RANKING OF CROATIAN CITIES ACCORDING TO HELLWIG\u27S INFORMATION CAPACITY METHOD IN THE SMART ECONOMY DIMENSION

The main objective of this research is to determine whether the size of the city by population is a prerequisite for better economic development and ranking of Croatian cities based on the weighted average z-score of smart economy indicators related to entrepreneurial potential, tourism, information comunication technology [ICT] and research and development [R&D] sector. The sample for this research consists of 127 Croatian cities and ten smart economy indicators. The Hellwig\u27s information capacity method uses only statistically significant indicators, on the basis of which the weights are determined when creating the Smart Economy Indeks. The results of the analyses suggest that the number of positively ranked cities decreases as the city population size decreases: 100 % large cities are positively rated, 48 % medium cities and 6 % small cities

Development of smart governance in Croatian cities - the size of a city as a determinant of smart governance

Purpose: The paper discusses the role and importance of smart governance as a modern form of urban development, identifies the key determinants of smart governance, analyzes models, evaluation and measurement indicators in smart and sustainable cities, and ranks 127 Croatian cities, regardless of city size. Methodology: A comprehensive database was prepared for the preparation of the study, including ten indicators of key smart governance determinants related to political participation of citizens, delivery of quality services to citizens, and sustainable functioning of city administration, in line with a review of models and indicators from previous studies. Results: The main goal of this research is to determine a correlation between the size of the city according to the number of inhabitants and statistically significant indicators of smart governance and, based on the value of the correlation coefficients, to determine the weights for the indicators in the process of city ranking. By aggregating the weighted z-scores, the Smart Governance Index was created for all Croatian cities and that index is not related to the size of a city. Conclusion: Statistically significant indicators for the formation of the Smart Governance Index for 127 cities in Croatia are the indicators of political participation and sustainable functioning of city administration. It is necessary to include as many indicators as possible in the future period so that the ranking results are as relevant as possible

Ultrafiltracija u bolesnika s akutnim zatajivanjem srca – prikaz bolesnika

SUMMARY As a syndrome accompanied by numerous symptoms and with various manifestations, heart failure (HF) has been the topic of many scientific studies as well as guidelines of cardiological societies across the world. The prevalence of HF in people above 70 years of age is higher than 10%. The seriousness of the disease is clear from its mortality, which is approximately 20% in a one-year period and as high as 53% in a five-year period. These data raise the question whether patients are diagnosed in a timely manner and what treatment modalities are available given the very high mortality. Herein we describe the treatment of a 67-year-old patient hospitalized with a clinical picture of anasarca. Laboratory findings and echocardiography allowed rapid establishment of the diagnosis of acute heart failure with reduced left ventricular ejection fraction (LVEF). As circumstances allowed, medications were gradually introduced into the treatment based on the Guidelines from the European Society of Cardiology (ESC). Despite several days of application of very high doses of diuretic therapy, good diuresis was established, but pitting edema in the lower and upper legs were still clinically present, as was ascites. Due to the above, treatment was started using intermittent slow ultrafiltration (SUF), which is also mentioned in the ESC Guidelines, but with no clearly defined recommendations on how it is to be employed. The patient underwent intermittent SUF using a dialysis catheter on nine separate occasions. These procedures successfully eliminated almost 25 liters of fluid, clinically resulting in decongestion. We further describe the subsequent rehospitalizations and follow-up examinations which included adjustments to the patient’s pharmacological therapy and the implantation of a cardiac resynchronization device. All of the above lead to improved patient quality of life, but also to improved LVEF. Recent studies have examined ultrafiltration as a supplemental treatment for HF. Despite the differences in the study populations and SUF modalities, the studies indicate that ultrafiltration leads to decongestion and hemodynamic stabilization, and most authors also report reduced need for rehospitalization. As patient mortality was not reduced, further studies are required on the application of ultrafiltration and other forms of treatment for patients with advanced HF.SAŽETAK Zatajivanje srca (HF) kao sindrom praćen brojnim simptomima i pojavnim oblicima s razlogom je tema mnogih radova, ali i smjernica svjetskih kardioloških društava. Prevalencija HF-a u osoba starijih od 70 godina iznosi više od 10%. O ozbiljnosti same bolesti govori njezina smrtnost koja u jednogodišnjem razdoblju iznosi oko 20%, a u petogodišnjem čak oko 53%. Navedeni brojevi postavljaju pitanje otkrivaju li se pravodobno oboljeli te koji su dostupni modaliteti liječenja s obzirom na vrlo veliku smrtnost. Ovim je radom prikazano liječenje 67-godišnjeg bolesnika hospitaliziranog s kliničkom slikom anasarke. Zahvaljujući laboratorijskim nalazima i ehokardiografiji vrlo je brzo postavljena dijagnoza akutnog zatajivanja srca sa sniženom ejekcijskom frakcijom lijeve klijetke (LVEF). Kako su okolnosti dopuštale, u terapiju su postupno uvedeni lijekovi preporučeni smjernicama Europskoga kardiološkog društva (ESC). Usprkos višednevnoj primjeni vrlo visokih doza diuretske terapije, uspostavljena je dobra diureza, ali su, klinički, i dalje bili prisutni tjestasti edemi potkoljenica i natkoljenica te ascites. Zbog navedenoga, započeto je liječenje intermitentnom sporom ultrafiltracijom (SUF) koja se također nalazi u smjernicama ESC-a, no bez jasno definiranih preporuka o načinu primjene. Bolesnik je u devet navrata bio podvrgnut intermitentnom SUF-u s pomoću dijaliznog katetera. Navedenim je postupcima uspješno odstranjeno gotovo 25 litara tekućine, što je klinički dovelo do dekongestije. U nastavku prikaza opisuju se ponovne hospitalizacije i kontrolni pregledi kojima je prilagođivana farmakološka terapija te je ugrađen uređaj za srčanu resinkronizaciju. Sve navedeno dovelo je do poboljšanja kvalitete bolesnikova života, ali i do poboljšanja LVEF-a. Aktualna istraživanja bavila su se ultrafiltracijom kao nadomjesnim liječenjem u HF-u. Usprkos razlikama u istraživanim populacijama i modalitetima SUF-a, zajednički stav istraživanja jest da ultrafiltracija dovodi do dekongestije i hemodinamske stabilizacije, a većina autora navodi i smanjenu potrebu za rehospitalizacijom bolesnika. Budući da se smrtnost bolesnika nije smanjila, potrebno je i dalje istraživati primjenu ultrafiltracije i ostalih oblika liječenja u bolesnika s uznapredovalim HF-om

