Višestruko poravnavanje i HMM

Višestruko poravnavanje je važan objekt u bioinformatici jer daje puno informacija proteinskim familijama. U ovom radu smo vidjeli kako napraviti višestruko poravnanje pomoću skrivenog Markovljevog modela. Pokazuje se da su rezultati vrlo osjetljivi i ovisni o uzorku. Provedena je analiza kojom je iz početnog poravnanja procijenjen model, zatim je na nekoliko načina provedena simulacija i pokazalo se da distribucija “score”-ova jest Gumbelova kako smo i očekivali. Naposljetku je napravljeno novo poravnanje. Provedena parametrizacija modela je vrlo osjetljiva, pa dobiveni model ne omogućava daljnju analizu. Zbog toga pokušavamo postepeno graditi model od najboljih poravnanja, koja su i najmanje varijabilna, a kako smo vidjeli to je dobar način da izbjegnemo neke od problema na koje smo naišli.Multiple sequence alignment is an important object in bioinformatics for obtaining information about protein families. In this thesis we show how to build a multiple sequence alignment using hidden Markov models. We have observed that the results are very sensitive to the choice of various parameters and sample biased. Analysis carried out consists of model estimation from given alignment, simulation and realigning. Distribution of scores is approximately Gumbel, as expected. Since parametrisation of a family profile is a very sensitive procedure, we gradually build a model using less variable subsamples. This method provides a good solution to avoid some of the obstacles we encountered

Višestruko poravnavanje i HMM

Višestruko poravnavanje je važan objekt u bioinformatici jer daje puno informacija proteinskim familijama. U ovom radu smo vidjeli kako napraviti višestruko poravnanje pomoću skrivenog Markovljevog modela. Pokazuje se da su rezultati vrlo osjetljivi i ovisni o uzorku. Provedena je analiza kojom je iz početnog poravnanja procijenjen model, zatim je na nekoliko načina provedena simulacija i pokazalo se da distribucija “score”-ova jest Gumbelova kako smo i očekivali. Naposljetku je napravljeno novo poravnanje. Provedena parametrizacija modela je vrlo osjetljiva, pa dobiveni model ne omogućava daljnju analizu. Zbog toga pokušavamo postepeno graditi model od najboljih poravnanja, koja su i najmanje varijabilna, a kako smo vidjeli to je dobar način da izbjegnemo neke od problema na koje smo naišli.Multiple sequence alignment is an important object in bioinformatics for obtaining information about protein families. In this thesis we show how to build a multiple sequence alignment using hidden Markov models. We have observed that the results are very sensitive to the choice of various parameters and sample biased. Analysis carried out consists of model estimation from given alignment, simulation and realigning. Distribution of scores is approximately Gumbel, as expected. Since parametrisation of a family profile is a very sensitive procedure, we gradually build a model using less variable subsamples. This method provides a good solution to avoid some of the obstacles we encountered

A case of angioedema of hereditary origin in a rural clinic near Subotica

Introduction: Hereditary angioedema (HAE) is inherited in an autosomal dominant manner. It manifests with bradykinin-mediated swelling due to a deficiency of C1 inhibitor. Managing these patients is challenging during acute edema and the onset of asphyxiation. Transportation to the hospital takes 25 minutes. Objective: To present a patient with HAE for whom specific therapy has only recently become available. Case Presentation: A female patient presented with difficulty breathing, swelling of the lips, and periorbital edema. Status: visibly distressed, talkative, facial and lip swelling, visible mucosa without edema, uvula and pharynx calm. Respiratory movements symmetric, without the use of accessory muscles. Auscultation revealed normal breath sounds, tachycardic heart action, clear tones without murmurs, and no urticaria. Blood pressure 120/70 mmHg, heart rate 100/min., respiratory rate 30/min., SpO2 98%, capillary refill time (CRT) 2 sec. Treatment: infusion, Methylprednisolone 40 mg IV. She was transported with monitoring. During transport, the condition worsened: blood pressure 105/60 mmHg, heart rate 130/min., respiratory rate 40/min., SpO2 94%, CRT 2 sec. Oxygen at 15 L/min. was initiated, an additional IV line was opened, and capnography showed ETCO2 of 36 mmHg. Methylprednisolone was increased to 80 mg. Preparation for difficult intubation was initiated. Parameters did not worsen, and the patient was transferred to the emergency department of the General Hospital Subotica. Conclusion: Since specific therapies, such as human C1 inhibitor concentrate or bradykinin receptor antagonists, have been approved for self-administration at home during acute attacks, the treatment of these patients has been facilitated, minimizing the potential fatal outcomes and morbidity

