Background and Objectives: Left ventricular aneurysm (LVA) causes geometric changes, including reduced systolic function and a more spherical shape, which is quantified by the sphericity index (SI), the ratio of the short to long axis in the apical four-chamber view. This study aimed to assess SI’s value in A-LVA and B-LVA, identify influencing factors, and evaluate its clinical relevance. Materials and Methods: This clinical study included 54 patients with post-infarction LVA and used echocardiography to determine LVA locations (A-LVA near the apex and B-LVA in the basal segments), with SI and other echocardiographic measures assessed in both systole and diastole for the entire cohort and stratified by A-LVA and B-LVA groups. Results: Among the 54 patients, 41 had A-LVA and 13 had B-LVA. The mean SI was 0.55 in diastole and 0.47 in systole for the cohort. Patients with A-LVA had a mean SI of 0.51 in diastole and 0.44 in systole, while B-LVA patients exhibited significantly higher SI values, with 0.65 in diastole and 0.57 in systole, due to lower long-axis (L) values in both phases. The mean left ventricular ejection fraction (EF) was 23.95% in A-LVA and 30.85% in B-LVA, with no significant difference. However, apical aneurysms were larger (greater LVAV and LVAA) and more significantly reduced functional myocardium. LVEDV, LVESV, LVEDA, and LVESA did not differ significantly between A-LVA and B-LVA. In cases of severe mitral regurgitation (MR), SI was notably higher (0.75 in diastole) due to a marked reduction in the L axis. Conclusions: SI is key in differentiating A-LVA and B-LVA on echocardiography. B-LVA has lower volume and area values, but similar aneurysm and left ventricular volumes and EF. Higher SI in B-LVA is due to a reduced L-axis, and is worsened by severe mitral regurgitation (MR). Surgical ventricular reconstruction (SVR) compensates for L-axis reduction, with preservation of the L axis critical for achieving a more physiological shape. SI thus serves as a marker for left ventricular geometry and surgical outcomes.

Background: Hemoplasmas represent the type of bacteria that infect red blood cells, potentially leading to various health impacts, including changes in blood parameters. The close interaction between hemoplasma and red blood cells results in cell damage through immune-related and other unspecified mechanisms. Even with a strong immune response and antibiotic treatment, affected animals are likely to remain chronic carriers once clinical symptoms have subsided. These microorganisms were previously documented in sheep and other small ruminants worldwide. Aim: Since there is a lack of research on the link between Mycoplasma infection and blood parameters, our aim was to investigate how Mycoplasma infection affects these blood parameters. In addition, the study conducted in Bosnia and Herzegovina represents the first documented research of hemoplasma infection in goats within this region. Methods: In this research, 20 Alpine goats were sampled to investigate the presence of hemoplasma using polymerase chain reaction (PCR) analysis. Sequences of the 16S rRNA gene fragments were identified subsequently. The effect of Mycoplasma ovis (M. ovis) infection was observed on the following hematological parameters: Red blood cell count (RBC), hematocrit (HCT), hemoglobin (HGB), mean cell volume (MCV), mean cell hemoglobin, mean cell hemoglobin concentration, Reticulocyte count, and white blood cell (WBC). Effect on white blood cell differentiation, absolute white blood cell counts, platelet count, and mean platelet volume were also investigated. Results: PCR analysis confirmed the presence of Mycoplasma spp. in 7 out of the 20 blood samples. Sequencing of the 16S rRNA gene fragments revealed that all positive samples were identified as M. ovis. The research findings highlighted potential effects on blood parameters in infected goats. Goats infected with M. ovis exhibited higher mean levels of HGB and HCT compared to uninfected goats. However, there were no statistically significant differences in RBC counts between infected and uninfected groups. The study also noted significantly higher WBC counts in goats without M. ovis infection. Conclusion: 35% of animals tested positive for M. ovis. Our study’s findings showed notable differences in hematological parameters between goats infected with M. ovis and those that were not infected.

