Suggestions and recommendations for fulfillment and implementation of the project for Broadband internet in Macedonia

Nowadays, broadband is defined on the basis of a number of parameters that can be offered through existing electronic communications networks (fixed or mobile networks) and the construction of some next generation of advanced electronic communications networks. This is extremely important for the quality of the received service, because with the existence of a quality electronic communication network, you will distribute a quality and fast data transfer to the end users, some of whom actually want it. Optical cable, among other types of cables, using the Operator and the access method known as fiber to the home , has a very good advantage for the end user, who uses the required service. On the other hand, wireless technologies such as Wi-Fi, Wi-Max and GSM / GPRS / UMTS / HSDPA, 4G and 5G are also new ways to access the Internet. This electronic communication infrastructure owned by a Public Operator for Electronic Communications Services (eg optical network or wireless 4G or 5G network) would be able to provide to the users significantly higher speed and security in data transmission, consistency at speeds, reduced error rates of real-time applications (video streaming, video communication, etc.). This paper provides suggestions and recommendations for fulfilling and implementing the broadband projest. It clarifies in which segments corrections should be made in the regulatory acts, with legal and by the laws. The real situation in the part of the broadband internet in our state is summarized in which direction the goals for improvement and fulfillment of the functioning of the broadband internet should move in the future

Price transmission in Serbian milk commodity chain

Focus in the paper is on price transmission at Serbian dairy market. It analyzes milk price transmission for three products: pasteurized milk, white yoghurt and cheese. Those three products types participated in formal milk market with 65% of processed row milk. Monthly data are collected from three levels of milk chain: farm level, processors and retailers. Three step approach based on: intensity, asymmetry and time lags in price transmission was applied. Distinction of two market levels was made, first between farmers and processors and second among processors and retailers. Additionally price transmission from world to nationally market was examined

BALANCE IN YOUNG GYMNASTS: AGE-GROUP DIFFERENCES

The aim of this study was to investigate difference in balance test scores and success on the balance beam of young gymnasts, international level of competition. Forty eight young gymnasts divided into two age groups participated in the study (Group 1: n=22, age 9.0 ± 1.1 years, 136.0 ± 7.6 cm, 30.8 ± 4.3 kg; Group 2: n=26, 12.1 ± 0.6 years, 146.0 ± 7.0 cm, 36.9 ± 6.6 kg;). To assess static balance, participants performed 3 stance variations (double leg, single leg, and tandem leg) on stiff surfaces and 3 specific static-balance tests consist of gymnastics elements on the balance beam (Scale, handstand and side handstand). For assessment of dynamic balance, participants performed multidirectional maximal single-leg reaches from a unilateral base of support (Y - balance test) and 3 specific dynamic-balance tests consisted of two connected gymnastics elements (Turns for 360°, jumps with 180º  and cartwheels). In the static balance test there is a significant difference only in one-leg stance (SRJN, .021) and specific static balance test SSSU (.000). In the dynamic balance tests, there was a significant difference in performing SD2Z test between the two groups (p=.043). These results suggests that the older gymnasts had better results in demanding tests such as one-leg stance, handstand and cartwheels on the balance beam. To achieve top results in the Women's Artistic gymnastics it is necessary to achieve good results on the balance beam and monitoring of balance ability for future success

Osvrt na hemijski sastav vina odabranih klonova sorte merlo

Wine is a complex mixture of natural organic compounds belonging to different structural classes. The aim of this study was to examine the chemical composition of Merlot wines of 11 selected clones obtained during third phase of individual clonal selection performed in the Republic of Serbia. The relative density (0.9956 to 0.9975), alcohol content (10.18 to 11.61 vol. %) and total extract (24.23 to 27.80 gl-1) of the wines of screened clones have indicated their good technological characteristics. In order to select the best clones for the final phase of the clonal selection, the evaluation of their viticultural properties and chemical ingredients will be continued.Vino predstavlja kompleksnu smešu prirodnih organskih jedinjenja različitih struktura. Cilj ovog rada bilo je ispitivanje hemijskog sastava vina 11 klonova sorte Merlo u okviru treće faze individualne klonske selekcije u Republici Srbiji. Dobijeni rezultati za relativinu gustinu (0,9956-0,9975), sadržaj alkohola (10,18-11,61 vol%) i ukupan ekstrakt (24,23-27,80 gl-1) ukazuju na dobre tehnološke karakteristike vina klonova. Radi selekcije najboljih klonova za poslednju fazu klonske selekcije, neophodno je sprovesti dalja ispitivanja kako vinogradarskih osobina, tako i hemijskih komponenti relevantnih grožđa i vina

