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In this reflection, I share my journey from being a participant in the first Connect Symposium in 2017 to returning as a junior organizer and lecturer in 2025. What began as a formative experience during my undergraduate studies became a turning point in my academic path, guiding me through a PhD and deeper engagement with the European research landscape. The symposium offered far more than lectures — it introduced me to the importance of science communication, regional cooperation, and networking, all of which shaped my career. Eight years later, I return to Neum alongside a student colleague I met during that first Connect, now ready to pass on what we once received. As we focus this year on “Towards the EU Research Area,” I hope our stories and experiences will inspire a new generation to see science not just as a profession, but as a shared, cross-border endeavor.

A. Cerovac, Damir Ramić, D. Habek, Asmir Aldžić, Ratko Knežević

A caesarean section (CS) is an obstetric surgical intervention and mode of delivery which aims to finish the pregnancy surgically. CS are one of the most important surgical interventions in modern obstetrics and have lead to a significant reduction of fetal and maternal mortality. However, it is important to take into consideration that CS can have risks and lead to unwanted short-term and long-term consequences. One of the main questions of modern obstetric is the ideal CS rate, including ways to reduce an undesirably high CS rate. The ideal CS rate ranging between 10 to 20% according to various research, but some countries have reached rates exceeding 50%, while in other, less developed countries, the issue of accessibility for CS still exists and consequently leads to a high mortality rate. Significant inequality exists in CS accessibility between developed and less developed areas of countries, and countries themselves. In some cases it is even desirable to increase CS rates in order to reduce negative patient outcome.

Stijn E Verleden, A. Snoeckx, Dieter J E Peeters, Wen Wen, R. Wener, P. V. Van Schil, S. Koljenović, Annelies Janssens et al.

PURPOSE Accurate lung cancer TNM staging depends on macroscopic and microscopic tumor evaluation of resection specimens. However, small nodules (<1 cm) are difficult to extract and correlate with in vivo imaging. We investigated whether microCT could better localize lesions or guide pathology to otherwise undetected abnormalities. MATERIALS AND METHODS Paired ex vivo CT and microCT were performed after inflating and freezing surgically removed lung lobes (resolution 80 to 120 µm). Rigorous matching between CT, microCT, and histopathology was performed on areas containing abnormalities on microCT. RESULTS A total of 57 lobectomy specimens were analyzed. MicroCT-guided microscopic examination led to 2 additional primary carcinomas, 2 separate tumor nodules from the primary lung tumor, and 1 atypical adenomatous hyperplasia lesion that were not evident before surgery. For both patients with separate tumor nodules, the cT1 stage was upgraded to a pT3. In addition, the microCT provided insight into underlying structural disease (ie, emphysema and fibrosis). CONCLUSIONS In 5 out of 57 resection specimens (9%), microCT showed additional (pre-)cancerous lesions. This explorative study suggests that lobar microCT could serve as a valuable guide for pathologists by pointing them toward areas that may warrant further investigation. In this way, it is a practical and beneficial tool, capable of facilitating a more precise TNM classification in tumor resection specimens, which needs further validation in a prospective study.

Amina Saračević, A. Pašić, N. Tihić, Azra Lukavačkić, A. Huremovic, Džana Kavazović

AimAcute respiratory infections caused by viral pathogens are the most common reason for hospitalization of children. Annually, 150 million infants worldwide are diagnosed with bronchiolitis, and 2-3% of them are hospitalized. This study aimed to compare bronchiolitis severity before and after the COVID-19 pandemic. MethodsThis retrospective study was conducted at the Department of Pulmonology, Paediatric Clinic, Clinical Centre University of Tuzla, covering the period from November 1st, 2018, to April th 30, 2019 (pre-COVID period) and November 1st, 2023, to April 30th, 2024 (post-COVID period). A total 129 children under the age of 2 years were involved. Results No significant differences in the age, body mass, comorbidities, duration of hospitalization, use of oxygen therapy, and mechanical ventilation was found. There was a significant reduction in antibiotic in the post-COVID group (p=0.0173), and a significant increase in the use of aminophylline and inhalation therapy drugs in the post-COVID group. There was a significantly higher number of isolated respiratory syncytial virus (RSV) cases in the post-COVID group, 32 (42.7%). prevalence of fully vaccinated children was significantly higher in the pre-COVID period compared to the post-COVID period,  34 (74.4%?) and  29 (45.3%), respectively. Conclusion This study reveals a significant increase in the severity of bronchiolitis and an increase in RSV cases after the COVID-19 pandemic. Keywords: anti-bacterial agents,coinfection, oxygen inhalation therapy,respiratory syncytial virus infections, vaccination.