EURECA One 2014: One-month data collection in the municipality of Subotica

Heart disease is the underlying cause in two thirds of outpatient cardiac arrests. Sudden cardiac arrest occurs in people with no previous confirmed cardiac disease and occurs in situations where is possible presence of eyewitnesses. In this situations the cooperation of witnesses is necessary. It is not rare that news appear in the media, as well as on social networks footage of young athletes and public figures who suddenly lost consciousness on the sports field or at work. Despite the few studies that deal with this issue, in the literature can be found data indicating that a significantly better outcome after a sudden cardiac arrest if the arrest happens at work than in any other place. The inclusion in the study EuReCa One 2014 European resuscitation Council organized by Resuscitation Council of Serbia, the first time we have got relevant information in this field for our region. METHOD A prospective study to collect data on a single questionnaire in the time period time from 1st to 31st October 2014 in the municipality of Subotica. The study included all patients recorded a sudden cardiac arrest out of hospital and intervened medical service. RESULTS Cardiac arrest was confirmed in case of 9 patients by emergency medical services during the month of October 2014 - The incidence of 6.35 / 100,000. From 9 confirmed cardiac arrests 8 are received as a first line of emergency, and 1 as the second row of urgency. Cardiopulmonary resuscitation were started in 8 ( 89 % of all patients are a medical emergency witnessed cardiac arrest ). The incidence of 5.65 per 100.000 inhabitants. Presumed cardiac cause of cardiac arrest preceded in all 9 patients. The incidence of cardiac cause is 6.35 / 100,000 patients. When the witness was present, resuscitation measures are started at 6 ( 75%), or 23.4 / 100,000 patients, however, no resuscitation was not initiated by the laity but exclusively by the Emergency Medical Service after the arrival of the intervention. Ventricular fibrillation or pulseless ventricular tachycardia were observed in 3 patients ( 37.5 % ) or at 2.12 / 100,000 as the first rhythm. Return of spontaneous circulation (ROSC ) was found in 2 ( 25% ) or 1:41 / 100.000. Discharge determined for a patient which represents an incidence of 0.71 / 100,000 inhabitants. One patient has survived after one month observation or 0.71 / 100,000 inhabitants. Conclusion: Collection of data in one month is too short period of time and it is impossible to draw conclusions about the outcome of sudden cardiac arrest in our community, because of the small research sample. It is necessary to continue with data collection. After long-term observations we can expect results that will contribute to improving the quality of work of our institution in the management of patients with sudden cardiac arrest

EuReCa Serbia One 2014 - Research center Vojvodina: Results of the research Vojvodina - Serbia October 2014

