Background/Objectives: Syncope is a common clinical problem often requiring pharmacological treatment, yet evidence-based therapies remain limited. Midodrine, a vasopressor agent, is frequently used, though its autonomic effects over time remain unclear. This study aimed to assess autonomic nervous system changes and blood pressure response in syncope patients treated with Midodrine, placebo, or their combination. Additionally, the structural properties of the Midodrine placebo were analyzed using nanotechnological methods. Methods: A total of 67 patients with syncope were randomized to receive Midodrine, sucrose placebo, or their combination over three weeks. All participants underwent 24 h Holter ECG with heart rate variability (HRV) analysis and ambulatory blood pressure monitoring before and after therapy. Structural analysis of Midodrine tablets, sucrose, and Midodrine placebo was performed using Raman spectroscopy and X-ray diffraction (XRD). Results: Patients receiving the Midodrine–placebo combination showed a significant reduction in HRV markers of parasympathetic activity (RMSSD, pNN50, HF) and an increase in sympathetic dominance (LF/HF ratio) compared to the other groups. Only this group showed a statistically significant rise in average systolic and diastolic blood pressure. Raman and XRD analyses revealed structural alterations in the sucrose-based placebo compared to its original form, indicating subtle changes in crystalline structure. Conclusions: In this exploratory study, the combination of Midodrine and placebo was associated with autonomic imbalance and modest increases in blood pressure, which may indicate a potential effect in patients with hypotensive syncope phenotypes. These preliminary findings should be interpreted with caution, and the structural modifications observed in the placebo formulation are presented as hypotheses requiring further investigation rather than established mechanisms.

Objectives The primary objective of this study was to examine the potential association between glutathione S-transferases (GSTT1/GSTM1) deletion polymorphisms and the development of apical periodontitis (AP) in a population of patients at two university centers: the Faculty of Medicine at the University of Banja Luka in Bosnia and Herzegovina and the School of Dental Medicine at the University of Belgrade in Serbia. Materials and Methods The study involved 200 patients with AP in the experimental and 250 healthy individuals without AP in the control group. As a source of genomic DNA, sterile buccal swabs were taken from each patient. Genotyping of GSTM1 and GSTT1 deletion polymorphisms was conducted using multiplex Polymerase Chain Reaction (PCR). The risk of AP development with regard to the genotypes was evaluated based on odds ratios (ORs) and 95% confidence intervals (CIs) that were calculated via unconditional logistic regression. Results There were significant differences in demographic characteristics between the investigated groups (p = 0.446, p = 0.154, respectively). GSTM1 and GSTT1 deletions were associated with a 3.05-fold and 5.69-fold risk (OR = 3.05, 95% CI = 2.07–4.49, OR = 5.69, 95% CI = 3.66–8.86, p < 0.001, p < 0.001, respectively) for the AP development. The co-occurrence of both deletions posed a significantly higher risk for AP development (OR = 52.76. 95% CI = 18.20–152.94, P < 0.001). Conclusions The carriers of null GSTT, null GSTM, and double null GSTT/GSTM genotypes are more susceptible to AP development in the populations examined at the two centers.

OBJECTIVES The presence of altered sagittal cervical balance and faulty posture has been observed in individuals with neck pain. However, there is a lack of literature investigating the relationship between radiological thoracic inlet alignment and clinical sagittal cervico-thoracic posture. This cross-sectional study aims to investigate these clinico-radiological associations, analyze their correlation with pain variables, and explore the diagnostic significance of thoracic inlet parameters for chronic neck pain (CNP). METHODS 88 subjects (N = 44 each in CNP and Control group) were recruited. T1 Slope (T1S), Thoracic inlet angle (TIA), Neck tilt (NT) were assessed on lateral cervical radiograph, and Craniovertebral angle (CVA), High thoracic angle (HTA), Sagittal head angle (SHA) were photographically analysed. Pain was quantified in terms of intensity and functional disability. Craniocervical flexion test (CCFT) assessed the deep neck flexors (DNF) performance. RESULTS After normality check, between-group comparisons utilized Unpaired t-test or Mann-Whitney U test. CNP group had lower T1S, and higher TIA, NT. The TIA had significant correlation with CVA and HTA (rs = -0.32, -0.30 respectively) in asymptomatic group, but not in CNP subjects. Patients with severe pain/disability had weaker DNF. Symptomatic group showed age-related declines in SHA, CVA and CCFT. Logistic regression revealed T1S (<26.36°) and NT (>47.41°) had diagnostic significance for CNP. CONCLUSION Neck pain corresponded with distinct postural, radiological, and clinical alterations compared to controls. Thoracic inlet parameters (primarily TIA) influenced cervicothoracic posture in asymptomatic individuals, but pain disrupted these associations, highlighting the complex interplay between alignment, posture, and symptomatology.