Aim to investigate the prevalence of cervical cytology abnormalities over five years and to correlate it with patient’s age and presence/absence of HPV infection. Methods Pap findings of 614 women with documented cervical abnormalities and Pap findings of HPV-positive women (regardless of whether the Pap test showed an intraepithelial abnormality) were included in this study. Results The majority of women included in the study (36.5%) were aged 30-39 years. The most common abnormalities included atypical squamous cells-ASC (47.4%) and low-grade intraepithelial lesions (LSIL)-15.1%. Out of 614 women, 270 (43.9%) were positive for HPV. HR HPV positivity was found in 256 (41.7%). The proportion of HPV infection positivity decreases with age, especially in the two oldest age groups (women older than 60), p=0.03. The analysis showed a higher ratio of Pap smear abnormalities in groups of patients older than 40 years of age (p=0.02). The youngest age group (patients younger than 20 years of age) showed no other lesions than ASC, while women younger than 40 had no SCC on Pap smear. (p<0.01). Out of 256 HR HPV- positive women 42.2% (n=108) showed Pap abnormalities. HR HPV-positive women more commonly had HSIL lesions, but without statistical significance (p>0.05). Conclusion The results obtained contribute to the knowledge about HPV prevalence and the incidence of squamous cell abnormalities and confirm the necessity for further implementation of HPV vaccination and organized cervical cancer screening program on national level. Keywords: cervical dysplasia, Pap smear, screening.

<p style="font-size: 11pt; color: #000000; font-weight: 400;"><strong>Aim </strong>to investigate the prevalence of cervical cytology abnormalities over five years and to correlate it with patient&rsquo;s age and presence/absence of HPV infection.</p> <p style="font-size: 11pt; color: #000000; font-weight: 400;"><strong>Methods</strong> Pap findings of 614 women with documented cervical abnormalities and Pap findings of HPV-positive women (regardless of whether the Pap test showed an intraepithelial abnormality) were included in this study.</p> <p style="font-size: 11pt; color: #000000; font-weight: 400;"><strong>Results </strong>The majority of women included in the study (36.5%) were aged 30-39 years. The most common abnormalities included atypical squamous cells-ASC (47.4%) and low-grade intraepithelial lesions (LSIL)-15.1%. Out of 614 women, 270 (43.9%) were positive for HPV. HR HPV positivity was found in 256 (41.7%). The proportion of HPV infection positivity decreases with age, especially in the two oldest age groups (women older than 60), <em>p</em>=0.03. The analysis showed a higher ratio of Pap smear abnormalities in groups of patients older than 40 years of age (<em>p</em>=0.02). The youngest age group (patients younger than 20 years of age) showed no other lesions than ASC, while women younger than 40 had no SCC on Pap smear. (<em>p</em>&lt;0.01). Out of 256 HR HPV- positive women 42.2% (n=108) showed Pap abnormalities. HR HPV-positive women more commonly had HSIL lesions, but without statistical significance (<em>p</em>&gt;0.05).</p> <p style="font-size: 11pt; color: #000000; font-weight: 400;"><strong>Conclusion</strong> The results obtained contribute to the knowledge about HPV prevalence and the incidence of squamous cell abnormalities and confirm the necessity for further implementation of HPV vaccination and organized cervical cancer screening program on national level.</p> <p style="font-size: 11pt; color: #000000; font-weight: 400;"><strong>Keywords:</strong> cervical dysplasia, Pap smear, screening</p>

Alisa Krdžalić, Amar Skakić, Harun Avdagić, Fuad Pašić, Tarik Odobašić, G. Krdžalić

