Perceived Effects of Croatian Customs Services Reform: the Opinion of Forwarders from Istarska County

The reforms of the public sector rank among the most complex problems Croatia has to face in the process of transition and accession to the EU. One of the recent reforms, the Customs Service Reform, offers insights into some of the achieved improvements and may serve as a guideline for reformers in other areas of public management. This research provides evidence of “customer satisfaction” with the functioning of the Croatian Customs System. Conclusions have been drawn based on the responses of 31 forwarders from Istarska County using a 19-item Likert scale. According to their opinion, services have improved in several aspects during the past few years, and accordingly the results can be interpreted as an indication of success of reform efforts.public services; quality perception; reform results; customs services

Tumor necrosis factor antagonists in the treatment of pyoderma gangrenosum, acne and suppurative hidradenitis (PASH) syndrome

The clinical triad of pyoderma gangrenosum (PG), acne and suppurative hidradenitis (HS) has been described under the acronym PASH syndrome and is considered to represent a distinct entity in the group of autoinflammatory diseases. It is a fairly new, only recently recognized disorder with a limited number of reported cases and without defined treatment recommendations. We aimed to summarize currently available data on the use of tumor necrosis factor (TNF) antagonists in the management of PASH syndrome and report on our own experience with the use of adalimumab in a patient presenting with this specific constellation of clinical signs and symptoms. Among the 11 cases identified in the literature, infliximab and adalimumab were the most commonly used agents, both exhibiting favorable effects in the majority of, but not all, patients. This was particularly evident in terms of relatively rapid remission of PG whereas HS lesions seemed to be more resistant to treatment. In our patient, adalimumab monotherapy resulted in a remarkable and sustained remission, although significant improvement of HS lesions was observed only from week 16 of therapy onwards. In summary, TNF antagonists are a promising treatment for PASH; however, conclusions regarding the choice of a specific agent, optimal dosing or use in combination with other treatment modalities cannot yet be drawn. </p

A Simple Python Testbed for Federated Learning Algorithms

Nowadays many researchers are developing various distributed and decentralized frameworks for federated learning algorithms. However, development of such a framework targeting smart Internet of Things in edge systems is still an open challenge. In this paper, we present our solution to that challenge called Python Testbed for Federated Learning Algorithms. The solution is written in pure Python, and it supports both centralized and decentralized algorithms. The usage of the presented solution is both validated and illustrated by three simple algorithm examples.Comment: 6 pages, 7 figures, 3 algorithms, as accepted at ZINC 2023, Published by IEEE Xplor

Intrarenal Resistance Index as a Prognostic Parameter in Patients with Liver Cirrhosis Compared with Other Hepatic Scoring Systems

Background and Aims: Patients with advanced liver cirrhosis who develop renal dysfunction have a poor prognosis. Elevated intrarenal resistance indices (RIs) due to renal vascular constriction have been described before in cirrhotic patients. In the current study, we prospectively investigated the course of intrarenal RIs and compared their prognostic impact with those of the Model for End-Stage Liver Disease (MELD) and the Child-Pugh scores. Methods: Sixty-three patients with liver cirrhosis underwent a baseline visit which included a sonographic examination and laboratory tests. Forty-four patients were prospectively monitored. The end points were death or survival at the day of the follow-up visit. Results: In 28 patients, a follow-up visit was performed after 22 8 months (group 1). Sixteen patients died during follow-up after 12 8 months (group 2). Group 2 patients showed a significantly higher baseline RI (0.76 +/- 0.05) than group 1 patients (RI = 0.72 +/- 0.06; p < 0.05). As shown by receiver operating characteristic analysis, the RI and the MELD score achieved similar sensitivity and specificity {[}area under the curve (AUC): 0.722; 95% confidence interval (95% CI): 0.575-0.873 vs. AUC: 0.724; 95% CI: 0.575-0.873, z = 0.029, n.s.] in predicting survival and were superior to the Child-Pugh score (AUC: 0.677; 96% Cl: 0.518-0.837). Conclusion: The RI is not inferior in sensitivity and specificity to the MELD score. Cirrhotic patients with elevated RIs have impaired short- and long-term survival. The RI may help identify high-risk patients that require special therapeutic care. Copyright (C) 2012 S. Karger AG, Base

COST Action “Harmonizing clinical care and research on adrenal tumours in European countries” (HARMONISATION) CA20122

Adrenal tumours affect more than 3% of the population aged > 50 years, and their absolute prevalence is increasing due to population aging. Most of these tumours are benign and hormonally inactive. However, 2-10% of them are at risk of malignancy, and 20-40% present hormone over-secretion, leading to significant morbidity. Management of adrenal tumours is quite heterogeneous, and this leads to substantial inequality in patient care throughout Europe. In this context, the goal of HARMONISATION is to constitute a multidisciplinary network to harmonize clinical care and research on adrenal tumours throughout Europe. Our focus will be on COST Inclusiveness Target Countries (ITCs). In addition, this collaborative network will establish a modern framework to develop a new generation of real-time and real-life randomized clinical trials, which will be federated and registry-based. For this purpose, HARMONISATION will be organized in five Working Groups: 1. Harmonizing clinical practice for adrenal tumours; 2. Harmonizing adrenal tumour research and -omics practice; 3. Harmonizing Information Technology (IT)/Artificial Intelligence (AI) tools towards a standardized registry; 4. Harmonizing the ethical and legal framework required for federated European trials; and 5. Communication, dissemination, and inclusiveness. The successful execution of HARMONISATION’s goals is guaranteed by the collaboration of clinicians, researchers, and experts from other relevant fields, including artificial intelligence, data science data protection, legal and ethical issues, and patients’ representatives

