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Inhaled β2 adrenergic receptor (β2-AR) agonists are the mainstay of asthma therapy. The β2-AR protein is encoded by the ADRB2 gene and variants within this gene can have significant consequences for modulating the response to asthma therapy. This cross-sectional study performed at the University Children’s Hospital in Belgrade, included 54 children with asthma. The subjects were genotyped for ADRB2 +46A>G (Arg16Gly, rs1042713) and +79C>G (Gln27Glu, rs 1042714) polymorphisms and the association with asthma severity and response to inhaled salbutamol was examined. In Serbian asthmatic children, allele +46A was detected with a frequency of 41.7% and allele +79G was detected with a frequency of 23.1%. Allele +46G was found to be associated with a better response to inhaled salbutamol (p G may be a determinant of asthma severity and response to salbutamol in children with asthma. We did not find any association of +79C>G polymorphisms with the asthma severity and bronchodilator response to inhaled salbutamol. The results of this study can be potentially useful for personalization of asthma treatment.

Introduction/objective Chronic obstructive pulmonary disease (COPD) is a pulmonary disease characterized by persistent respiratory difficulties and impaired airflow. COPD patients have a higher risk for lung infections, like the flu or pneumonia, lung cancer, heart problems, weak muscles, brittle bones, depression, and anxiety. The purpose of this study was to estimate the prevalence of ECG abnormalities in patients with COPD experiencing exacerbations. Patients and methods The research encompassed a cohort of 832 individuals diagnosed with COPD who encountered episodes of exacerbations. Five hundred seventy-five (69.11%) of the included participants were women, and 257 (30.89%) were men. The included participants ranged from 18 to 60 years old. It was ensured that none of the participants had received any treatment for their condition for more than 3 days. Results Based on the level of exacerbation severity, the patient population is categorized into three distinct groups: moderate, comprising 330 (39.66%) individuals; severe, encompassing 406 (48.79%) individuals; and extremely severe, consisting of 96 (11.53%) individuals. During episodes of exacerbation in patients with COPD, the following ECG alterations were observed: a QTc less than 0.40 s in 99.15% of cases, a transitional ECG zone in 74.33% of cases, a P more than 2.5 mm in 45.67% of cases, an axis deviation towards the second quadrant (axis II) in 28% of cases, an incomplete right bundle branch block in 26.32% of cases, and a full right bundle branch block in 25.60% of cases. Conclusion Regardless of prior cardiac pathology, ECG is a low-cost, quick, and dependable modality for detecting ischemic changes in people experiencing a flare-up of COPD.

Turbulence investigations of the flow past an unswept wing at a high angle of attack are reported. Detailed predictions were carried out using large-eddy simulations (LES) with very fine grids in the vicinity of the wall in order to resolve the near-wall structures. Since only a well-resolved LES ensures reliable results and hence allows a detailed analysis of turbulence, the Reynolds number investigated was restricted to [Re.sub.c]= [10.sup.5] based on the chord length c. Admittedly, under real flight conditions [Re.sub.c] is considerably higher (about (35-40). [10.sub.6]). However, in combination with the inclination angle of attack [alpha]=18 deg this [Re.sub.c] value guarantees a practically relevant flow behavior, i.e., the flow exhibits a trailing-edge separation including some interesting flow phenomena such as a thin separation bubble, transition, separation of the turbulent boundary layer, and large-scale vortical structures in the wake. Due to the fine grid resolution applied, the aforementioned flow features are predicted in detail. Thus, reliable results are obtained which form the basis for advanced turbulence analysis. In order to provide a deeper insight into the nature of turbulence, the flow was analyzed using the invariant theory of turbulence by Lumley and Newman (J. Fluid Mech., 82, 161-178, 1977). Therefore, the anisotropy of various portions of the flow was extracted and displayed in the invariant map. This allowed us to examine the state of turbulence in distinct regions and provided an improved illustration of what happens in the turbulent flow. Thus, turbulence itself and the way in which it develops were extensively investigated, leading to an improved understanding of the physical mechanisms involved, not restricted to a standard test case such as channel flow but for a realistic, practically relevant flow problem at a moderate Reynolds number [DOI: 10.1115/1.2175162]

Introduction. Staphylococcus (S.) aureus is one of the most omnipresent and dangerous human pathogens, whose main characteristic is the production of the enzyme coagulase. This characteristic serves to identify and assess the pathogenicity of the bacteria. In addition to skin infections, endocarditis, osteomyelitis, and infectious arthritis, it is a common cause of pneumonia both in children and adults. Case report. We described a case of a 65-year-old woman with a dry cough and malaise with patchy areas of consolidation on the chest X-ray and “ground-glass” opacity with bronchial wall thickening and unilateral mediastinal lymphadenopathy on chest computed tomography imaging. Methicillin-resistant S. aureus was isolated from the bronchoalveolar aspirate taken during bronchoscopy. The woman was empirically treated with azithromycin, and later, based on the antibiogram findings, azithromycin was replaced with meropenem, after which her health improved. Conclusion. We presented a rare case of pneumonia with unconvincing symptomatology and laboratory and radiological findings. Paying more attention to such cases in the future is crucial, especially to the use of antibiotics to which staphylococci are increasingly developing resistance.

