In March 2022, an outbreak of Q fever (Coxiella burnetii) with non‐occupational exposure was confirmed in a semi‐urban area in Čavle, Croatia. Veterinary and human epidemiological investigations were ...conducted to identify the source of the outbreak and to implement appropriate control measures. Three farms were settled next to each other near the homes of the first human cases at the end of the street. The closest farm was less than 500 meters away. These farms contained 161 adult sheep and goats. Among the animal samples analysed, all 16 goats (100%) and 24/50 sheep (48%) tested positive for C. burnetii IgM/IgG antibodies, phase I and II. One out of five sheeps' vaginal swabs were C. burnetti DNA positive. Human testing revealed 20 confirmed and three probable cases (9/23 pneumonia, 2/23 hepatitis, 21/23 fever), with three hospitalizations, and one death. Twenty‐seven cases were discarded following negative laboratory results. The epidemiological investigation revealed airborne transmission as the most likely route of transmission. Multiple logistic regression analyses were used to evaluate risk factors for Q fever infection. Persons who were near the farms (≤750 m) (OR 4.5; 95% CI = 1.1–18.3) and lived in the nearest street to the farms had the highest risk of contracting Q fever (OR 3.7; 95% CI = 1.1–13.6). Decreased rainfall compared to monthly averages was recorded in the months prior to the outbreak with several days of strong wind in January preceding the outbreak. This was the largest Q fever outbreak in the county in the last 16 years, which was unexpected due to its location and non‐occupational exposure. To stop the outbreak, numerous intensive biosecurity measures were implemented. The outbreak highlights the importance of urban development strategies to limit the number of animal housing near residential areas while providing regular biosecurity measures to prevent infections in livestock.
Objectives This study sought to assess the extent and composition of atherosclerosis contributing to acute coronary syndrome events in women compared with men. Background Pathological studies suggest ...that plaque composition and burden may differ by sex. It is unclear whether sex impacts the extent, characteristics, and potential vulnerability of coronary plaques. Methods A total of 697 patients (24% women) with acute coronary syndromes were enrolled in the prospective, multicenter PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) study. Three-vessel multimodality intracoronary imaging (quantitative coronary angiography, grayscale, and radiofrequency intravascular ultrasound IVUS) was performed after treatment of the culprit lesion(s). Events during a median 3.4-year follow-up were ascribed to recurrent culprit versus untreated nonculprit lesions. The authors performed a post hoc, sex-based subgroup analysis. Results Women were older and had more comorbid disease than men. By angiography, women had a similar number of angiographic culprit (p = 0.53) but fewer nonculprit (p = 0.05) lesions, and fewer vessels with nonculprit lesions (p = 0.048) compared with men even after multivariable adjustment (p = 0.002). By IVUS, women had fewer nonculprit lesions (p = 0.002), but similar plaque burden (PB) per lesion (55.6% vs. 55.3%; p = 0.35), and female sex was not predictive of severe (>70%) PB (p = 0.052). Plaque rupture was less common in women (6.6% vs. 16.3%; p = 0.002) even after adjusting for comorbidities (p = 0.004), as was the total necrotic core volume (p < 0.0001). The frequency of other plaque phenotypes was similar for men and women including pathological intimal thickening, thin-cap fibroatheromas (TCFA), and thick-cap fibroatheromas. Rates of major adverse cardiovascular events attributed to culprit and nonculprit lesions at 1-, 2-, and 3-year follow-up were not significantly different between men and women, although women were rehospitalized more frequently due to culprit lesion–related angina. For men, nonculprit lesion minimal lumen area ≤4.0 mm2 , PB ≥70%, and TCFA predicted nonculprit MACE at 3 years, whereas for women, only TCFA and PB were predictive. Conclusions The PROSPECT study validates that despite having more comorbid risk factors than men, women have less extensive coronary artery disease by both angiographic and IVUS measures, and that lesions in women compared with men have less plaque rupture, less necrotic core and calcium, similar plaque burden, and smaller lumens. TCFA may also be a stronger marker of plaque vulnerability in women than men.