ABSTRACT Introduction The aim of the study was to assess the seroprevalence of SARS‐CoV‐2 in the Republika Srpska, Bosnia and Herzegovina, after five waves of COVID‐19 and 1 year after introduction of vaccination to better understand the true extent of the COVID‐19 pandemic in the population of the Republika Srpska and role of vaccination in achieving herd immunity. Methods The population‐based study was conducted from December 2021 to February 2022 in a group of 4463 individuals in the Republika Srpska. Total anti–SARS‐CoV‐2 antibodies were determined in serum specimens using the Wantai total antibody ELISA assay. Quantitative analysis, using Kantaro IgG assays, was performed in subsamples (1273 specimens) to asses and compare levels of IgG among vaccinated, recovered and participants with hybrid immunity. To adjust for age and gender distribution in sample, poststratification method is applied. Results The overall cumulative seroprevalence was 94.6% (95% CI = 93.9–95.3). Significantly higher seroprevalence rates were observed among vaccinated 97.8% (95% CI = 97.3–98.4) comparing to unvaccinated participants (89.5%, 95% CI = 88.0–91.0). Seroprevalence increases with the number of received doses. Among various professions, the highest seroprevalence was found in the service industry (98.1%), education (98.0%) and healthcare (96.9%). We found that 2.2% of vaccinated and 3.6% of participants with SARS‐CoV‐2 positivity during 2021 had no detectable IgG antibodies. Both seroprevalence (98.6%) and antibody titres (1094.4 AU/mL) were significantly higher among people with hybrid immunity. Conclusion Our findings reveal a 2.3‐fold increase in seroprevalence of SARS‐CoV‐2 antibodies due to infection and vaccination, comparing to the first study performed 1 year earlier. This study provides better understanding of the SARS‐CoV‐2 transmission and highlights the important role of the vaccination in achieving the population immunity. Periodically conducted population‐based seroprevalence studies are important to understand temporal trends and assess surveillance system performance and public compliance with vaccination policies.

The best maintenance therapy after a steroid-responsive acute severe ulcerative colitis (ASUC) episode remains poorly studied and is not addressed in current guidelines. We aimed to compare the impact of different treatment strategies following hospitalization for steroid-responsive ASUC. Multicentric, multinational, retrospective cohort study including patients hospitalized with ASUC, between 2010-2021, who responded to intravenous steroids (Oxford Criteria). Patients were categorized according to treatment instituted after discharge - 5ASA, immunomodulators (IMM) and advanced therapy (AT). AT was considered as the reference for comparison. Our primary outcome was a composite of time until disease progression (need for steroids, need for therapy change, new hospitalization or colectomy); secondary outcomes were each event analyzed separately. Survival analysis and multivariate cox regression were performed. 271 steroid-responsive patients from 19 countries were included; median-age at diagnosis was 33 (IQR 25-48) years, 49% were male, 49% had extensive colitis at diagnosis; median disease duration was 26 (IQR 3.0-92.3) months. Following hospitalization for steroid responsive ASUC, 34% of patients received 5-ASA as a maintenance therapy, 23% IMM and 43% AT. During a median follow up of 59 months (IQR 38-92), 68% had disease progression: new course of steroids was needed in 40%, therapy change in 54%, new hospitalization in 33% and colectomy in 10%. In univariate analysis, patients treated with 5-ASA had a trend towards earlier disease progression, compared to AT (HR 1.37, CI 95% 0.99-1.91, p=0.06), earlier need for steroids (HR 1.70, CI 95% 1.11-2.59, p=0.014) and therapy change (HR 1.68, CI 95% 1.15-2.43, p=0.007). In multivariate analysis, adjusting for age and disease extension at diagnosis, disease duration, use of AT prior to ASUC hospitalization, and period of hospitalization (2010-2015 vs 2016-2021), patients treated with 5-ASA had a higher risk of disease progression compared to both IMM (HR 1.50, CI 95% 1.02-2.21, p=0.041) and AT (HR 1.86, CI 95% 1.26-2.74, p=0.002) – Figure 1. No differences were seen between IMM and AT in uni- and multivariate analysis. Shorter disease duration (HR 0.99, CI 95% 0.99-0.99, p=0.007), and prior use of AT (HR 1.67, CI 95% 1.13-2.47, p=0.010) were also associated with higher risk of disease progression – Table 1. After an episode of steroid-responsive ASUC, shorter disease duration and prior use of advanced therapy were risk factors for disease progression. Approximately 1/3 of patients was treated with 5ASA alone. This strategy was also associated with a higher risk of poor outcomes and should be avoided.