AIM This study aims to identify independent risk factors associated with postoperative respiratory complications (PRC) in patients undergoing coronary artery bypass surgery (CABG). METHODS A retrospective cohort study was conducted on 98 patients (82 male, 16 female) who underwent CABG at the Cardiovascular Surgery Clinic, University Hospital Tuzla. The incidence of PRC and potential risk factors were analyzed. Univariate analysis was performed to assess associations, followed by multivariable logistic regression to adjust for confounding factors. Independent risk factors were identified, including diabetes mellitus, smoking, hypertension, gender, and preoperative oxygen saturation <94%. RESULTS PRC were observed in 48 patients (48.97%). Preoperative factors significantly associated with PRC included diabetes mellitus, smoking, hypertension, and low preoperative oxygen saturation. Intraoperative and postoperative factors, such as prolonged surgery duration (>180 min), mechanical ventilation >120 min, and blood transfusion exceeding 500 ml/24 h, were also identified as risk factors. Multivariable logistic regression confirmed that prolonged surgery duration, extended respiratory support, and transfusions >500 ml/24 h were independent predictors of PRC. CONCLUSION This study highlights the importance of perioperative risk stratification in preventing PRC. Reducing prolonged mechanical ventilation and minimizing unnecessary transfusions may improve postoperative outcomes. Further studies with larger cohorts are needed to refine risk prediction models and optimize perioperative management strategies.

I. Iveljic, Lejla Alidzanovic Nurkanovic, Alisa Krdžalić, D. Aksentijević

Aim To assess whether colorectal carcinoma (CRC) survivors 5 years post-fluoropyrimidine (5-fluorouracil and capecitabine) chemotherapy (ChemT) have increased presence of subclinical coronary artery disease (CAD), lower iron and altered blood cell composition. Methods This prospective, 2 year, single-center study used invasive coronary angiography to detect the presence of CAD among ChemT (N=45) and control group patients (age, gender-matched, cancer-naïve (N=45). Full blood count and iron levels were compared between two groups. Results Coronary angiography in 90 patients (mean age 65±7 years; 60% male) identified significantly higher presence of CAD in CRC ChemT patient group compared to control: 80% vs. 55 % (p=0.013). CRC ChemT patients had lower red blood cell count (4.45± 0.56 vs. 4.68± 0.50 x109/L; p=0.044), platelet count (214.18±50.99 vs. 251.00 ±156.40 x109/L; p=0.002) and white blood cell count (5.50 ±1.62 vs. 7.67±1.72 x109/L; p=0.000). Mean corpuscular hemoglobin concentration was higher in CRC ChemT patients (342.11 g/L ±15.74 vs. 336.42 g/L ±10.29: p=0.046), and iron deficiency was more prevalent (ChemT20.40 µmol/L ±3.891vs. control 23.37 µmol/L ±4.10: p=0.001). Conclusion Our study shows that among CRC survivors who underwent 5-FU and capecitabine therapy there is a significantly higher prevalence of CAD accompanied by long-term impairment in blood erythropoiesis. Keywords: coronary artery disease, coronary angiography, erythropoiesis.

S. Hasić, Aida Đozo, E. Kiseljaković, R. Jadrić, Lamija Mlaćo, Amil Topuz, Selma Hasić

AIM This study aimed to reveal the prevalence of the insulin resistance (IR) identified by triglyceride glucose index (TyG index) among students of University of Sarajevo. The impact of visceral fat level and waist to hip ratio measures on TyG value in students has been investigated. PATIENTS AND METHODS Study included 160 apparently healthy students, both genders, aged from 19-27 years. Two groups were formed: Group1, TyG <4,49 and Group 2, TyG³4,49. A short interview, questionnaire, anthropometric measures, visceral fat level (VFL), blood pressure and biochemical parameters were applied. The statistical level of significance was P<0,05. RESULTS Forty-five students (28, 1%) were insulin resistant. There was a significant difference in TyG value (P<0,001), [group 1- 4,19 (3,93-4,34 vs. group 2 - 4,59 (4,55-4,74)]. Fasting blood glucose (FBG) and lipid parameters-total cholesterol, triglycerides and very low-density lipoprotein cholesterol (TC, TG and VLDL-C) were significantly higher in group TyG ³4,49 compared to TyG <4,49 group, with exception of HDL-C of LDL-C (P>0.05). Stepwise linear regression analysis showed significant impact of waist to hip ratio on TyG value (P=0,001). CONCLUSION The prevalence of IR measured by TyG in university students was 28,1%. The impact of waist to hip ratio on value of TyG index points on possible application of both parameters in visceral obesity and insulin resistance assessment in apparently healthy individuals.