The study aimed to evaluate the audiologic profile of preschool children with hearing loss, i.e., to determine the type, degree, and configuration of hearing loss, amplitude of otoacoustic emissions, and word recognition performance. This retrospective study included 260 children examined in a secondary healthcare setting. For statistical data analysis, we used the Chi-square test with a level of significance p < 0.05. Conductive, sensorineural, and mixed hearing loss was present in 93.1%, 4.6%, and 2.3%, respectively. Mild hearing loss was present in 96.1%, moderate in 2.3%, and severe hearing loss in 1.6%. Type B tympanogram was the most common (p = 0.00001). The mean amplitude of otoacoustic emissions was -7.6 dB in sensorineural hearing loss and 12.3 dB in normal hearing. The maximum word recognition score was frequently obtained at presentation levels of 25-40 dB SL (p = 0.009). The majority of children had mild conductive hearing loss with normal word recognition ability.

Introduction: Stress is an essential element of students' academic lives, especially as exams approach. Due to academic demands, social pressure, and personal expectations, stress can negatively impact students' mental and physical health and lead to an increased risk of chronic illness. This study investigated the effects of oral exams on students' physiological parameters. Material and Methods: The study involved 35 physiotherapy students. The "Smart Bracelet TK 30" monitored heart rate, blood pressure, and blood glucose levels before and during the exams. Results: Significant blood pressure and pulse changes were observed between resting and exam conditions. Blood glucose levels were higher in men than in women during the exams. Conclusion: Exam stress significantly impacts students' physiological responses. Given the potential long-term health risks, preventive health strategies should be developed to help students cope with academic stress.

Lung development is governed by tightly regulated signaling mechanisms, including endocytosis-mediated pathways critical for epithelial–mesenchymal communication and tissue remodeling. This study investigated the effects of Dab1 deficiency on the expression of endocytic and signaling-related proteins, Megalin, Cubilin, Caveolin-1, GIPC1, and Dab2IP, during embryonic lung development in yotari mice. Using immunofluorescence and quantitative image analysis, protein expressions were compared between yotari and wild-type embryos at gestational days E13.5 and E15.5. Results showed significantly reduced expression of Caveolin-1 in the yotari epithelium across both stages, along with diminished mesenchymal levels of Megalin and GIPC1 at E13.5. Cubilin and Dab2IP expression patterns showed no statistically significant differences, although developmental and compartmental shifts were observed. These findings suggest that Dab1 deficiency selectively disrupts endocytic and signaling scaffolds crucial for branching morphogenesis and alveolar maturation. The altered spatiotemporal expression of these proteins underscores the essential role of Dab1 in regulating lung epithelial–mesenchymal dynamics and maintaining developmental homeostasis during critical stages of organogenesis.

Background/Objectives: This study investigates the antimicrobial properties of pomegranate peel extract (PoPEx) and its major polyphenolic constituents against Gram-positive and Gram-negative bacteria, employing six clinical isolates of Staphylococcus aureus and five isolates of Escherichia coli. The study further aims to elucidate mechanisms of action through molecular docking and transport studies. Methods: Chemical composition was analyzed using liquid chromatography–mass spectrometry (LC–MS). Antimicrobial activity was determined by the broth microdilution method. Molecular docking was performed with the AutoDock Vina algorithm, and transport studies through porin channels were carried out using Caver software. Results: PoPEx showed stronger activity against Gram-positive (MICs 15.62–500.00 μg/mL) than Gram-negative bacteria (MICs 125.00–500.00 μg/mL). Punicalagin was most active against S. aureus, while gallic acid was most effective against E. coli. Docking revealed high affinities of punicalagin and punicalin, whereas transport studies highlighted the advantage of smaller phenolics like gallic acid in crossing porins. Conclusions: Larger tannins exhibited strong target binding but limited porin permeability, reducing efficacy in Gram-negative bacteria. These findings provide insights into structure–activity relationships of pomegranate polyphenols and support their potential as natural antimicrobial agents.

Abstract This study presents the first comprehensive ecological assessment of the Dabar River, a small karstic watercourse in the Sanski Most area, using biological indicators focusing on the macrozoobenthos community, microbiological parameters, and ichthyofaunal composition. Sampling was conducted at three sites (headwaters, middle course, and downstream section), applying standard methods for the analysis of macrozoobenthos composition, bacterial abundance (including Escherichia coli), and biological indices (SI, BMWP, ASPT, EBI). The results indicate a good ecological status of the river, particularly in the headwater section, with a slight decline in water quality downstream. A rich and stable benthic fauna was identified, dominated by Gammarus fossarum, Sadleriana fluminensis, and representatives of the EPT groups. Microbiological findings revealed low to moderate levels of contamination, with no presence of fecal bacteria. Dabarska Cave, which hosts endemic subterranean crustaceans and olm Proteus anguinus, represents a particular ecological value of the area. Guidelines for conservation and sustainable management are proposed, including legal protection of the watercourse, pollution control, and the development of ecotourism.