Особливості організації оперативно-службової діяльності Державної прикордонної служби України

Мета роботи: надати рекомендації щодо застосування сил та засобів Державної прикордонної служби України в нових умовах. Дизайн/Метод/Підхід дослідження: в основу рекомендацій покладено аналітичний метод, що базується на аналізі стану Державної прикордонної служби України відповідно до сучасних умов. Результати дослідження: надано рекомендації органам управління Державної прикордонної служби України щодо формування нових сил та засобів, порядку їх застосування спільно із іншими складовими сектору безпеки та оборони. Теоретична цінність дослідження: рекомендації дозволяють з достатньою адекватністю представити найбільш суттєві сторони процесу роботи органів управління під час планування оперативно-службової діяльності та забезпечити раціональну послідовність виконання управлінських процедур. Оригінальність/Цінність дослідження: новизна рекомендацій полягає у приведенні частин та підрозділів до єдиної структури, яка є сумісною із іншими складовими сектору безпеки і оборони, що дозволить підвищити якість виконання завдань у прикордонні. Майбутні дослідження: у ході подальших досліджень доцільно удосконалити моделі дій сил і засобів Державної прикордонної служби України під час ведення стабілізаційної операції та оборонної операції. Тип статті: теоретична

Effects of Alpha-MSH on Corneal Epithelial Lesions in Rats

We investigated the influence of alpha-melanocyte stimulating hormone (a-MSH) on the healing of corneal epithelial lesions in male Wistar rats. The lesions were induced by abrading corneal epithelium with a surgical lancet under a biomicroscope. Before the abrasion corneal epithelium was softened with 40% ethanol. a-MSH drops in a concentration of 1×10–4 mg/mL significantly promoted epithelial healing, when compared to the control group treated with 0.9% NaCl. Significant reduction of ocular irritation was also observed. Topical a-MSH medication could promote the healing of corneal wounds and reduce local inflammatory response without the major side effects of the corticosteroid therapy

Circulating miRNA Expression Profiling in Primary Aldosteronism

Objective: Primary aldosteronism is a major cause of secondary hypertension. Its two principal forms are bilateral adrenal hyperplasia (BAH) and aldosterone-producing adenoma (APA) whose differentiation is clinically pivotal. There is a major clinical need for a reliable and easily accessible diagnostic biomarker for case identification and subtyping. Circulating microRNAs were shown to be useful as minimally invasive diagnostic markers. Our aim was to determine and compare the circulating microRNA expression profiles of adenoma and hyperplasia plasma samples, and to evaluate their applicability as minimally invasive markers. Methods: One hundred and twenty-three samples from primary aldosteronism patients were included. Next-generation sequencing was performed on 30 EDTA-anticoagulated plasma samples (discovery cohort). Significantly differently expressed miRNAs were validated by real-time reverse transcription-qPCR in an independent validation cohort (93 samples). Results: We have found relative overexpression of miR-30e-5p, miR-30d-5p, miR-223-3p, and miR-7-5p in hyperplasia compared to adenoma by next-generation sequencing. Validation by qRT-PCR confirmed significant overexpression of hsa-miR-30e-5p, hsa-miR-30d-5p, and hsa-miR-7-5p in hyperplasia samples. Regarding the microRNA expressional variations, adenoma is more heterogeneous at the miRNA level compared to hyperplasia. Conclusion: Three microRNAs were significantly overexpressed in hyperplasia samples compared to adenoma samples, but their sensitivity and specificity values are not good enough for introduction to clinical practice

The Characteristics of Incidental Pituitary Microadenomas in 120 Korean Forensic Autopsy Cases

To investigate the characteristics of incidental pituitary microadenomas, we examined 120 pituitary glands from Korean forensic autopsy cases, from which eight tumors were identified (incidence 6.7%). The average age of the affected subjects was 50 yr (range: 33-96 yr) with a female predominance. The maximum diameters of the tumors ranged from 0.4 to 5.4 mm (mean: 2.8 mm). Immunohistochemical analysis of pituitary hormones revealed three growth hormone-secreting adenomas, one prolactin-producing adenoma, one gonadotropin-producing adenoma, one plurihormonal adenoma, and two null cell adenomas. MIB-1 staining for Ki-67 antigen showed no positive expression. The microvessel density (MVD) of the pituitary microadenomas ranged from 2.3 to 11.6% (mean: 5.3%) and was significantly lower than that of nonneoplastic pituitary glands (11.9-20.1%, mean: 14.8%). Our study provides reference data on incidental pituitary microadenomas in the Korean population