Introduction Alcoholic liver disease represents a growing global pandemic, particularly among younger men, and is one of the leading causes of premature death worldwide. Observing complications during the decompensation stage and monitoring disease progression dynamics using scoring systems are particularly important. Materials and methods This retrospective-prospective, descriptive, and analytical study included 123 male patients with a confirmed diagnosis of alcoholic liver cirrhosis, hospitalized at the Internal Medicine Clinic, University Clinical Centre of the Republic of Srpska in Banja Luka, Department of Gastroenterology and Hepatology. The study period spanned from January 2023 to January 2025, with the note that patient selection and monitoring began much earlier, in June 2021. After hospitalization, patients were followed monthly through a program of outpatient control examinations, with disease outcomes recorded. The study included all male patients over 18 years of age with a confirmed diagnosis of alcoholic liver cirrhosis and signed informed consent. Female patients and those with cirrhosis or other etiologies were excluded. For statistical data analysis, the Statistical Package for the Social Sciences (SPSS) version 29 (IBM Corp., Armonk, NY, USA) was used. The statistical analyses performed included median, standard deviation, analysis of variance, Student's t-test, chi-square test, and survival analysis. Results The mean age of the patients was 59.09±9.316 years. Most of them had anemia: 113 patients (91.86%) with decreased erythrocytes and 109 patients (88.62%) with decreased hemoglobin. Thrombocytopenia was observed in 104 patients (84.55%), while an increased mean corpuscular volume (MCV) was recorded in 68 patients (55.28%). Among biochemical parameters, the most common findings were increased bilirubin in 98 patients (79.67%), aspartate aminotransferase (AST) in 111 patients (90.24%), gamma-glutamyl transferase (GGT) in 109 patients (88.61%), and D-dimer in 110 patients (89.44%), while albumin levels were decreased in 107 patients (87.00%). Hyponatremia (decreased sodium) was observed in 63 patients (51.21%), and hypercalcemia (increased calcium) in 116 patients (94.30%). Jaundice was the most common external sign, present in 98 patients (79.67%), while ascites were noted in 86 patients (69.91%). Death during the first decompensation occurred in 31 patients (25.20%), of whom 17 (54.83%) died in the hospital. The leading cause of mortality is bleeding from esophageal varices. Conclusion Although a healthy liver performs over 200 distinct functions in the human body, a cirrhotic liver leads, one might say, to an even greater number of dysfunctions. This pathology is extremely complex, characterized by numerous complications and high treatment costs, which, despite all applied measures, do not ensure a favorable long-term prognosis without liver transplantation.

We introduce the concept of Diophantine spherical vague set approach to multiple-attribute decision-making. The Spherical vague set is a novel expansion of the vague set and interval valued spherical fuzzy set. Three new concepts have been introduce such as Diophantine spherical vague weighted averaging operator, Diophantine spherical vague weighted geometric operator, generalized Diophantine spherical vague weighted averaging operator and generalized Diophantine spherical vague weighted geometric operator. We provide a numerical example to show how Euclidean distance and Hamming distance interact. Applications of the Diophantine spherical vague number include idempotency, boundedness, commutativity and monotonicity in algebraic operations. They can determine the optimal option and are more well-known and reasonable. Our goal was to identify the optimal choice by comparing expert opinions with the criteria. As a result, the model’s output was more accurate as well as in the range of the natural number . The weighted averaging distance and weighted geometric distance operators are distance measure that is based on aggregating model. By comparing the models under discussion with those suggested in the literature, we hoped to show their worth and reliability. It is possible to find a better solution more quickly, simply, and practically. Our objective was to compare the expert evaluations with the criteria and determine which option was the most suitable. Because they yield more precise solutions, these models are more accurate and more related to models with . To show the superiority and the validity of the proposed aggregation operations, we compared it with the existing method and concluded from the comparison and sensitivity analysis that our proposed technique is more effective and reliable. This investigation yielded some intriguing results.