Collaborative approach for integrating natural and cultural heritage for sustainable urban development: the case of action plan for Sombor within Danurb+

The protection and sustainable use of natural and cultural heritage in order to improve local identity and quality of life, as well as the positioning of Serbian cities on the global map of eco-cultural tourism, are still not suffi ciently recognized as development opportunities and therefore are not prioritized in their development plans. Following the increase in interest, and thus the representation of various types of tourism based on the integration of tangible and intangible cultural heritage and natural values in the overall tourist offer, it is necessary to review the possibilities of such approach. Smaller towns and settlements, which are frequently declining, are a particularly important group of settlements whose sustainable development should be viewed through this perspective. Many European countries have recognized the importance of cultural and natural heritage protection and their potential for sustainable (urban) development, so in recent decades a large number of national and pan-European projects have been launched with focus on this kind of approach and within which various methodological processes are developed and pilot projects for their verifi cation are funded. Raising their capacities for formulating, initiating and launching natural and cultural heritagebased development projects, necessitates various types of training, participatory and collaborative workshops, and the organization of various events aimed at informing and mobilizing the public. As part of the international DANURB+ project, an Action Plan for the protection and sustainable use of the natural and cultural heritage of Sombor was developed. The plan was created with the active and continuous participation of those responsible for , as well as those interested in development. The process is designed to help in the articulation of integral projects as well as their networking on a local, national, and international level. The paper will present the methodological procedure, the development process and the content of this plan

Perkutana aspiracijska trombektomija u Paget-Schroetterovu sindromu – prikaz bolesnika

SUMMARY We report the case of a younger, physically active patient who presented at the emergency department with swelling, pain, and bluish discoloration of the left arm, with clinical examination identifying effort-induced deep vein thrombosis of the arm (Paget-Schroetter syndrome). After unsuccessful medication treatment with a therapy dose of low-molecular-weight heparin, the patient was treated with an endovascular procedure – percutaneous aspiration thrombectomy. The procedure was successful, with the establishment of peripheral flow through the subclavian, axillary, and cephalic vein despite some thrombotic masses remaining. Before discharge, the patient was placed on peroral anticoagulation treatment with rivaroxaban. Additional imaging was performed during treatment of the superior thoracic aperture, confirming the diagnosis. Expanded laboratory testing showed values within normal limits. Follow-up showed regression of the symptoms. Color Doppler ultrasound and clinical examination verified maintenance of peripheral flow through the affected veins, with residual small thrombi and the development of collaterals. The patient was subsequently considered for decompression therapy by removing the first rib as a permanent solution for the symptoms.SAŽETAK Prikazujemo slučaj mlađeg, fizički aktivnog bolesnika u kojeg su se pri hitnom prijemu manifestirali oteklina, bolnost i plavičasta diskoloracija lijeve ruke te mu je obradom ustanovljena naporom inducirana duboka venska tromboza ruke (Paget-Schroetterov sindrom). Nakon neuspješna medikamentnog liječenja terapijskom dozom niskomolekularnog heparina liječen je endovaskularnim zahvatom – perkutanom aspiracijskom trombektomijom. Postupak je protekao uredno uz uspostavu rubnog protoka kroz potključnu, pazušnu te cefaličnu venu usprkos ostatnim trombotskim masama. Prije otpusta uvedena je peroralna antikoagulantna terapija rivaroksabanom. U sklopu obrade sindroma gornje torakalne aperture provedena je dodatna slikovna obrada kojom je dijagnoza potvrđena. Nalazi proširene laboratorijske obrade bili su u granicama normale. Na kontrolnim pregledima praćena je regresija tegoba. Color Doppler ultrazvukom te klinički verificiran je i dalje održan rubni protok kroz zahvaćene vene uz rezidualne male trombe te razvoj kolaterala. U bolesnika se razmatra dekompresijsko liječenje resekcijom prvog rebra kao konačno rješenje uzroka tegoba