Emir Begagić, Amina Džidić-Krivić, Hakija Bečulić, Ragib Pugonja, Adnana Ljevaković, Binasa Bašić, Adem Nuhović, Elma Milanović et al.

Glioblastoma (GBM) remains a major clinical challenge due to limited therapeutic success despite standard treatments including surgery, radiotherapy, and temozolomide (TMZ). Recent evidence links hyperglycemia to cancer progression, and altered glucose metabolism has emerged as a key factor in GBM development. Metformin, an antidiabetic drug, has shown promise in improving survival in GBM patients, possibly due to its ability to cross the blood-brain barrier and target metabolic pathways involved in tumor growth. Preclinical studies suggest metformin may enhance TMZ efficacy by acting on glioma stem cells and overcoming resistance mechanisms. Its activation of AMPK and modulation of Wnt signaling further support its therapeutic potential. However, while early studies and clinical trials have explored metformin’s safety and efficacy, its direct impact on GBM survival remains unclear. Ongoing research aims to clarify its mechanisms and identify responsive patient subgroups. Novel strategies, including PPARγ agonists and nanoerythrosome-based drug delivery systems, are also under investigation to improve metformin’s therapeutic profile. Rigorous clinical trials and mechanistic studies are essential to determine the role of metformin as adjunct therapy in GBM treatment.

Dragan M. Djuric, Zorislava Bajic, Nina Radisavljević, Tanja Sobot, Slavica Mutavdžin Krneta, S. Stanković, R. Škrbić

As the leading cause of global mortality, cardiovascular diseases demand improved and innovative strategies for early detection and risk assessment to enhance prevention and timely treatment. This comprehensive review examines the potential of combining high-sensitivity cardiac troponins (hs-cTns) and homocysteine (Hcy) as complementary biomarkers for enhanced cardiovascular risk prediction. hs-cTn assays have revolutionized cardiovascular diagnostics by enabling the detection of minimal myocardial injury, improving early diagnosis of acute coronary syndrome, and providing robust prognostic information in both symptomatic and asymptomatic populations. Hcy, while established as a marker of vascular dysfunction, presents an interpretative challenge due to multiple confounding factors and inconsistent therapeutic responses. Emerging evidence demonstrates significant correlations between elevated Hcy and troponins across various clinical conditions, suggesting that their combined assessment—reflecting both myocardial injury and vascular dysfunction—may improve cardiovascular risk stratification. While initial findings are promising, additional studies are required to validate the clinical value of the combined marker approach. Future development of personalized interpretation algorithms, and multi-marker panels incorporating these biomarkers, may significantly advance cardiovascular medicine and enable more effective population-specific risk management strategies.

The aim of this study was to determine differences in hydration status before and after a judo training session. The sample of participants included boys (N = 60) and girls (N = 35) aged 11–14 years. The variables used as indicators of hydration status were body weight (BW), body mass index (BMI), fat mass (FM), and total body water (TBW). Based on mean values obtained after training, body weight decreased by 0.78 kg in girls and 0.54 kg in boys. Body mass index decreased by 0.39 in girls and 0.45 in boys, while fat mass decreased by 0.52 kg in girls and 0.18 kg in boys. Finally, the reduction in total body water amounted to 0.72 in boys and 0.28 in girls. Statistical significance was confirmed using a t-test for changes in body weight, body mass index, and total body water. Based on the findings of this study, it can be concluded that the introduction of scheduled rehydration breaks during training may reduce fluid loss and help preserve muscular strength in young judo athletes.