Gastronomy, as one of the most important segments in tourism, allows tourists to discover the cultural roots of the destination, so it is motives for planning a tourist visit. This paper is a pilot ...study for Belgrade, and therefore can be used for other destinations in the country and the world. The aim of this paper is to examine the attitudes of employees about the impression of guest tourists on the gastronomic offer of Belgrade. The methodology used in this paper is based on a questionnaire (n = 303), the survey was conducted among employees in the hospitality sector.Based on the obtained results it is proven that the guests are satisfied with the offer of food and drinks, and that traditional cousine and beverage are motives for visiting the restaurant. It can be concluded that when visiting a restaurant, the gastronomic offer is an important segment in the overall experience.
In this article, we have analyzed the experiences of women with infertility. We were interested in what we can learn about their feelings, thoughts and problems by analyzing the results obtained in ...qualitative research. We analyzed 10 qualitative studies dealing with infertile women. Using the thematic analysis, we identified seven core themes: Motherhood, Stories of Infertility, All Colors of Feelings, Changes in Identity, Complexity of Partnership, Social Environment (Social Support), Coping Strategies. Each selected core theme includes a number of subthemes. The article explains in detail each selected theme, and their justification is supported by appropriate quotations.
Violence in schools is one of the biggest problems faced by children, parents, schools, and society as a whole. The causes of violence are multiple, and the consequences numerous, so it is difficult, ...and at the same time very important, to find potential strategies to prevent and handle this problem. One of the solutions for prevention and treatment can be derived by the application of the attachment theory, which represents a useful theoretical framework for recognizing and understanding the development of violent behavior, and for dealing with it more effectively. The paper will show how some of the important antecedents of peer violence are formed in the context of early interaction with the primary caregiver. The paper summarizes the research indicating that children with a secure pattern of attachment commit peer violence less often, while children with an avoidant and disorganized attachment pattern are the most common in the group of children who behave aggressively and violently towards others. The negative model of others and the underdevelopment of the capacity for mentalization, as a consequence of rejecting caregiving or mothering in which the mother is perceived as fearful and helpless, are key in understanding the inadequate, often reactive and defensive problematic behaviors of these children. The paper will represent the point of view that in the process of preventing peer violence, a positive, sensitive and empathetic relationship that develops between teachers and students is of great importance, and that a teacher’s capacity for mentalizing is an important segment for developing mentalizing in children.
Type-2 diabetes is associated with severe health outcomes, the effects of which are responsible for approximately 1/4
of the total healthcare spending in the United States (US). Current treatment ...guidelines endorse a massive number of potential anti-hyperglycemic treatment options in various combinations. Strategies for optimizing treatment selection are lacking. Real-world data from a nationwide population of over one million high-risk diabetic patients (HbA1c ≥ 9%) in the US is analyzed to evaluate the comparative effectiveness for HbA1c reduction in this population of more than 80 different treatment strategies ranging from monotherapy up to combinations of five concomitant classes of drugs across each of 10 clinical cohorts defined by age, insulin dependence, and a number of other chronic conditions. A causal deep learning approach developed on such data allows for more personalized evaluation of treatment selection. An average confounder-adjusted reduction in HbA1c of 0.69% -0.75, -0.65 is observed between patients receiving high vs low ranked treatments across cohorts for which the difference was significant. This method can be extended to explore treatment optimization for other chronic conditions.
