The three-phase state estimation algorithms developed for distribution systems (DS) are based on traditional approaches, requiring components modeling and the complete knowledge of grid parameters. These algorithms are capable of dealing with the particular characteristics of DS but cannot be used in cases where grid topology and parameters are unknown, which is the most common situation in existing low voltage grids. This paper presents a novel three-phase state estimator for DS that enables the explicit estimation of voltage magnitudes and phase angles in all phases, neutral, and ground wires even when grid topology and parameters are unknown. The proposed approach is based on the use of auto-associative neural networks, the autoencoders (AE), which only require an historical database and few quasi-real-time measurements to perform an effective state estimation. Two test cases were used to evaluate the algorithm's performance: a low and a medium voltage grid. Results show that the algorithm provides accurate results even without information about grid topology and parameters. Several tests were performed to evaluate the best AE configuration. It was found that training an AE for each network feeder leads generally to better results than having a single AE for the entire system. The same happened when different AE were trained for each network phase in comparison with a single AE for the three phases.

Background Clinical studies suggest that vestibular migraine patients have psychiatric comorbidities and low life quality. However, the absence of a multidisciplinary approach to vestibular migraine patients, including otorhinolaryngologists and psychiatrists, is concerning. We aimed to investigate these patients comprehensively and to compare the results of three questionnaires—the Hospital Anxiety and Depression Scale (HADS), Dizziness Handicap Inventory (DHI), and Short Form Health Survey (SF-36)—between patients with definite vestibular migraine (dVM), migraine without vertigo (MO), and healthy controls (HCs). Methods: A total of 104 participants were divided into 3 groups: dVM patients (19 participants), MO patients (22 participants), and HCs (63 participants). The scores of the three questionnaires across the three groups were compared using analysis of variance, and linear regression was used to examine the associations between the questionnaire scores within each group. Results: Compared to MO patients and HCs, dVM patients had significantly higher total scores on the HADS (p < 0.0001) and DHI (p < 0.0001) scales, and lower scores for all nine components of the SF-36, indicating poorer health. In the vestibular migraine group, the DHI score was strongly negatively correlated with the Physical Functioning subscale of the SF-36. Conclusions: Anxiety and depression are more prevalent in patients with definite vestibular migraine compared to patients with migraine without vertigo and healthy controls. The physical functioning of patients with definite vestibular migraine is highly affected by their dizziness, resulting in a lower quality of life. Timely screening for psychiatric comorbidity in vestibular migraine patients is essential to prevent psychiatric consequences.

Background/Objectives: Our study describes hyperbaric oxygen therapy (HBOT) as an additional therapy in the conservative treatment of Crohn’s disease (CD) and its benefit in the early postoperative period to prevent surgical complications and improve gastrointestinal motility. Methods: This retrospective study evaluated HBOT in patients hospitalized at the Clinical Hospital Center Split for complications of CD between 2015 and 2020. Patients (N = 61) aged 19 to 67 with perianal fistulas, abscesses, fistulas, obstruction, stenosis, or bleeding were included, excluding those with ulcerative colitis or requiring intensive care. Patients were retrospectively divided into conservatively and surgically treated groups, and HBOT was administered over 15–25 days, with treatment lasting 60 min at 2.2 absolute atmospheres (ATA). We analyzed treatment outcomes between the HBOT-treated surgical and conservative groups and compared patients treated with HBOT to a cohort from the preceding five years who did not receive HBOT. Results: We treated 61 CD patients with HBOT, including 34 conservatively and 27 surgically treated patients. HBOT significantly reduced disease activity indices (311.7 ± 59.1 vs. 114 ± 29.8; 203.6 ± 24.1 vs. 83.8 ± 15, for conservatively treated patients, and 352.8 ± 45.7 vs. 109 ± 22.8; 270.4 ± 19.7 vs. 140.3 ± 10.6 for surgically treated patients) and accelerated bowel peristalsis recovery, with 94.1% of conservatively treated patients achieving remission. Comparison with a historical cohort showed faster recovery and improved outcomes in the HBOT group. Conclusions: HBOT is useful in postponing or avoiding surgical treatment, and in operated patients, it improves postoperative recovery and reduces the rate of postoperative complications.