M. Barbagallo, M. Zahn, J. Zimmermann, R. Klövekorn, J. Held, B. Németh, B. Reolon, J. Bellomo et al.

Introduction Reperfusion failure (RF) describes a condition in which patients suffering a large vessel occlusion (LVO) stroke present insufficient tissue reperfusion and recovery despite optimal mechanical thrombectomy (MT) results. Approximately 50% of patients suffering from LVO are affected. Our current understanding of the underlying pathomechanisms is limited and mostly based on rodent models. The goal of this study was to further characterize RF by applying advanced multimodal hemodynamic imaging in stroke patients. Methods Patients from the IMPreST study with LVO stroke and successful recanalization [corresponding to thrombolysis in cerebral ischemia grade (TICI) 2b-3] were included. Follow-ups with blood oxygenation-level dependent cerebrovascular reactivity (BOLD-CVR) and non-invasive optimal vessel analysis (NOVA) imaging were performed (<72 h, 7 days and 90 days). Demographic and clinical data (NIHSS and mRS) were collected. Results Of the 49 patients included in IMPreST, 18 patients met the inclusion criteria. Based on the perfusion weighted imaging (PWI) of the affected area compared to the contralateral side after MT, patients were stratified into three groups: hypoperfusion (n = 3), normalization (n = 8), and hyperperfusion (n = 7). The hyperperfusion group tended to show poorest clinical outcome (mRS 3 months: 2.5 [Q1–Q3 2.0–3.0] vs. normalization: 1 [Q1–Q3 0.75–3.0], p = 0.169) and had significantly lower BOLD-CVR values at visit one and two compared to hypoperfusion and normalization groups, indicating impaired cerebrovascular reactivity (visit1 hyperperfusion group −0.01 [Q1–Q3–0.02 – 0.07], normalization group 0.12 [0.09, 0.19], hypoperfusion group, 0.09 [0.09, 0.11] p = 0.049, visit2 hyperperfusion group 0.07 [Q1–Q3 0.03–0.10], normalization group 0.17 [0.16, 0.18], hypoperfusion group 0.10 [0.09, 0.11], p = 0.014). Discussion We found three patterns of reperfusion after successful MT of LVO stroke: normalization, hypo- and hyperperfusion of the ischemic area on days at < 72 h after stroke. There was substantial inhomogeneity in perfusion and clinical outcomes between the three groups. Next to poorest clinical outcome, the hyperperfusion-group showed poorest cerebrovascular reserve, reflecting findings of RF in rodent models. Thus, we suggest that RF includes both hypo- as well as hyperperfusion. Early detection using advanced imaging would allow a better identification of patients at risk for poor clinical outcome. Clinical trial registration http://clinicaltrials.gov, Identifier (NCT04035746).

Michael Shola David, Jann Harberts, Raquel Sanchez Salcedo, Muamer Dervisevic, V. Cadarso, N. Voelcker

Mammalian cells, particularly human cell culture models, are essential for studying disease pathophysiology and producing cell-based therapeutic products. Monitoring and controlling cell culture conditions accurately is essential for optimal cell growth and health, as even minor variations can significantly influence cell behavior. The presence of viruses, bacteria, and their by-products are key indicators of cell culture contamination. Conventional assays for quantifying cellular health and microbial contaminants such as endotoxins are end-point assays that are often laborious, require specialized equipment, and typically detect contamination only at advanced stages. For example, the chromogenic Limulus amoebocyte lysate assay, used for quantifying endotoxin, a bacte rial by-product, is often susceptible to interference from serum proteins in the culture medium. In this work, we present a simple and sensitive aptamer-based biosensor designed to detect bacterial-secreted endotoxins in various complex cell culture media. As a proof of concept, human induced pluripotent stem cells (hiPSCs) were deliberately contaminated with Escherichia coli (E. coli), and the biosensor's response to endotoxins released by the bacteria was monitored over a 24-h period. The biosensor demonstrated a reliable linear response with a detection limit of 0.33 ± 0.06 pg/mL in DMEM and 0.142 ± 0.025 pg/mL in StemFlex medium. Its performance in complex sample matrices suggests the potential for integration with industrial-scale cell culture systems for real-time contamination detection, providing a cost-effective, efficient, and timely method to monitor cell health and ensure sterile conditions for therapeutic cell cultivation.

Jingchuan Wang, N. Schmerr, Naoma McCall, Sarah Kruse, V. Lekić, P. Whelley, Jacob Giles, L. Wike et al.

Lava tubes, a common volcanic feature on terrestrial planets, offer critical insights into lava flow processes and may serve as future potential habitats for space crews and other facilities on the Moon and Mars. Seismic detection of these features is challenging as the irregular morphology and rough cave ceilings and walls generate complex seismic wavefields dominated by strong scattering and reverberation rather than pure reflections. Here we present observations of enhanced backscattering in seismic data collected above terrestrial lava tubes. We show that the spatial and frequency characteristics of wavefield intensity can be related to the dimensions of the lava tubes. Our findings suggest that, when geological indicators such as collapse pits are present, this method would enable mapping lava tubes on Earth and, by proxy, on the Moon and Mars, and that the approach is readily adaptable for future planetary exploration.

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