At the beginning and during the development of civilization, natural sources were the only available source of energy. With the development of society and industry, they were replaced by intensive use of fossil fuels. Non-renewability and negative impact on the environment called into question the rationality of using such sources. Therefore, natural sources of energy are becoming more and more important, especially biomass, which is becoming an important source of energy due to its ecological advantages. There are numerous ways to convert agricultural biomass into different forms of biofuel. Thermochemical conversion includes a process of pyrolysis in which, under the influence of a high temperature of 400 to 600 °C without the presence of oxygen, very valuable products are obtained in the form of biochar. The aim of this research is to evaluate the energy properties of agricultural biomass (corn, wheat, barley, oats, triticale, rye, soybeans, rapeseed and sunflower) by thermochemical conversion by pyrolysis and analysis of biochar for the evaluation of value-added products and to suggest its application. The mentioned raw materials are characterized by significant pyrolytic conversion potential, i.e. biochar production ranged from 30.03% to 47.0%. Similarly, the heating value (HHV) of biochar after the pyrolysis process increased to 27.11 MJ/kg, which proves that agricultural biomass is a good source of energy per unit mass.

This paper presents modeling, simulations and control of the ground-to-air missile fin actuation system, where brushed DC motors are used as actuators, which are driven using voltage regulation-Pulse Width Modulation (PWM). The mathematical model of the system was determined using the differential equations of behavior of the lowest order that was experimentally confirmed. This model was taken as a starting point in the synthesis of the Lead compensator, used to regulate the position of the missile's control surfaces. The trial and error method was used for the synthesis of Lead compensator, taking care to meet the required characteristics of the System, in form of bandwidth and gain. The improved transient process and behavior of the System have also been experimentally confirmed.

Introduction. Celiac crisis is a rare and life-threatening complication of celiac disease. Although it occurs in all ages, the most common affects children within the first two years. Outline of cases. We report three infants (two female, one male, age range 9–12) with celiac crises as an initial presentation of celiac disease precipitated with rotavirus gastroenteritis. Celiac crisis was preceded by failure to thrive caused by anorexia, occasional vomiting and frequent abundant stools for 4–8 weeks, and 1–2 days before admission with fever, frequent vomiting and profuse watery diarrhea. They were admitted in a very severe general condition, severely dehydrated, markedly malnourished, with an enormously distended abdomen, edema of the lower legs and feet, and perianal erythema. After correction of dehydration and hypoalbuminemia, they were placed on a gluten- and disaccharide-free diet and within the first two weeks on additional parenteral nutrition. The applied therapeutic measures resulted in stabilization and further rapid improvement of the patient’s condition. In all three patients the latex agglutination test for rotavirus was positive, IgA anti-TTG antibodies elevated (58.6–78 U/ml) and all three were homozygous carriers of the HLA DQ2 gene. Enterobiopsy was performed two weeks after the admission and total villous atrophy (Marsh IIIc) was registered in all three patients. In the further course, the complete recovery of the patient was accomplished by a strict gluten-free diet. Conclusion. Our experience indicates that rotavirus gastroenteritis in timely unrecognized classical celiac disease in infants can lead to celiac crisis.

