions pre and post 14-day bed rest. We decomposed the hdEMG signals by convolution kernel compensation technique into contributions of individual motor units and analyzed common and individual oscillations in motor unit discharge rates before and after the bed rest. We further compared the results to oscillations of measured plantar flexion force. Our results demonstrate that, after the bed rest, muscle control strategies in young volunteers change differently than in older. Specifically, after the bed rest, the young exhibit slower oscillations of common drive to gastrocnemii muscles than older adnlts, bnt faster individual motor unit discharge rate oscillations. They also exhibit higher freqnency oscillations of force. These results demonstrate the potential of hdEMG decomposition in identifying and quantifying the changes in muscle control strategies after bed rest.

Background Osteoarthritis (OA) of the hip is a common condition which affects men and women of all ages. The cartilage becomes damaged. Stiffness and reduced range of movement are common. The pain experienced from OA of the hip may be felt in your lower back, buttocks and groin. You may also feel pain from your hip in your leg and down into your knee. This is called referred pain.The goals of OA treatment include alleviation of pain and improvement of functional status. Optimally, patients should receive a combination of nonpharmacologic and pharmacologic treatment. A physiatrist may help in formulating a nonpharmacologic management plan for the patient with OA. Guidelines from Osteoarthritis Research Society International (OARSI) advise that nonpharmacologic treatment of hip and knee OA include the following: patient education; heat and cold; weight loss; exercise; physical therapy; occupational therapy; unloading in certain joints (eg, knee, hip). Objectives The aim of this study was to investigate the importance of exercise and TENS (Transcutaneous electrical nerve stimulation) therapy in patients with OA of the hip on the pain and functional status. Methods This was a prospective clinical study involving 20 patients with primary hip OA treated stationary at the Center for Physical Medicine and Rehabilitation during 2016. On receipt of all the respondents filled out the social survey, quantification of pain was conducted by visual analogue scale (VAS) and function was evaluated through measurement of the range of motionin hip joint. After that, they received physical therapy (exercise and TENS therapy) for 21 days. TENSwas applied once a day for 30 minnuteson both hip joints, with the frequency of 85 Hz and with short-term pulses (4 ms) (appliance TENS-2, Electronic Design Medical, Serbia). Exercisewas applied once a day for 30 minutes, according to individually customized protocol; active and active-assisted exercises were used to the point of pain for strengthening the muscles of the lower extremities and to increase range of motion in the hip joints.One month after the inspection we tested functional status and pain. Results There was 100% of women, mean age 64.15±4.06 years. The most represented were retirees, 60%, followed by workers and unemployed 10% and 30%.BMI was 27,3±4,22 kg/m2. After a month there was a statistically significant reduction in pain measured by VAS (at the beginning it was 6,7; at the end 3,2; p 0.05). Conclusions The ACR strongly recommends the following nonpharmacologic measures for patients with knee or hip OA: cardiovascular or resistance land-based exercise, aquatic exercise, weight loss, for overweight patients. TENS may be another treatment option for pain relief. Our study showed that exercise and TENS therapy led to a statistically significant reduction in pain as measured by VAS pain scale and improving range of motion in hip joint. Disclosure of Interest None declared

BACKGROUND Apolipoproteins A-I and B (apoA-I and apoB) may be better indicators of the risk of cardiovascular and cerebrovascular diseases than conventional risk factors (RFs). The onset of ischemic stroke (IS) may be preceded by the development of atherosclerotic changes in carotid arteries, which can be detected by ultrasound. Only a certain % of patients with IS have an (underlying) carotid etiology. OBJECTIVE The aim of our study was to determine the association between ultrasound indicators of carotid atherosclerosis and the presence of apolipoproteins and other biomarkers in patients with IS. METHODS The study included 120 patients with clinically first, non-cardioembolic ischemic stroke in the carotid circulation. For all patients the following data were recorded: risk factors (hypertension, diabetes, hyperlipoproteinemia, smoking, obesity, metabolic syndrome, (MetS) hyperhomocysteinemia and inflammation), and levels of blood pressure, glucose, glycosylated hemoglobin, lipids, apoA-I and apoB apolipoproteins, body mass index, homocysteine, and C-reactive protein (CRP). Carotid duplex ultrasound was used to measure carotid intima media thickness (cIMT) and determine the presence of an unstable (hypoechogenic) plaque. RESULTS The most significant associations were found between cIMT and older age (β=0.230; p=0.006), lower concentrations of apoA-I (β=-0.244; p=0.008) and a higher apoB/apoA-I ratio (β=0.247; p=0.007). The presence of a hypoechogenic plaque was most significantly associated with increased concentrations of apoB (OR=2.29; 95% CI=4.9-173.5; p

(1-3)-ß-D-Glucan (BDG) is a marker for invasive fungal diseases (IFD). Administration of intravenous immunoglobulin preparations (IVIG) has been reported to lead to false positive BDG serum levels80 pg/ml. The aim of the study was to determine the time interval between IVIG infusion and normalisation of BDG serum levels.In 22 paediatric haemato-/oncologic patients, we analysed 92 BDG serum levels obtained within 4 weeks after IVIG administration (0.5 to 1 g/kg body weight), correlated them to 54 IVIG episodes and compared them to 76 BDG levels obtained in 29 patients without IVIG administration in the 4 weeks prior to BDG analyses (control group).BDG peak levels within 3 days after IVIG ranged from 21.47 to 660.38 (median 201.4) pg/ml. BDG serum levels at 7, 14 and 21 days (+/-1 day each) after IVIG infusion were significantly higher than BDG serum levels in the control group (p 0.001 each). By days 7, 14, and 21 (+/-1 day each) after IVIG infusion, BDG serum levels have normalized (80 pg/ml) in 64.0%, 76.5% and 100%, respectively.IVIG administration leads to false positive BDG levels in the vast majority of patients. Elevated BDG levels may be detectable for more than two weeks after IVIG administration, while BDG levels normalized within 3 weeks in all patients. Therefore, BDG should not be used to diagnose IFD within three weeks after IVIG administration.

The information and communications technology (ICT) industry is making important contributions to economic growth both locally and globally. There is a high demand for ICT professionals that higher education institutions are still struggling to meet. An effective literature review is an important part of understanding the existing findings and issues in the education of future ICT professionals, and for planning future research directions. This comprehensive study presented here includes a review of 761 papers on the level of summary analysis and 155 papers in depth, according to ten research questions related to: curriculum design and delivery, knowledge and skills of future ICT professionals, teaching methods, collaboration between academia and industry, and future employment and career development of ICT professionals in the labor market. Based on the findings from a content and cluster analysis, the results indicate the need for a more holistic and strategic approach to the education of future ICT professionals, including career development support within formal processes of higher education.

The paper presents the development of an automated procedure for creating a small-scale world political map from OpenStreetMap (OSM) data, and the map itself. A novel approach was used for cartographic processing, while the fitness for use of OSM data for this task was evaluated. It was anticipated and shown that creating a world political map from OSM data is a methodologically and technologically demanding task. The result was a political map of the world at a scale of 1:30,000,000, showing independent states, dependencies and areas of special sovereignty as in the OSM data set, with no adaptation to specific political recognition issues. A high degree of automation built on open-source software was achieved. The resulting map is an intermediate stage of production, requiring modest manual intervention for the final map. By allocating a code to the community (http://github.com/GEOF-OSGL/OSMPoliticalMap), we have provided opportunities for its continuing development.