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Delnice in the light of historical cartographic representations until the beginning of the 20th century
No full textDelnice su najveće naselje i središte Gorskog kotara. Smještene su na nadmorskoj visini od 698 metara, što ih čini najvišim gradom u Hrvatskoj. Osim što su poznate po prirodnim ljepotama i povoljnom geografskom položaju, Delnice su zanimljive i iz kartografske perspektive. Naime, tijekom povijesti Delnice su prikazivane na različite načine, od ranih zemljovida do suvremenih digitalnih karata, što pruža vrijednu osnovu za proučavanje razvoja kartografije i percepcije prostora. U ovom diplomskom radu analizira se kartografski prikaz Delnica kroz povijest, s naglaskom na razlike u prikazima i njihovoj ulozi u razumijevanju prostora. Cilj rada je prikazati kako su se kroz vrijeme mijenjale metode kartiranja i kako su te promjene utjecale na prikaz samoga naselja. Također, istražit će se i uloga kartografskih prikaza u razvoju Delnica kao urbanog središta. Metodologija rada uključuje analizu dostupnih karata različitih vremenskih razdoblja, njihovu usporedbu i interpretaciju, kao i proučavanje povijesnih izvora koji prate kartografske prikaze
Patients with Higher Pulse Wave Velocity Are More Likely to Develop a More Severe Form of Knee Osteoarthritis: Implications for Cardiovascular Risk
No full textBackground/Objectives: Knee osteoarthritis (KOA) is a progressive degenerative joint disease characterised by low-grade inflammation and is associated with increased cardiovascular (CV) risk and arterial stiffness. Pulse wave velocity (PWV) is a quantitative measure of arterial stiffness and an important tool for detecting subclinical arterial calcification and CV risk. This study aimed to determine whether PWV can distinguish radiographically mild KOA (Kellgren–Lawrence grades 1-2) from severe KAO (Kellgren–Lawrence grades 3-4) in terms of CV risk factors. Methods: A total of 223 postmenopausal women with KOA participated in this cross-sectional study. Assessments included anthropometry, laboratory analyses, blood pressure and PWV measurements, a 6 min walk test, pain evaluation using a visual analogue scale (VAS), and completion of the International Physical Activity Questionnaire (IPAQ). Results: PWV was significantly higher in the severe KOA group (10.53 m/s vs. 8.78 m/s, p 8.4 m/s, compared to the group with PWV ≤ 8.4 m/s. Conversely, eGFR, the 6 min walk test and physical activity of patients were reduced in the group with PWV > 8.4 m/s. A patient with a PWV > 8.4 m/s has a 1.77 times higher chance of developing a more severe form of the disease than a patient with a lower PWV. Conclusions: Patients with a higher PWV are more likely to develop a more severe form of KOA, which is associated with increased cardiovascular risk
The Role of Infusion Therapy in The Treatment of Advanced Parkinson’s Disease
No full textParkinsonova bolest (PB) druga je najčešća neurodegenerativna bolest, karakterizirana gubitkom dopaminergičkih neurona i prisutnošću motoričkih i nemotoričkih simptoma. U posljednja tri desetljeća, prevalencija PB-a značajno je porasla, potaknuvši sve veći interes za istraživanjem naprednih metoda liječenja, pogotovo u uznapredovanoj fazi bolesti. Uznapredovana faza PB-a karakterizirana je neadekvatnim odgovorom na peroralnu terapiju te motoričkim fluktuacijama i diskinezijama. Kao odgovor na ove izazove razvijene su invazivne terapijske opcije, poput infuzijskih metoda, koje predstavljaju značajan napredak u liječenju uznapredovane bolesti. U ovom preglednom radu obuhvatili smo sve trenutno dostupne infuzijske terapije koje se koriste u liječenju PB-a. Prva infuzijska terapija korištena u liječenju PB-a bila je apomorfinska supkutana pumpa, koja se koristi posljednjih 30 godina i uspješno smanjuje motoričke fluktuacije i diskinezije. Intestinalni gel levodopa/karbidopa također se ističe po sposobnosti smanjenja “OFF” perioda i poboljšanju kvalitete života pacijenata, uz učinkovitost i na nemotoričke simptome. Terapija intestinalnim gelom levodopa/karbidopa/entakapon omogućuje postizanje sličnog terapijskog