Introduction/Objective. Cardiovascular disease is one of the most common comorbidities among subjects with chronic obstructive pulmonary disease (COPD). The aim of this study is to evaluate electrocardiogram (ECG) parameters and mortality predictors in COPD patients. Methods. A total of 835 consecutive patients were included. The patients were classified to suffer from COPD if the forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) was < 70% in three consecutive postbronchodilator measurements. The following ECG changes were observed: axis, P wave, low ORS complex, transitional zone, left bundle branch block (LBBB), right bundle branch block (RBBB), incomplete RBBB, S1S2S3 configuration, negative T in V1–V3. The patients were followed up for mortality over a five-year period. Results. Both survivors and non-survivors were of similar age, sex, and COPD status. FVC and FEV1, as well as Global Initiative for Chronic Obstructive Lung Disease stadiums were significantly higher in the survivor group (p < 0.016, p < 0.001, p < 0.001, respectively). Normal axis was in significantly higher percentage in non-survived patients (p = 0.020). RBBB and incomplete RBBB are more frequent findings in patients who died (p < 0.001, p < 0.05, respectively). LBBB, S1S2S3 configuration is in significantly higher percentage present in non-survivors (p < 0.016, p < 0.001, respectively). In the multivariable logistic model, patients with LBBB have two times higher chance of mortality compared to patients without LBBB. In contrast, patients with RBBB have 1.6 times lower chance of having death outcome. Conclusion. The main ECG predictors of COPD patients’ five-year mortality are LBBB and RBBB, but according to statistical model, ECG should be further explored and possibly obligatory involved in a routine clinical practice as an easy and low-cost screening method.

In recent years, there has been an increase in the production of textiles and clothing, which is the result of an increase in the global population and an improvement in living standards. The consequence of this fact is the unlimited use of resources for the needs of the production process of textiles and clothing, as well as an increase in the amount of generated textile waste, which is currently not treated adequately. For the textile industry to have a chance in the future to take advantage of environmental, economic and social opportunities that it is currently unable to do, it is necessary to transform the current, linear system into a circular system. The paper presents the possibility of implementing the basic principles of the circular economy in the textile and clothing industry. According to the principles of the circular economy, the textile industry is based on the realization of four activities: elimination of unwanted substances and release (emission) of microfibers, increasing the utilization of clothing, improving the recycling sector, efficient use of resources and switching to renewable sources.

The circular economy (CE) is currently a worldwide popular concept that should ensure sustainable development and resource efficiency. It is established on the theory of consumption and use of resources in the process of production in a way that affects a limitation of adverse effects on the environment. Simultaneously, this concept creates additional value and reuse of the products. In the Republic of Serbia (RS), the idea of CE is still new and underdeveloped. Hence, this paper aims to explore the possibility of implementing a CE in companies that operate in the RS by adopting the already developed methodology in the European Union. This research was conducted by monitoring the production process in the company "MB INTERNACIONAL" that produced cardboard packaging. The obtained approximate value of Circular Indicator of this company was 0.47, which indicated that the company had excellent chances for full implementation of the CE model in the business with the application of specific measures. The low-budget and highbudget measures, which could improve the circularity level in the analyzed company, are also presented in the research.

Introduction/Objective. Pain is a disturbing experience associated with existing or potential tissue damage, with a sensory, emotional, cognitive, and social component. The aim of this study was to show the efficiency of regional anesthetic techniques in postoperative pain in children. Methods. The retrospective cohort study was conducted on a group of 564 pediatric patients during the period from 2013 to 2016. Types of regional anesthesia were classified into the following six groups: caudal, epidural, spinal block, upper limb blocks, lower limb blocks, and truncal nerve block. From statistical methods, we used descriptive statistical methods of absolute and relative numbers, measurements of variability, central tendencies for numerical features, and methods of inferential statistics. We used the χ2 test for the attributive features of observations. Results. In relation to the postoperative time when an analgesic was required, a statistically significant difference was observed in the age of children (p = 0.000), disease diagnosis (p = 0.000), type of block (p = 0.000), type of local anesthetic (p = 0.000), and type of anesthesia or sedation preoperatively (p = 0.005). Conclusion. Postoperative analgesia was most needed by older children and children who were awake during surgery. Children with injuries and tumors need postoperative analgesia the earliest. The longest postoperative analgesia was recorded in patients who received caudal block. The longest postoperative analgesia can be seen in patients who received levobupivacaine, bupivacaine or levobupivacaine combined with lidocaine to perform the block.

Background/Aim. Finger tapping test is commonly used in neurological examinations as a test of motor performance. The new system comprising inertial and force sensors and custom proprietary software was developed for quantitative estimation and assessment of finger and foot tapping tests. The aim of this system was to provide diagnosis support and objective assessment of motor function. Methods. Miniature inertial sensors were placed on fingertips and used for measuring finger movements. A force sensor was placed on the fingertip of one finger, in order to measure the force during tapping. For foot tapping assessment, an inertial sensor was mounted on the subject’s foot, which was placed above a force platform. By using this system, various parameters such as a number of taps, tapping duration, rhythm, open and close speed, the applied force and tapping angle, can be extracted for detailed analysis of a patient’s motor performance. The system was tested on 13 patients with Parkinson’s disease and 14 healthy controls. Results. The system allowed easy measurement of listed parameters, and additional graphical representation showed quantitative differences in these parameters between neurological patient and healthy subjects. Conclusion. The novel system for finger and foot tapping test is compact, simple to use and efficiently collects patient data. Parameters measured in patients can be compared to those measured in healthy subjects, or among groups of patients, or used to monitor progress of the disease, or therapy effects. Created data and scores could be used together with the scores from clinical tests, providing the possibility for better insight into the diagnosis. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175090 and Grant no. 175016]