INTRODUCTION: Heart diseases are the leading cause of death throughout Europe. About 40% of all deaths among under 75 year olds are caused by cardiovascular condition. There weren't any valid epidemiological data about sudden cardiac arrest in Serbia, until now. AIM: The aim of this paper is to emhasise the importance of cardiac arrest research and to announce the first results of EuReCa One 2014 programme, which will improve the quality of resuscitation, and therefore reduce consequences. MATERIALS AND METHODS: A prospective study was conducted by means of questionnaire concerning out-of-hospital cardiac arrest during the time period from 1 to 31 October 2014, with recording of one month survival. RESULTS: The results are presented per 100.000 people (n/100.000). The incidence of Out of hospital cardiac arrest (OHCA) in Subotica was 6,35 and on the territory of Serbia 13,21 per 100.000. Resuscitations were initiated in 5,65 cases per 100.000 in Subotica, and for Serbia overall the incidence is 6,47/100.000. More than half of all OHCAs happened at patient's home - 3,53 for Subotica and 4,40 for Serbia. Layman witnessing OHCA never initiated CPR in Subotica, but in Serbia on the whole 1,08/100.000 did start CPR. All of the recorded OHCA in Subotica were caused by presumed heart condition, while in Serbia cardiac etiology caused arrest in 5,4 cases per 100.000. Other causes of OHCA were represented by 1,06/100.000 in Serbia. The incidence of ROSC in Subotica was 1,41 - all of cardiac origin, in Serbia it was 1,08/100.000, and including those of different origin 1,66. Hospital transfer of patients with ROSC was recorded in 1,41/100.000 in Subotica and in 1,40/100.000 on the territory of Serbia. CONCLUSION: A high percentage of conducted resuscitations is evident, as well as the fact that OHCAs were often witnessed. It is therefore important to put emphasis on improvement of providing basic life support untill EMT professionals arrive, and promote health education of civilians

Višestruko poravnavanje i HMM

Višestruko poravnavanje je važan objekt u bioinformatici jer daje puno informacija proteinskim familijama. U ovom radu smo vidjeli kako napraviti višestruko poravnanje pomoću skrivenog Markovljevog modela. Pokazuje se da su rezultati vrlo osjetljivi i ovisni o uzorku. Provedena je analiza kojom je iz početnog poravnanja procijenjen model, zatim je na nekoliko načina provedena simulacija i pokazalo se da distribucija “score”-ova jest Gumbelova kako smo i očekivali. Naposljetku je napravljeno novo poravnanje. Provedena parametrizacija modela je vrlo osjetljiva, pa dobiveni model ne omogućava daljnju analizu. Zbog toga pokušavamo postepeno graditi model od najboljih poravnanja, koja su i najmanje varijabilna, a kako smo vidjeli to je dobar način da izbjegnemo neke od problema na koje smo naišli.Multiple sequence alignment is an important object in bioinformatics for obtaining information about protein families. In this thesis we show how to build a multiple sequence alignment using hidden Markov models. We have observed that the results are very sensitive to the choice of various parameters and sample biased. Analysis carried out consists of model estimation from given alignment, simulation and realigning. Distribution of scores is approximately Gumbel, as expected. Since parametrisation of a family profile is a very sensitive procedure, we gradually build a model using less variable subsamples. This method provides a good solution to avoid some of the obstacles we encountered

EURECA One 2014: ROSC analysis

INTRODUCTION Cardiac arrest survival rate after out of hospital cardiopulmonary resuscitations is pretty low and goes from 1,7% to 6,1%. The return of spontaneous circulation is the first step towards complete recovery of the patient after experiencing cardiac arrest. Predictors of sustainable ROSC include witnessing of collapse by laymen, initial heart rhythm, bystander initiation of CPR, early EMS engagement, early defibrillation and short duration of medical transport. AIM: It is to investigate the return of ROSC in regards to epidemiological and demographic characteristics, treatment and outcome (survival after a month) with shockable initial rhythm for a six-month sample. METHOD: Prospective observational study where data were gathered through particular questionnaire that concerned OHCA (out-of-hospital cardiac arrest) on the territory of Vojvodina during six month period (from October 1st 2104. until March 31st 2015.). The data that were used are registered in the data base of European programme EuReCA One 2014. RESULTS: 276 patients that have had OHCA on the territory of Vojvodina were analyzed - the incidence of 40,63 per 100 000. EMS conducted CPR in 51,16% (N=155, n=22,82/100 000), ROSC was established in 30,32% (N=47, n=6,92/100 000), and 30 days survival was documented in 9,03% of the cases (N=14, n=2,06/100 000). Shockable rhythm was initially recognized with 59,57% of the patients (N=28, n=4,10/100 000). CONCLUSION: Cardiopulmonary resuscitation sets the return of spontaneous circulation (ROSC) as its primary objective, which depends great deal on key factors affecting the course of CPR, and positive variables for CPR course are initial shockable rhythm, witnessing of cardiac arrest by layman or EMS, heart condition as the presumed cause, female gender and age under 80 years