Academic writing is a crucial skill for university students, with argumentative essays being a fundamental form of written expression. Despite various instructional approaches, students, particularly those with lower foreign language proficiency, continue to struggle with essay writing. Grounded in the socio-cognitive theoretical framework and metacognitive strategies, this study examines the impact of explicit writing instruction on English major students. It explores the effectiveness of strategies such as modelling, practice with feedback, and independent practice in enhancing students’ essay-writing performance. A total of 110 argumentative essays, produced by experimental and control groups over one semester, were analysed. The findings reveal a statistically significant improvement in overall writing performance across seven assessed criteria, though not all elements improved equally. The results underscore the necessity of teaching essay writing explicitly, demonstrating that explicit instruction is an effective approach to enhancing academic writing skills among university students.

Objective This study aimed to evaluate the functional status of the urethra using uroflowmetry before surgery, as well as three and six months postoperatively in cases of distal hypospadias. Material and Methods Thirty-nine consecutive patients who underwent surgery for distal hypospadias (hypospadias group) between 2016 and 2019 were prospectively included as part of this study. The control group consisted of 40 patients with a normal urethra who underwent surgery due to conditions other than hypospadias (phimosis, undescended testis, hernia). Uroflowmetry was performed preoperatively in these patients. Postoperative uroflowmetry was performed at three and six months following hypospadias surgery. Uroflowmetric results [maximum flow rate (Qmax), average flow rate (Qave), voided volume, void duration, flow start time, time to maximum urine flow rate, post-void residual urine, flow curve] were compared between the groups. Results The mean age for the patients with distal hypospadias was 35.9±29.6 months and 40.8±26.1 months for the control group. Pre- and postoperative Qmax values (three and six months after surgery) were 6.9 mL/s (0.1-15), 6.4 (0.2-14), and 7.5 (2.5-15). Qave values were preoperatively 4.0 (0.1-12.1), 3.8 (0.3-8.1), and 4.7 (1.0-11.1) mL/s three and six months after surgery, respectively. Bell-type flow was the most frequent uroflow flow curve in the preoperative hypospadias and control groups (95% and 66.6%, respectively). Postoperatively, bell-type flow remained the most common pattern, while a significant reduction in plateau-type flow was observed. Four boys (10.3%) had symptoms of obstruction. Conclusion Surgery improved urination dynamics and partial urethral obstruction of hypospadias cases that were present from the baseline. The urinary flow rates improve over time as the reconstructed neourethra regains functionality six months after the tubularized incised plate procedure.

Four new heteroleptic neutral paramagnetic mononuclear oxidovanadium(IV) complexes, designated as [VOL(phen)], where L corresponds to acetophenone isoniazid hydrazone or its 5-halogenated derivatives and phen stands for 1,10-phenanthroline, were synthesized and thoroughly characterized using chemical analysis, various spectroscopic techniques, and diffraction methods. Single-crystal X-ray diffraction revealed the molecular and crystal structures of two complexes, showing an octahedral coordination environment around the vanadium(IV) center. The coordination includes a tridentate ONO donor hydrazone ligand in its deprotonated enol-imine form, 1,10-phenanthroline as a bidentate NN donor ternary ligand, and one terminal oxygen atom. The biochemical and hematological effects of these complexes were evaluated in a streptozotocin-induced diabetic rat model. All synthesized complexes showed cholesterol-lowering effects compared to the diabetic rat group, with the vanadium complex lacking a substituent on the acetophenone ring of hydrazone showing the strongest effect. Complexes exhibited comparable and significant antidiabetic activity in vivo, effectively reducing hyperglycemia within 1 week of treatment. Additionally, the histopathological effects of complex (4) on liver, kidney, and brain tissues were investigated. All four complexes were found to have low bioaccumulation levels, with total absolute bioaccumulation in all tested organs less than 0.35% of the administered dose.