We describe design and verification of a novel autonomous sensor system (Magnetic Cubes) for evaluating the distance between two points as well as the rotation matrix between the coordinate systems attached to the sensors. The system is based on two sensors, each comprising three orthogonal coils wound on foam cubes, and near-field coupling between the sensors, which operate the medium frequency band. Testing and verification of the designed system was done by performing various 2D and 3D movements, and comparing positions and orientations estimated by Magnetic Cubes with those measured by an optical motion capture system. In all cases, good agreement is obtained: the RMS error for the estimation of the distances between the cubes is less than 10 mm (less than 2%), while the RMS errors for the estimation of the Cartesian coordinates are less than 7%. The discrepancies between the results obtained from the two systems were also assessed by the Pearson correlation coefficient (greater than 0.9 for the Cartesian coordinates and greater than 0.99 for the distances between the cubes).

Background/Aim. Postural impairments and gait disorders in Parkinson's disease (PD) affect limits of stability, impaire postural adjustment, and evoke poor responses to perturbation. In the later stage of the disease, some patients can suffer from episodic features such as freezing of gait (FOG). Objective gait assessment and monitoring progress of the disease can give clinicians and therapist important information about changes in gait pattern and potential gait deviations, in order to prevent concomitant falls. The aim of this study was to propose a method for identification of freezing episodes and gait disturbances in patients with PD. A wireless inertial sensor system can be used to provide follow-up of the treatment effects or progress of the disease. Methods. The system is simple for mounting a subject, comfortable, simple for installing and recording, reliable and provides high-quality sensor data. A total of 12 patients were recorded and tested. Software calculates various gait parameters that could be estimated. User friendly visual tool provides information about changes in gait characteristics, either in a form of spectrogram or by observing spatiotemporal parameters. Based on these parameters, the algorithm performs classification of strides and identification of FOG types. Results. The described stride classification was merged with an algorithm for stride reconstruction resulting in a useful graphical tool that allows clinicians to inspect and analyze subject’s movements. Conclusion. The described gait assessment system can be used for detection and categorization of gait disturbances by applying rule-based classification based on stride length, stride time, and frequency of the shank segment movements. The method provides an valuable graphical interface which is easy to interpret and provides clinicians and therapists with valuable information regarding the temporal changes in gait. [Projekat Ministarstva nauke Republike Srbije, br. 175016 i br. 175090]

Abstract Background The control of movement in humans is hierarchical and distributed and uses feedback. An assistive system could be best integrated into the therapy of a human with a central nervous system lesion if the system is controlled in a similar manner. Here, we present a novel wireless architecture and routing protocol for a distributed functional electrical stimulation system that enables control of movement. Methods The new system comprises a set of miniature battery-powered devices with stimulating and sensing functionality mounted on the body of the subject. The devices communicate wirelessly with one coordinator device, which is connected to a host computer. The control algorithm runs on the computer in open- or closed-loop form. A prototype of the system was designed using commercial, off-the-shelf components. The propagation characteristics of electromagnetic waves and the distributed nature of the system were considered during the development of a two-hop routing protocol, which was implemented in the prototype’s software. Results The outcomes of this research include a novel system architecture and routing protocol and a functional prototype based on commercial, off-the-shelf components. A proof-of-concept study was performed on a hemiplegic subject with paresis of the right arm. The subject was tasked with generating a fully functional palmar grasp (closing of the fingers). One node was used to provide this movement, while a second node controlled the activation of extensor muscles to eliminate undesired wrist flexion. The system was tested with the open- and closed-loop control algorithms. Conclusions The system fulfilled technical and application requirements. The novel communication protocol enabled reliable real-time use of the system in both closed- and open-loop forms. The testing on a patient showed that the multi-node system could operate effectively to generate functional movement.