EURECA Serbia One 2014: Cardiopulmonary resuscitation by bystander

INTRODUCTION: Cardiopulmonary resuscitation initiated by witnesses before EMS responding is related with increased survival rate in out of hospital cardiac arrest cases. AIM: Investigating the incidence of basic life support measures provided by layman witnesses before EMS arrival in out of hospital cardiac arrest OHCA cases. METHOD: Prospective, observational study. The data were used from a single data base of Clinical Trials ID: NCT02236819 - Eureca ONE 2014. which is available at www.eureca.rs RESULTS: 1677 (63,31/100 000) cardiac arrests have been entered in this single registry, and in 534 (20,16/100 000) of all EMS provided CPR. Layman witnessed the patient collapse in 64,79% (N=346; n=13,78/100 000) of all cases, and started basic life support measures before EMS arrival in 7,11% (N=38; 1,43/100 000). 38 cardiac arrests with initiated basic life support by bystanders were analyzed: conventional CPR was conducted in 27 patients (5,47/100 000), and only chest compressions (only hand CPR) were used in 11 cases (2,27/100 000). Heart condition was presumed to be the etiological factor in 35 patients (1,32/100 000), respiratory failure in 1 (0,04/100 000), and in 2 cases etiological factor wasn't recorded. OHCA happened mostly at patient's home =31 (1.17/100 000), in the street =3 (0,62/100 000), at public institutions -3 (0,62/100 000), at elderly care facilities -1 (0,04/100 000). Initial shockable rhythm was recorded 4 times, and non-shockable 34. ROSC was achieved 6 times (0,23/100 000), and 6 patients (0,23/100 000) were transported to hospital with positive vitals. One month survival was recorded in 2 cases (0,08/100 000). CONCLUSION: Citizens' involvement in initiation of cardiopulmonary resuscitation of OHCA victims before EMS arrival is of great importance, but in practice the use of this link in the chain of survival is unsatisfactory in our country

Occupational stress in emergency medical services

INTRODUCTION: Occupational stress is connected with own profession. Commonly follows usually or unexpectedly pressures or responsibilities. AIM: Presenting ways in which working conditions can affect quality of life, and reflection on means of channeling occupational stress. METHOD: The results of a survey concerning occupational stress, conducted in April 2013. were analyzed. 200 physicians from 15 Emergency Medicine Services were meant to participate, but only ~50% of them (103 physicians from 12 centers) answered our questionnaire. Statistical analysis was performed with program spss 11 for windows. RESULTS: 54 (53%) of the total number of participants were females and 49 (47%) were males. The age structure showed the highest percentage of those between 31 and 40 years of age. The respondents declared themselves mainly as non-smokers - 87 (84%) and moderate alcohol consumers - 43 (42%). 9 (8,7%) of them admitted they need to take tranquilizers. Reviewing the health condition of the participants, we found that 31 of them (30%) had one or more chronic diseases. Low wages and public exposure had a great impact on physicians' attitude about their profession. Physicians without any stress related symptoms were present in the highest number - 31 (30%), while a minor group reported frequent fatigue and weariness - 23 (22%). For 39 people (38%), the best way for channeling occupational stress was an active use of free time, for 24 of them (23%) it was conversation with colleagues, and for 21 (20%) the solution was simply keeping to themselves. 64 (62%) respondents said that they take their professional problems home after work, and 25 (24%) said they forget about them when the shift ends. CONCLUSION: Working conditions do not have a significant impact on employees in Emergency Medicine Services. Occupational stress related symptoms are present in young doctors as well as in those older than 56 years. The most common ways for stress channeling are free activities and conversations with colleagues