The objectives of this study are to determine the prevalence of Staphylococcus aureus in nasal and throat swab samples collected from healthy individuals within a population of workers and students, analyze its frequency in relation to the gender distribution of partici- pants, and assess the antibiotic susceptibility profile. S. aureus was isolated exclusively from nasal swab samples (111/1403). The findings indicate that nasal carriage is significantly more prevalent in male participants than in females and is independent of age. No statistically significant differences in S. aureus prevalence were observed between the worker and student populations. Resistance was detected for: penicillin, ampicillin, amoxicillin/clavulanate, oxa- cillin, cephalexin, gentamicin, erythromycin, chloramphenicol, trimethoprim-sulfamethoxaz- ole and ciprofloxacin. Further research involving a larger sample size and an extended study period is required to elucidate the influence of geographic and sociodemographic factors on S. aureus carriage, as well as the potential impact of gender on the prevalence of resistant strains.

Objective Postoperative respiratory complications (PRCs) are a significant concern after cardiac surgery, contributing to increased morbidity and mortality. This study aimed to analyze the incidence and risk factors for PRCs in a tertiary center in Bosnia and Herzegovina and compare findings with data from developed countries. Material and Methods This prospective cohort study included 300 adult patients who underwent open-heart surgery with cardiopulmonary bypass at the Clinic for Cardiovascular Surgery, University Clinical Center Tuzla, between January 2020 and October 2023. Preoperative, intraoperative, and postoperative variables were analyzed, including comorbidities, surgical procedures, mechanical ventilation duration, and intensive care unit stay. PRCs were defined based on standardized clinical and radiological criteria. Multivariate logistic regression identified independent risk factors. Results The most common PRCs were pneumonia (37.3%), atelectasis (29.3%), pleural effusion (22.0%), and respiratory failure (10.7%). Key independent risk factors included oxygen saturation <94%, ejection fraction <45%, diabetes mellitus, anemia, and red blood cell transfusion >500 mL. In contrast to studies from developed countries, intraoperative variables were not significant predictors. Conclusion Our findings suggest that preoperative comorbidities play a more dominant role in PRC development in our setting compared to developed nations. The high incidence of pneumonia may reflect delayed postoperative mobilization and limited access to respiratory therapy. These results underscore the need for optimized preoperative patient management and improved postoperative respiratory care protocols in resource-limited healthcare settings.

This study aimed to examine position-specific physical demands among elite U19 football players competing in a 4-3-3 formation, using data collected via STATSports GPS technology. A total of 23 players from a top-tier Bosnian club, FK “Sarajevo”, were monitored during 26 official matches in the 2024/2025 season. Match data included total distance, distance in six speed zones, high-speed running (HSR), sprint distance, number of sprints, maximum speed, and acceleration/deceleration events. One-way ANOVA and Bonferroni post hoc analyses revealed significant positional differences across all performance metrics (p < 0.05). Central midfielders (CMs) covered the greatest total distance and distance per minute, while side defenders (SD) and forwards (FWs) recorded the highest values in sprint distance, HSR, and sprint frequency. Central defenders (CDs) consistently demonstrated the lowest outputs in high-speed and sprint metrics. These findings highlight the distinct physical profiles required for each playing position in a 4-3-3 system and provide practical insights for designing position-specific training and load management strategies in elite youth football.

Background/Objectives: In many low- and middle-income countries (LMICs), including Bosnia and Herzegovina, oncology services are constrained by a limited number of specialists and uneven access to evidence-based care. Artificial intelligence (AI), particularly large language models (LLMs) such as ChatGPT, may provide clinical decision support to help standardize treatment and assist clinicians where oncology expertise is scarce. This study aimed to evaluate the concordance, safety, and clinical appropriateness of ChatGPT-generated treatment recommendations compared to decisions made by a multidisciplinary team (MDT) in the management of newly diagnosed breast cancer patients. Methods: This retrospective study included 91 patients with newly diagnosed, treatment-naïve breast cancer, presented to an MDT in Bosnia and Herzegovina in 2023. Patient data were entered into ChatGPT-4.0 to generate treatment recommendations. Four board-certified oncologists, two internal and two external, evaluated ChatGPT’s suggestions against MDT decisions using a 4-point Likert scale. Agreement was analyzed using descriptive statistics, Cronbach’s alpha, and Fleiss’ kappa. Results: The mean agreement score between ChatGPT and MDT decisions was 3.31 (SD = 0.10), with high consistency across oncologist ratings (Cronbach’s alpha = 0.86). Fleiss’ kappa indicated moderate inter-rater reliability (κ = 0.31, p < 0.001). Higher agreement was observed in patients with hormone receptor-negative tumors and those treated with standard chemotherapy regimens. Lower agreement occurred in cases requiring individualized decisions, such as low-grade tumors or uncertain indications for surgery or endocrine therapy. Conclusions: ChatGPT showed high concordance with MDT treatment plans, especially in standardized clinical scenarios. In resource-limited settings, AI tools may support oncology decision-making and help bridge gaps in clinical expertise. However, careful validation and expert oversight remain essential for safe and effective use in practice.