Background/Objectives : Prediction of a difficult airway during pre-anesthetic evaluation is of great importance because it enables an adequate anesthetic approach and airway management. As there is a scarcity of prospective studies evaluating the role of anthropometric measures of the face and neck in predicting difficult airways in infants with an apparently normal airway, we aimed to identify the aforementioned predictors of difficult facemask ventilation and intubation in infants. Methods : A prospective, observational study that included 97 infants requiring general endotracheal anesthesia was conducted. Anthropometric and specific facial measurements were obtained before ventilation and intubation. Results : The incidence of difficult facemask ventilation was 15.5% and 38.1% for difficult intubation. SMD (sternomental distance), TMA (tragus-to-mouth angle distance), NL (neck length) and mouth opening were significantly lower in the difficult facemask ventilation group. HMDn (hyomental distance in neutral head position), HMDe (hyomental distance in neck extension), TMD (thyromental distance), SMD, mandibular development and mouth opening were significantly different in the intubation difficulty group compared to the non-difficult group. HMDn and HMDe showed significantly greater specificities for difficult intubation (83.8% and 76.7%, respectively), while higher sensitivities were observed in TMD, SMD and RHSMD (ratio of height to SMD) (89.2%, 75.7%, and 70.3%, respectively). Regarding difficult facemask ventilation, TMA showed greater sensitivity (86.7%) and SMD showed greater specificity (80%) compared to other anthropometric parameters. In a multivariate model, BMI (body mass index), COPUR (Colorado Pediatric Airway Score), BOV (best oropharyngeal view) and TMA were found to be independent predictors of difficult intubation, while BMI, ASA (The American Society Physical Status Classification System), CL (Cormack-Lehane Score), TMA and SMD predicted difficult facemask ventilation. Conclusions : Preoperative airway assessment is of great importance for ventilation and intubation. Patient's overall condition and facial measurements can be used as predictors of difficult intubation and ventilation.

Objective: The aim of this study was to translate the Sinus and Nasal Quality of Life Surgery Survey into the Serbian language to evaluate the test-retest reliability and validity., Study Design: The study included 49 consecutive patients between 12 and 18 years old with rhinologic symptoms. Patients were given a paper survey to complete along with a link to complete the online survey within the same day., Setting: The study was conducted at the University Children's Hospital Clinic for Pulmonology and Allergology between January 2023 and March 2023., Methods: Responses between the paper and online survey were compared and regression analysis was performed to evaluate the relationship. Internal reliability and test-retest reliability were assessed using Cronbach's α coefficient and intraclass correlation coefficient. All data were collected and analyzed using SPSS 29.0., Results: Pearson correlation coefficient between the paper and online survey was very high and statistically significant ( r  = 0.999; P  < .001). Each item had a high correlation (0.993-1.000), where the lowest correlation coefficient was obtained from question 2 (0.993). Average scores in each item differed slightly for only item 2 (mean difference = -0.041), but not to the level of statistical significance. Bland-Altman plot indicated no proportional bias between the 2 versions. Linear regression analysis suggested a high level of agreement between the 2 versions (slope = 1.00, R 2  = 0.999)., Conclusion: The survey is a useful questionnaire to evaluate the quality of life in patients with rhinologic symptoms. The high correlation between the paper and online survey shows the reliability of the questionnaire regardless of administration modality., Competing Interests: The authors state that they have no conflict of interest., (© 2024 The Authors. OTO Open published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

The aim of this study was to evaluate the alterations of the hippocampal function that may be related to anxiogenic response to thermal skin injury, including the morpho-functional alterations, and the effects of hyperbaric oxygen (HBO) and Filipendula ulmaria (FU) extract in the treatment of anxiety-like behavior that coincides with thermal skin injury. A rat thermal skin injury experimental model was performed on 2-month-old male Wistar albino rats. The evaluated therapeutic protocols included HBO and/or antioxidant supplementation. HBO was applied for 7 days in the hyperbaric chamber (100% O 2 , 2.5 ATA, 60 min). Oral administration of FU extract (final concentration of 100 mg/kg b.w.) to achieve antioxidant supplementation was also applied for 7 days. Anxiety level was estimated in the open field and elevated plus-maze test, which was followed by anesthesia, sacrifice, and collection of hippocampal tissue samples. HBO treatment and FU supplementation significantly abolished anxiogenic response to thermal skin injury. This beneficial effect was accompanied by the reduction in hippocampal pro-inflammatory and pro-apoptotic indicators, and enhanced BDNF and GABA-ARα2S gene expression, previously observed in untreated burns. The hippocampal relative gene expression of melatonin receptors and NPY positively responded to the applied protocols, in the same manner as µ and δ opioid receptors, while the opposite response was observed for κ receptors. The results of this study provide some confirmations that adjuvant strategies, such as HBO and antioxidant supplementation, may be simultaneously applied in the treatment of the anxiety-like behavior that coincides with thermal skin injury.