učinka uz manju dozu lijeka zbog dodatka entakapona. Supkutana pumpa foslevodopa/foskarbidopa novija je terapijska opcija koja postiže iste terapijske učinke, ali bez potrebe za invazivnom procedurom. Njezina prednost u odnosu na enteralne pumpe je u tome što ne zahtijeva invazivnu proceduru poput ugradnje sonde u probavni trakt. Odabir pacijenata za ove terapije zahtijeva detaljnu procjenu simptoma i odgovora na terapiju. Iako ove metode liječenja ne utječu na temeljni neurodegenerativni proces, ključne su u kontroli simptoma i poboljšanju kvalitete života pacijenata.Parkinson’s disease (PD) is the second most common neurodegenerative disease, marked by motor and non-motor symptoms due to dopaminergic neuron loss. In the past three decades, PD prevalence has significantly increased, arousing growing interest in exploring advanced treatment methods, especially for advanced stages of the disease. The advanced stage of PD is characterized by an inadequate response to oral therapy as well as motor fluctuations and dyskinesias. In response to these challenges, invasive therapeutic options such as infusion therapies have been developed, representing a significant advance in treating advanced PD. This review covers currently available infusion therapies used in PD patients. The first infusion therapy used in PD was the apomorphine subcutaneous pump, which has been used for 30 years and effectively reduces motor fluctuations and dyskinesias. Levodopa/carbidopa intestinal gel also reduces “OFF” periods and improves patients’ quality of life, with effectiveness in addressing non-motor symptoms as well. Levodopa/carbidopa/entacapone intestinal gel therapy allows for a similar therapeutic effect with a lower drug dose due to the addition of entacapone. The foslevodopa/foscarbidopa subcutaneous pump is a newer therapeutic option that achieves the same therapeutic effects without the need for an invasive procedure. Its advantage over enteral pumps is that it does not require an invasive procedure, such as the placement of a tube in the digestive tract. Selecting patients for these therapies requires a detailed assessment of symptoms and response to treatment. Although these treatment methods do not affect the underlying neurodegenerative process, they are crucial in symptom management
InterobServer AgreeMent in Pd‐l1 evaLuatIoN on cytoloGical samples—SAMPLING project: A multi‐institutional, international study
No full textThe overall moderate agreement observed highlights that improvement is still needed in inter‐pathologist agreement for programmed death‐ligand 1 (PD‐L1) evaluation on cytological samples. Sample preparation standardization, focused training in PD‐L1 evaluation on cytological material, its inclusion in External Quality Assessment, and machine learning‐derived image analysis tools could improve interobserver agreement
The potential of single-walled carbon nanotube-based therapeutic platforms targeting astrocytes
No full textCultivatable Bacteriota of Chronic Wound of Patients with Diabetic Foot Syndrome with Critical Limb Ischemia Based on Wound Biopsy in Peri-Revascularization Period
No full textDiabetic foot syndrome is often associated with inflammation. The aim of this study was to evaluate the impact of improved blood supply on the change in the clinical status and culturable bacteriota of chronic wounds. Patients with diabetic foot and peripheral arterial disease with a Rutherford score of 5 or 6 were included (n = 23). The blood supply to the limb was assessed with laboratory tests and two time-point qualitative cultures using a wound biopsy. The baseline parameters of the blood supply to the limb were Transcutaneous Oxygen Perfusion (TCPO2) of 15.0 mmHg, an Ankle Brachial Index (ABI) of 0.7, and a Toe Brachial Index (TBI) of 0.1, with an average Wound, Infection, Inflammation (WIfI) score of 5.7 (high). The most frequently isolated pathogens were Staphylococcus aureus (26.1%), followed by the Enterobacteriaceae family and Pseudomonas spp. (13.0%, each). Negative cultures were present in 47.8% (n = 11). The control parameters of blood supply improved; TCPO2 was 38.5 