Network emulators play an important role in testing network systems, applications, and protocols. Emulators bridge the gap between simulation setups that lack realism in results and real-world trials that are accurate but often expensive, non-reproducible, and uncontrollable. This article presents an extended model of the Quantum Key Distribution Network Simulation Module (QKDNetSim) with a model catalog of QKD components and functionalities. We explore emulations of point-to-point connections in QKD networks and the interaction of essential components within QKD nodes. The presented tool will undoubtedly spur future development and teaching, and it is critical for testing novel applications and protocols applied to QKD networks.

Background: The prevalence of obesity and obesity-related clinical conditions, including metabolic-associated steatotic liver disease (MASLD), sarcopenia, and a wide spectrum of pathological manifestations, is rising globally. According to WHO, BMI is the only anthropometric measure currently used to classify obesity, overweight, and underweight. However, emerging research suggests that obesity is a complex pathological state influenced by multiple etiological factors. Given the limitations of BMI, there is a growing need for a more comprehensive assessment of body composition, particularly fat mass quantity and distribution. Bioelectrical impedance analysis (BIA) provides valuable anthropometric data that can help differentiate obesity phenotypes and guide improved therapeutic approaches. Objective: This study aims to analyze body composition using BIA in a randomly selected sample of adults from primary healthcare settings in Bosnia and Herzegovina. The primary goal is to assess total body weight, fat mass quantity, fat distribution, and obesity types prevalent in this population. Additionally, the study seeks to establish reference values for further diagnostic, preventive, and therapeutic strategies to improve public health outcomes. Methods: A cross-sectional study was conducted on adults (≥18 years) in Gračanica, Bosnia & Herzegovina (B6H), from January 2021 to January 2025. Inclusion criteria required participants to provide signed informed consent, while exclusion criteria included acute systemic diseases, severe dehydration, and fasting for more than 24 hours. Anthropometric parameters measured included age, height, weight, BMI, body fat mass (BFM), fat-free mass (FFM), percent body fat (PBF), waist-hip ratio (WHR), and bone mineral content (BMC). Data were analyzed using SPSS (version 18), with results presented as medians, interquartile ranges, and percentiles (5th, 25th, 50th, 75th, and 95th). Results: A total of 4,628 adults participated in the study, of whom 2,824 (61.0%) were female and 1,804 (39.0%) were male. The median age was 45 years (IQR: 29 years). The findings revealed that over one-quarter of the B&H population is obese, with abdominal obesity being the predominant type. This phenotype is associated with the highest risk for metabolic syndrome and MASLD. Conclusion: Our study highlights a high prevalence of obesity among the examined individuals in primary care settings in B&H, with abdominal obesity being the most common type. This phenotype is strongly associated with metabolic complications. BIA-derived parameters of fat distribution and visceral fat mass may serve as valuable tools for improving obesity classification and developing more effective preventive and therapeutic strategies.

This paper aims to generalize linear models for the multiproduct break-even point. Taking into consideration identified research gaps, the paper focuses on deriving formulas for determining the multiproduct break-even point through determination models. Different assumptions regarding the constancy of individual product contribution structures to total physical production volume, total revenue, total variable costs, and total contribution margin are taken into account. Additionally, connections between the obtained solutions from different models and different assumptions regarding the constancy of individual product contributions are established. The verification of the optimality of solutions obtained through different determination models is conducted by comparing them with solutions derived from linear programming as a benchmark. The developed models are tested using a case study of a multiproduct company in the metal processing industry. Through comparative analysis, the hypotheses concerning obtaining an optimal solution and the identical nature of solutions derived from the determination model and linear programming are examined. This paper contributes to the understanding of the multiproduct break-even point, providing a theoretical and practical framework for evaluation and enabling the application of various determination models in the context of a multiproduct situation.