Background/Objectives: The World Health Organization’s Surgical Safety Checklist (WHO SSC) is known to reduce surgical complications and mortality, yet its implementation remains inconsistent across institutions. This study evaluated compliance with a modified SSC and assessed the impact of structured interventions to improve adherence at the University Hospital of Split, Croatia. Methods: A before-and-after study analyzed a sample of 1437 completed SSCs over four time points between April 2024 and May 2025: the baseline and after three successive interventions (an official letter from the hospital director emphasizing mandatory SSC use, individual meetings with department heads and head nurses reinforcing its importance, and a quality audit review of SSC completeness with leadership). Checklist completeness was assessed across five SSC sections: General Information, Sign In, Time Out, Sign Out, and Staff Info. Results: Overall checklist completeness increased from 78.3 ± 8.5% at baseline to 86.3 ± 2.5%, 92.0 ± 3.8%, and 94.7 ± 4.8% after the first, second, and third interventions, respectively (p < 0.001). All checklist sections improved significantly: General Info rose from 91.1 ± 6.0% to 98.6 ± 2.6% (p < 0.001); Sign In from 85.0 ± 11.4% to 97.0 ± 3.5% (p = 0.002); Time Out from 79.0 ± 14.6% to 96.4 ± 6.5% (p < 0.001); Sign Out from 70.2 ± 11.2% to 87.7 ± 11.0% (p = 0.003); and Staff Info from 70.7 ± 12.9% to 100.0 ± 0.0% (p < 0.001). Post hoc testing confirmed significant gains versus baseline for all three interventions (Dunnett’s test), with a further significant improvement between the first and third interventions (Tukey’s HSD, p = 0.011). Conclusions: Structured, low-cost interventions emphasizing administrative support, education, and communication significantly improved SSC adherence across a large tertiary hospital. This initiative represents a pioneering effort in Croatia and offers a scalable model for similar public healthcare systems aiming to enhance patient safety.

Objective To explore the barriers and facilitators to implementing the WHO’s Surgical Safety Checklist (SSC) at a tertiary-level hospital in Croatia, a country with a publicly funded universal healthcare system. Design Focus group-based study which used Graneheim and Lundman’s qualitative content analysis approach. Setting and participants We used purposive sampling to gather participants who were representative of the usual surgical team: nurses, residents, anaesthesiologists and surgeons. Aside from this requirement, we set no specific inclusion or exclusion criteria. We conducted 6 focus groups (2 with nurses, 2 with residents, 1 with anaesthesiologists and 1 with surgeons) with 29 participants. The nurses were all female, the residents and surgeons were all male, and anaesthesiologists were mostly male (60%). Most participants had at least a bachelor’s degree (93%). The focus groups were held in person at the hospital’s Department of Surgery in Croatia and were conducted in the local language, based on a predeveloped topic guide. Results Our analysis revealed two distinct themes that were fundamentally independent of each other. The first concerned within-team hierarchies and relationships that prevented the SSC from being used as intended, while the second was related to a diverse set of resource and logistical constraints that had existed before the implementation of the SSC. Conclusions Understanding the barriers faced by healthcare providers is crucial in designing training programmes that could help integrate the SSC into routine surgical practice. Our findings highlight the importance of actively including members of the surgical team in the implementation of the SSC and implementing interventions for improving within-team communication.

Background: In this cross-sectional study, we assessed the ethical climate at the University Hospital of Split in Croatia and investigated its potential indicators. Methods: We used a validated Croatian translation of the 36-item Ethical Climate Questionnaire, which we distributed online (via an e-mail sent by the hospital administration to hospital employees) and as a paper and pen survey directly to all hospital departments. We compared ECQ scores between doctors of medicine (MDs)/doctors of dental medicine (DMDs) and other employees; MDs/DMDs and nurses; employees working with patients and those not working with patients; and employees working in the ICU versus those not working in the ICU using the Mann-Whitney U test. We used linear regression to explore the relationship of each ethical climate with gender, age, degree level, and years spent working in the hospital. Results: We collected 325 physical and 222 online questionnaires (547 responses in total), after which we excluded 146 incomplete responses. This left 401 questionnaires for analysis, primarily from doctors (n = 175; 43.6%) and nursing staff (n = 131; 32.7%). The two dominant climates were ‘Company rules’ and ‘Laws and professional codes’. Stratified by profession, we observed higher scores for ‘Personal morality’ among doctors of medicine or dental medicine, whereas the group comprising other health professionals and non-medical staff had higher scores for ‘Team interests’, ‘Efficiency’, ‘Social responsibility’, and ‘Laws and professional codes’. In comparing nurses and doctors of medicine/dental medicine, we observed the former group had higher scores for ‘Social responsibility’, ‘Efficiency’, and ‘Team interest’, while the latter had higher scores for ‘Personal morality’. Those who worked outside of the ICU had higher scores for ‘Social responsibility’ compared to those who did not. In the regression analyses, age was a significant positive predictor of the ‘Laws and professional codes’ climates, and years spent working in the hospital acted as a positive predictor of the ‘Self-interest’ climate. Conclusion: A large university hospital center in a fully publicly funded national healthcare system has a positive ethical work climate, which could be further developed by further development and implementation of codes of ethics to outline expected behaviors from all employees.