Campanula versicolor is a constituent of the Campanula pyramidalis complex, distributed in the central and southern Balkan Peninsula with a small disjunct range in SE Italy. The taxonomy of the ...broadly defined C. versicolor was controversial in the past due to high morphological variability of the populations across the range. We used microsatellite DNA data along with morphometric analyses on an extensive population sampling covering the entire range to reconstruct the relationships among populations of the intricate C. versicolor s.l. Based on the results three distinct entities can be distinguished, circumscribed here on the subspecies level, with newly established combinations: C. versicolor subsp. versicolor, C. versicolor subsp. korabensis and C. versicolor subsp. tenorei. We propose a new taxonomic treatment of C. versicolor s.l. with description, distribution and habitat data for each of the subspecies and a key for their identification.
Surface modification of nanocrystalline TiO(2) particles (45 Å) with catecholate-type ligands consisting of an extended aromatic ring system, i.e., 2,3-dihydroxynaphthalene and anthrarobin, was found ...to alter the optical properties of the nanoparticles in a similar way to modification with catechol. The formation of inner-sphere charge-transfer (CT) complexes results in a red shift of the semiconductor absorption compared to unmodified nanocrystallites and the reduction of the band gap upon the increase of the electron delocalization on the inclusion of additional rings. The binding structures were investigated by FTIR spectroscopy. The investigated ligands have the optimal geometry for binding to surface Ti atoms, resulting in ring coordination complexes of catecholate type (binuclear bidentate binding-bridging) thus restoring the six-coordinated octahedral geometry of surface Ti atoms. From the Benesi-Hildebrand plot, stability constants in methanol/water = 90/10 solutions at pH 2 of the order 10(3) M(-1) have been determined. Quantum chemical calculations on model systems using density functional theory (DFT) were performed to obtain vibrational frequencies of charge transfer complexes, and the calculated values were compared with the experimental data.
is a well-known zoonotic pathogen that can cause disease in both animals and humans. Moreover, it has a high bioterrorism potential as its lethal spores are resistant to inactivation, are easy to ...produce in large quantities, and are easily spread over large areas. Anthrax cases occur in different parts of the world, including most European countries. Specific areas of Croatia are long known as anthrax districts, but with sporadically reported cases over the years. Here, we present a major outbreak of animal and human anthrax in the region of Lonjsko Polje in Croatia, a region not known to have anthrax cases in the past. The outbreak started in July 2022 and lasted several months, but most human and animal cases were reported in the first month. During the outbreak, there were 17 reported human cases of cutaneous anthrax and 29 laboratory-confirmed animal cases. However, due to issues in reporting in animals and the late finding of the carcasses, which made laboratory diagnostics challenging, the actual number of animal cases was probably significantly higher.
Leptospirosis is one of the most common zoonotic infections and a major problem in terms of both veterinary medicine and public health. However, the disease is under-recognised and under-diagnosed ...worldwide, particularly in horses. Clinical leptospirosis in horses is mainly associated with recurrent uveitis (ERU), which has recently been studied more intensively, and reproductive disorders, the epidemiology of which is still relatively poorly understood. To enhance our comprehension of abortions caused by leptospirosis in horses and to identify the causative strains, a serological study was carried out with subsequent molecular characterisation of the isolate obtained. Using the microscopic agglutination test (MAT), serum samples from mares that aborted and foetal fluids (when available) were tested for antibodies against Leptospira spp. Furthermore, bacteria isolation from kidney cultures was conducted. Of 97 mare serum samples, 21 (21.64%) tested positive, with Grippotyphosa and Pomona being the most frequently detected serogroups. A significantly higher seroprevalence was found in aborting mares compared to the healthy horse population from the same geographical area, as well as a pronounced seasonal variation. Leptospiral antibodies were not detected in any of the foetal fluids, but isolation was successful in 1 case out of 39 (2.56%). Genotyping by multilocus sequence typing (MLST) and core genome multilocus sequence typing (cgMLST) identified the obtained isolate as Leptospira kirschneri, serogroup Pomona, serovar Mozdok. Further surveillance and molecular typing of Leptospira strains causing abortion in horses would be invaluable in understanding the prevalence and impact of leptospirosis on equine reproductive health in Europe.
PDF