mmHg, the ABI was 0.9, and the TBI was 0.3, with a reduction in the average WIfI score to 3.7 (mild), while total colony-forming units (CFUs) increased by 13.5%. No cases of reocclusion or restenosis were observed during the study; however, small amputations were performed in two patients (8.7%). Five (21.7%) ulcers were significantly reduced and two (8.7%) progressed, while a negative culture at follow-up was obtained in five fewer patients than at baseline and nine patients presented growth despite having an initial negative result. Quantitative reduction was obtained in four (17.4%) cases. Pathogen distribution at follow-up resembled baseline findings. Optimizing clinical environments (enhancing blood flow and controlling inflammation) in general over focusing singularly on microbiota composition or revascularization seems to be crucial and arguably outweighed the impact of microbial change alone; in particular, reperfusion may increase the conditions to bacterial growth at the first stage
Green Bonds in the EU - Development and Perspectives
No full textOd prvog izdanja zelenih obveznica 2007. godine, zelene obveznice bilježe rast, a zainteresiranost za njih ne posustaje. Zelene obveznice predstavljaju instrument čiji je krajnji cilj financiranje projekata koji pridonose održivom razvoju. Danas se svijet suočava s mnogobrojnim izazovima, od klimatskih pa do društvenih, te se nastoje pronaći učinkovita rješenja. Osim želje za promjenom, potrebna su i novčana sredstva koja će realizirati potencijalna rješenja, a tu dolazi do izražaja uloga zelenih obveznica. Unutar Europske unije, određene države, među kojima se ističu Njemačka, Francuska i Nizozemska, izdale su vlastite zelene obveznice kojima financiraju održive projekte. Osim njih, i druge članice Europske unije također su izdale zelene obveznice, a područja na kojima se one najviše ističu uključuju energetiku, transport i građevinarstvo. Na primjer, Njemačka koristi zelene obveznice za financiranje projekata obnovljivih izvora energije, dok Francuska ulaže u modernizaciju infrastrukture za smanjenje emisije stakleničkih plinova. Nizozemska, s druge strane, fokusira se na zaštitu od poplava i održivo upravljanje vodama. Svrha ovog rada je istražiti što su to zelene obveznice, njihov razvojni put, ulogu unutar Europske unije te kakve su naznake za budućnost. Cilj je prikazati njihov razvoj i potkrijepiti ga dostupnim podacima, na temelju kojih će se izvesti određeni zaključci. Na temelju prikupljenih podataka i analiza, ovaj rad nastojat će pružiti sveobuhvatan pregled trenutnog stanja i budućih perspektiva zelenih obveznica, te ponuditi preporuke za daljnji razvoj i unapređenje ovog financijskog instrumenta
The diagnostic yield of non-invasive testing features in cardiac amyloidosis
No full textBackground: Cardiac amyloidosis (CA) is a progressive disease in which amyloid fibrils infiltrate the heart muscle. This study aimed to identify features from cardiac biomarkers, electrocardiography (ECG), and echocardiography that may distinguish between transthyretin amyloidosis (ATTR) scintigraphy-positive and negative patients. Material and methods: Seventy-eight consecutive patients, median age 69 years (range 34–81), with suspected CA, negative serum free light chains, and negative serum and urine protein electrophoresis with immunofixation, referred to cardiac scintigraphy between 2021 and 2024, were retrospectively enrolled. Cardiac uptake was assessed by Perugini grades. Troponin T, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and various ECG and echocardiographic features were compared between ATTR scintigraphy-positive and negative participants using the t-test, Mann–Whitney U-test, and χ2-test as appropriate. Multivariable stepwise logistic regression created the prediction model for ATTR-positive scintigraphy. The significance level was 0.05. Results: Scintigraphy was ATTR-positive in 24 participants (30.77%). The variables significantly connected with ATTR-positive testing were atrial fibrillation (p = 0.010), first- or second-degree atrioventricular block (p = 0.041), left ventricle (LV) end-diastolic dimension (p = 0.018), LV global longitudinal strain (GLS) (p = 0.040), a restrictive transmitral inflow pattern (p = 0.025), LV posterior wall thickness (p < 0.001), interventricular septum (IVS) thickness (p < 0.001), QRS voltages (p < 0.001), the pseudo-infarct pattern (p < 0.001), and relative apical sparing of the GLS ratio (p < 0.001). The latter four were incorporated into the prediction model for ATTR-positive scintigraphy. Conclusions: ECG and echocardiography remain the essential diagnostic procedures that raise the suspicion of CA and trigger further diagnostics. Low QRS voltages, the pseudo-infarct pattern, IVS thickness, and relative apical sparing of the GLS ratio are sensitive predictors of ATTR-positive scintigraphy findings
Radijalni klizni ležaj osovinskog voda
No full textU ovom radu je obrađena tema radijalnog kliznog ležaja osovinskog voda s hidrodinamičkim podmazivanjem. Prikazan je razvoj ležajeva kroz povijest zajedno s njihovim glavnim komponentama. Prikazana je glavna podjela ležajeva na klizne i valjne, a detaljnije su opisani klizni ležajevi. Opisane su vrste materijala za blazinice i rukavce te njihove prednosti i nedostaci. Objašnjeno je kako se izborom maziva i materijala može produljiti njihov životni vijek i smanjiti trenje. Podjela kliznih ležajeva po načinu podmazivanje je na hidrostatske i hidrodinamičke, a prema vrsti opterećenja koje djeluje na njih dijele se na aksijalne i radijalne. Također je prikazan osovinski vod sa svojim glavnim komponentama te položaj i uloga radijalnog kliznog ležaja u njemu.In this paper, the subject of the propeller shaft radial plain bearing with hydrodynamic lubrication is dealt with. The development of bearings throughout history is presented together with their main components. The main division of bearings is into plain and roller bearings, and plain bearings are described more detailed. The types of materials for shells and jornals are described with their advantages and disadvantages. It is explained how the choice of lubricants and materials can extend their life and reduce friction. Plain bearings are classified according to lubrication method into hydrostatic and hydrodynamic, and according to the type of load acting on them, they are divided into axial and radial. Also shown is the propeller shaft with its main components, and the part of the radial plain bearing in it
Prognostic Value of Biomarkers in COVID-19: Associations with Disease Severity, Viral Variants, and Comorbidities—A Retrospective Observational Single-Center Cohort Study
No full textCoronavirus disease (COVID-19) exhibits a wide spectrum of clinical severity and has been associated with specific biomarkers linked to disease progression and outcomes. This retrospective study analyzed sera from 1222 adult COVID-19 patients hospitalized at the University Hospital for Infectious Diseases in Croatia. We examined the association between several laboratory biomarker levels measured at patient admission and disease severity, fatal outcomes, viral variants and clinical parameters. Deceased patients and surviving patients with severe COVID-19 exhibited significantly elevated levels of several biomarkers on admission, including hs-troponin T, N-terminal pro-brain natriuretic peptide, creatine kinase, C-reactive protein, procalcitonin, interleukin-6, lactate dehydrogenase, lactate, urea and creatinine. Random forest models identified lymphocyte percentage, D-dimers, and hs-troponin T as the most important biomarkers for fatal outcome prediction, achieving 84.1% accuracy. Patients infected with the Delta SARS-CoV-2 variant exhibited significantly higher levels of proinflammatory, cardiac and renal biomarkers. Vaccination correlated with reduced proinflammatory parameters and higher lymphocyte proportions. Hypertension, chronic renal disease and diabetes were associated with increased cardiac, renal and metabolic biomarker levels, respectively. These findings highlight the association of several laboratory biomarkers with COVID-19 severity, viral variants, vaccination status and comorbidities, potentially offering prognostic insights into COVID-19 outcomes