Analysis of cardiac manifestation and treatment of multisystem inflammatory syndrome in children related to SARS-CoV-2

Cardiovascular manifestations are common (35–100%) in the multisystem inflammatory syndrome in children. Our study aimed to analyze treatment impact and cardiovascular involvement in patients with multisystem inflammatory syndrome in children. The retrospective cohort included 81 patients treated between April 2020 and December 2021 (9.3±4.6 years). Elevated cardiac troponin I and pro-B-type natriuretic peptide were observed in 34.2% and 88.5% of patients, respectively. Myocardial dysfunction was observed in 50.6%. Children older than 10 years had a 4-fold increased risk of myocardial dysfunction (odds ratio [OR] 3.6, 95% confidence interval [CI] 1.4-8.9; p=0.006). A moderate negative correlation was proved between left ventricle ejection fraction and C-reactive protein (rr = - 0.48; p < 0.001). More than one-fifth of the patients presented with shock. Coronary artery dilatation was observed in 6.2% of patients. Mild pericardial effusion was detected in 27.1% of children. On standard electrocardiogram, 52.6% of children had negative T waves in the inferior and/or precordial leads; transient QTc prolongation was registered in 43% of patients. Treatment failure was observed in 19 patients. Patients initially treated with intravenous immunoglobulins had 10-fold higher chances for treatment failure than patients treated with corticosteroids (OR 10.6, 95% CI 3,18 – 35.35; p < 0.001). Cardiovascular manifestations were observed in more than half of the patients, with acute myocardial dysfunction being the most common, especially in children older than 10 years. We established a negative association between the degree of elevation of inflammatory markers and left ventricular ejection fraction. Patients treated with intravenous immunoglobulins who had cardiovascular manifestations had treatment failures more frequently than patients treated with corticosteroids

The risk of stroke recurrence in patients with atrial fibrillation and reduced ejection fraction

Abstract Background: Atrial fibrillation (AF) and congestive heart failure often coexist due to their shared risk factors leading to potential worse outcome, particularly cerebrovascular events. The aims of this study were to calculate the rates of ischemic and severe bleeding events in ischemic stroke patients having both AF and reduced ejection fraction (rEF) (⩽40%), compared to ischemic stroke patients with AF but without rEF. Methods: We performed a retrospective analysis that drew data from prospective studies. The primary outcome was the composite of either ischemic (stroke or systemic embolism), or hemorrhagic events (symptomatic intracranial bleeding and severe extracranial bleeding). Results: The cohort for this analysis comprised 3477 patients with ischemic stroke and AF, of which, 643 (18.3%) had also rEF. After a mean follow-up of 7.5 ± 9.1 months, 375 (10.8%) patients had 382 recorded outcome events, for an annual rate of 18.0%. While the number of primary outcome events in patients with rEF was 86 (13.4%), compared to 289 (10.2%) for the patients without rEF; on multivariable analysis rEF was not associated with the primary outcome (OR 1.25; 95% CI 0.84–1.88). At the end of follow-up, 321 (49.9%) patients with rEF were deceased or disabled (mRS ⩾3), compared with 1145 (40.4%) of those without rEF; on multivariable analysis, rEF was correlated with mortality or disability (OR 1.35; 95% CI 1.03–1.77). Conclusions: In patients with ischemic stroke and AF, the presence of rEF was not associated with the composite outcome of ischemic or hemorrhagic events over short-term follow-up but was associated with increased mortality or disability

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions