Faecal incontinence is a debilitating anorectal disorder that can severely affect a person's quality of life. The variability in reported outcomes in studies on treatments for faecal incontinence complicates the synthesis of evidence, thereby weakening treatment recommendations. Furthermore, the emphasis on clinical outcomes often neglects outcomes that are crucial to patients' daily lives. Incorporating diverse stakeholder perspectives, we aimed to develop a core outcome set (COS)-a minimum set of outcomes that should be measured in future studies evaluating the efficacy of a treatment in adults with faecal incontinence. Following guidelines from the COMET initiative, this study proceeded through three steps: identifying outcomes via patient interviews and a systematic literature review; ranking and refining outcomes through two rounds of Delphi surveys involving patients, health-care professionals, and researchers; and finalising the COS through a consensus meeting with relevant stakeholders. Round 1 of the Delphi survey included 109 participants (73 health-care professionals and researchers and 36 patients) and round 2 involved 74 participants (54 and 20, respectively). In both rounds, participants ranked the importance of potential outcomes on a 9-point Likert scale. Of the 58 outcomes that entered round 1 and the three that were later added, 27 outcomes were voted out and the remaining 34 were discussed during a consensus meeting to finalise the COS. The final COS encompasses 13 outcomes: seven quality of life-related outcomes (quality of life, influence on daily activities, social functioning, treatment satisfaction, enjoyment in life, embarrassment, and peace of mind) and six clinical outcomes (severity of faecal incontinence, number of faecal incontinence episodes, urgency, stool consistency, adverse events, and adherence to therapy). This study establishes what outcomes should be included in a COS for use in faecal incontinence research, but future research is needed to identify the appropriate measurement instruments for each outcome and to establish appropriate timing for their assessment, which will further refine outcome definitions before this COS can be implemented. Once these aspects are clarified, the COS can be adopted into faecal incontinence research, which we hope will ultimately improve clinical care.

Maars are volcanoes with a central crater surrounded by an ejecta ring formed through surface explosive processes from underlying magma interacting with fluids. The study of terrestrial maar volcanoes, as analogs to explosive volcanic vents on the Moon and other planets, can improve our understanding of planetary volcanism and evolution. In this study, we conducted a series of geophysical experiments at Kilbourne Hole Maar, New Mexico, a well‐preserved crater used for both science and crewed exploration lunar analog studies. The surveys included multiple active source seismic lines that sampled the geological units of both the crater rim and floor. We demonstrate the effectiveness of shallow seismic reflection methods integrated with P wave refraction and surface wave analysis to determine the elastic properties and create detailed near‐surface structural models in a terrestrial volcanic setting. The reflection profiles capture the top‐down strata of the crater rim. The velocity changes derived from independent inversions of refraction travel times and surface wave dispersions indicate varying (6–15 m) ash thickness around the rim and reveal the presence of high‐velocity anomalies in possible connection with crater collapse beneath the crater floor. Additionally, we estimate a base surge volume of approximately 6.4×106 $6.4\times {10}^{6}$ m3 ${\mathrm{m}}^{3}$ present on the rim. The integrated results highlight the potential for characterizing the subsurface of planetary bodies in greater detail and provide high‐fidelity data simulations for astronaut training. The operational insights serve as a valuable guideline for future crewed lunar missions and contribute to the development of strategies for optimizing planetary exploration.

Abstract The aim of this paper is the histopathological assessment of the effects of a newly synthesized nanomaterial based on calcium aluminate ALBO-CA on the pulp of rat teeth. In 18 Wistar rats, 54 Class I cavities and exposed pulp of maxillary molars were treated with the tested materials: two experimental materials ALBO-CA (18 teeth), ALBO-CS (18 teeth), and MTA control (18 teeth), and cavities were restored with glass ionomer. The histopathological analysis included the following parameters: presence of pulp inflammation, degree of dentin bridge formation, and presence of bacteria in the pulp. Complete absence of pulp inflammation was noted in 12 (66.67 %) teeth with ALBO-CA, 10 (55.56 %) teeth with ALBO-CS, and 11 (60.95 %) teeth with MTA cement. A statistically significant difference in the results of pulp inflammatory response was found only when comparing the presence of a small number of polymorphonuclear leukocytes between ALBO-CS and MTA cement (Kruskal Wallis H test p=7.8255). A fully formed dentine bridge was recorded only after the application of ALBO-CA with a statistically significant difference compared to ALBO-CS and MTA (F test p=0.519, S-test p=0.656, Man-Whitney test p=2.802, Chi-square test p=4.747). Thirty days after the direct pulp capping with ALBO-CA, ALBO-CS, and MTA cements, bacteria were absent in rat teeth and surrounding tissue. Newly synthesized calcium aluminate ALBOCA showed good reparative abilities and possible use in direct pulp capping therapy.

Background/Aim: Rheumatoid arthritis (RA) is an autoimmune inflammatory disease, characterized by the production of numerous pro-inflammatory cytokines, such as tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β), which lead to pathophysiological changes in innate and acquired immunity. The existing evidence shows that pro-inflammatory cytokines in rheumatoid arthritis impact monoaminergic neurotransmission, neurotropic factors, and synaptic activity, which may lead to the development of depression. Materials and Methods: In our study, we explored the association between TNF-α and IL-6, disease activity, and the degree of depression in patients with RA. The association between TNF-α and IL-6 and the Beck and Hamilton depression scales was analyzed in a group of 116 RA patients with depression. We investigated the same correlation in 45 patients with primary depression who represented the control group. Results: A Spearman test showed that IL-6 levels had a positive association with the Beck and Hamilton scales (p < 0.05) and that TNF-α had a positive association with the Hamilton scale (p < 0.05). Also, the Hamilton depression scale was the more sensitive scale in the detection of depressive symptoms. Conclusions: Our study indicates that elevated values of pro-inflammatory cytokines are associated with the degree of depression in patients with RA. Future preclinical and clinical studies will contribute to a better understanding of the pathophysiological mechanism of depression in patients with RA and may serve as the basis for new treatment modalities. By detecting depression promptly, with the help of the HAM-D as the more sensitive scale, we could influence the future modality of treatment, and with a multidisciplinary approach, we could ensure an improvement in the quality of life of patients with RA.

Background: The objective of this investigation was to assess the oral health (OH) of Bosnia and Herzegovinian adolescents in relation to differences and socioeconomic status (SES). Methods: This cross-sectional study included 306 school children from high schools located in the Tuzla Canton (Bosnia and Herzegovina). The sample consisted of 183 females and 123 males between 15 and 18 years old (mean of 16.82 years old). The study was conducted between December 2019 and March 2020, via an Annex 8 questionnaire from the World Health Organization (WHO), which collected information on OH behaviours, self-perceptions of oral health and dietary factors responsible for the OH of each subject. SES was categorized using five variables (occupation, education, income, place of residence and number of family members). Cross-tabulations were evaluated according to sex and socioeconomic status (SES) via the chi-square test. Results: Over 40% of the participants consumed sweets, cakes and biscuits on daily basis, whereas 41.5% of the participants visited a dentist only in the case of pain. The consumption of sweets (p = 0.024) and cakes and biscuits (p = 0.011) on a daily basis was significantly greater in female adolescents than in male adolescents. Compared with male adolescents, female adolescents reported occasional toothaches more frequently (p = 0.001) and were more dissatisfied with their dental appearance (p = 0.008) but presented a greater frequency of flossing (p = 0.001) and toothbrushing (3–5 times a day) (p = 0.0001). There was no association between the different levels (below average, average, above average) of SES and factors affecting OH status of adolescents. Conclusions: The study revealed significant sex differences in several factors affecting OH status and revealed no relationship between SES and OH behaviours or between perceptions and risk factors affecting OH in 15–18-year-old adolescents. Data obtained from this study might help in the creation of new OH prevention programs aimed at improving the OH status of adolescents in Bosnia and Herzegovina.

The severity and frequency of short-term but highly damaging urban floods have increased in recent years worldwide and have been caused by climate change. The casualties of urban floods are usually not high, but the material damage and economic losses can be quite significant due to the population density of these areas and the various economic activities concentrated in urban regions. For this reason, this type of flooding is always catastrophic. This paper explores the impact of urban flooding on the tourism infrastructure in Bihać using the multi-criteria ArcGIS analysis. The results show that 55.8% of the studied area is at a low elevation and has gentle slopes, making it particularly susceptible to flooding. Annual precipitation reaches up to 1,305 mm, with 35–38% of the total rainfall recorded in the urban centre of Bihać, where the key tourism infrastructure is located. The buffer zone analysis revealed that most hospitality and accommodation facilities are situated within 20 to 100 meters of the Una River’s shoreline, making them directly vulnerable during seasonal floods. Despite this, the number of tourist arrivals has been steadily increasing – from 33,433 arrivals in 2021 to 48,330 in 2023, with foreign tourists accounting for 60% of all visitors. The research findings highlight the need for the implementation of precise spatial plans and protective measures to reduce the negative impact of floods on tourism trends in this city.

Autism spectrum disorder (ASD) as a neurological disorder can result from the interaction of genetic and environmental factors such as air pollution and exposure to chemical pollutants. This study tested the hypothesis that living in areas near petrochemical industries and exposure to benzene, toluene, ethylbenzene, and xylene (BTEX) may adversely affect maternal and fetal health and increase the risk of autism. We conducted a prospective cohort study from 2019 to 2024, following 110 pregnant women divided into exposure and control groups, along with 145 children born during the study [exposure group (n=80) and control group (n=65)]. Prenatal urinary BTEX concentrations were measured using gas chromatography-mass spectrometry (GC/MS). The MCHAT-R/F screening tool was used to track the child's behavior in terms of the occurrence of autism spectrum symptoms. The results showed that the mean concentration of prenatal BTEX urine concentration in the exposed group (557 ng/l) was significantly higher than that in the control group (258 ng/l). The M-CHAT-R/F screening indicated moderate ASD risk in six exposure group children and three control group children; and high ASD risk for four exposure group children and one control group child. The findings in the exposure group revealed a higher incidence of ASD among boys compared to girls (4:2 in medium risk and 3:1 in high risk). Multivariate logistic regression analysis indicated that the prevalence of autism in the exposed group was significantly associated with exposure to benzene (OR, 2.10; 95%CI, 1.93-2.17; Pvalue<0.05) and toluene (OR, 1.7; 95%CI, 1.62-1.81; Pvalue<0.05). Living in industrial areas and perinatal exposure to BTEX compounds may increase the risk of ASD. Therefore, health impact assessment studies focusing on the health of vulnerable groups before the construction of petrochemical industries, as well as the monitoring of relevant health indices during the operational phase, should be prioritized.

Abstract Background Rapid changes and dynamic markets significantly impact the way businesses operate. Many companies fail to adapt and innovate their business models, which jeopardises their sustainability. Managers, as key decision-makers, play a pivotal role in the innovation process, whereby their entrepreneurial competencies directly influence various dimensions of business model innovation. Objectives The main aim of this study is to examine the impact of entrepreneurial competencies on the new value proposition dimension of business model innovation (BMI), exploring competencies such as opportunity recognition, analytical thinking, innovativeness, tenacity, and passion for work. It investigates how these competencies contribute to developing new offerings and new channels, attracting new customers and markets, and building new customer relations. Methods/Approach The study is conducted on a sample of 267 managers of medium and large companies across various industries in Bosnia and Herzegovina. The data were analysed using Structural Equation Modelling (SEM). Results The results show that different entrepreneurial competencies have a significant impact on various aspects of a new value proposition. Conclusions The study contributes to a deeper understanding of the influence of different entrepreneurial competencies on new value proposition dimensions within BMI. Managers who effectively utilise these competencies can enhance their companies’ value propositions, thereby increasing competitiveness and business success.

Abstract This paper examines the key aspects of corporate governance of state-owned enterprises (SOEs) through a comparative survey conducted in Bosnia and Herzegovina, Croatia, and Serbia. The research explores two distinct perspectives: the state’s view on the necessity and governance of SOEs, and the perspective of SOE boards on operational and strategic challenges. From the state’s perspective, the survey addresses issues such as the protection of national economic interests, state ownership in key industries, equitable service provision, and the reinvestment of SOE profits into public projects. Findings suggest a strong alignment among respondents across all three countries, supporting the idea that state ownership ensures economic sovereignty and guarantees fair access to essential services. On the other hand, the board perspective highlights concern about the bureaucratic barriers faced by SOEs, the influence of political interference on financial performance, and the limitations of public ownership in enhancing global competitiveness. Board respondents expressed the need for greater autonomy in decision-making and stressed the importance of partnerships with the private sector to optimise SOE efficiency and market position. The article synthesises these findings to address the broader question: Are SOEs essential in modern economies, or do they require reform to meet contemporary challenges? The results indicate that while SOEs hold strategic importance, reforms focused on reducing bureaucracy, enhancing governance, and promoting public-private partnerships are crucial for their future viability.

Studies dealing with injury occurrence in basketball refereeing are scarce. The aim of this preliminary investigation was to retrospectively observe injury occurrence and analyze some specific predictors of injury in high-level basketball referees. The participants were basketball referees from Croatia and Bosnia and Herzegovina (all males, n=39, 25–45 years of age, with more than 5 years of experience in basketball refereeing). Data were collected via structured, previously validated questionnaire, and the variables included specific sociodemographic factors, basketball refereeing factors, and medical (injury-related) factors. Differences between injured and noninjured referees were calculated via t tests and chi-square tests, whereas associations between predictors and injury occurrence (criterion) were evaluated via logistic regression for binarized criterion. Injury occurrence was relatively low, with only 15% of referees reporting an injury during the previous competitive season. A higher level of basketball refereeing (more advanced competitive level) was associated with a greater likelihood of being injured (OR=1.44, 95% CI: 1.02–1.98). Additionally, referees who used dietary supplements were more likely to be injured during the previous competitive season (OR=1.51, 95% CI: 1.01–2.05). Although preliminary, the results emphasize the need for structured prevention strategies and support systems tailored specifically to the challenges of high-level officiating.

Congenital anomalies of the kidney and urinary tract (CAKUT) are a major cause of pediatric renal failure, but the molecular mechanisms driving these conditions are not yet fully understood. Fibroblast Growth Factor 23 (FGF23) and its co-receptor α-KLOTHO play crucial roles in regulating calcium and phosphate homeostasis in adult kidneys, but their roles in kidney development and the pathogenesis of CAKUT remain unclear. Because of that, we analyzed the spatial and temporal expression of FGF23 and α-KLOTHO in normal fetal kidney development and CAKUT using an immunofluorescence technique. Our results demonstrate a dynamic pattern of FGF23 and α-KLOTHO expression in healthy kidney development, with FGF23 levels decreasing and α-KLOTHO levels increasing with gestational age. Also, we showed that FGF23 expression was significantly reduced in horseshoe (HKs) and duplex kidneys (DKs), while α-KLOTHO expression remained unchanged across all CAKUT conditions. Based on our results, we suggest that altered FGF23 expression in CAKUT contributes to disease pathogenesis and may represent a potential therapeutic target.

Polyploid giant cancer cells (PGCCs) are characterized by enlarged nuclei, association with tumors, and resistance to treatment, contributing significantly to cellular heterogeneity. These cells arise from endoreplication and cell fusion, often triggered by stressors such as radiation and chemotherapy. PGCCs exhibit chromosomal instability and aneuploidy, leading to poor prognosis in various cancers. Key features include the ability to produce progeny cells via amitotic division and the expression of cancer stem cell markers. PGCC formation and function involve signaling pathways like cell fusion (GCM1/syncytin-1), cell cycle control, stress response, and EMT. Understanding these pathways is crucial for identifying therapeutic targets. Current therapeutic strategies targeting PGCCs involve drugs like azacitidine, decitabine, and zoledronic acid, as well as DNMT inhibitors in combination therapies. These approaches aim to reverse drug resistance and enhance antitumor efficacy. Furthermore, microRNAs (miRNAs) are pivotal in regulating gene expression and influencing the cell cycle, proliferation, and apoptosis. Cataloging miRNAs and understanding their function is critical for developing potential cancer treatments. Researchers are exploring miRNA-based modulation of signaling pathways to block tumor growth. This review highlights the complex biology of PGCCs and emphasizes the need for targeted therapies to improve cancer treatment outcomes.

Background/Objectives: Ivy leaf extract has been shown to alleviate bronchial infection symptoms through various mechanisms, including anti-inflammatory effects. However, its impact on adaptive immunity, particularly dendritic cell (DC)/T-cell interactions, remains unexplored. This study investigated the immunomodulatory potential of ivy leaf extract (EA 575®) using human monocyte-derived DCs (MoDCs). Methods: Immature MoDCs (imMoDCs) were differentiated with IL-4/GM-CSF and matured with LPS/IFN-γ (mMoDCs). MoDCs, treated with EA 575® during differentiation, were co-cultured with purified T cells. Results: EA 575® (non-cytotoxic up to 100 µg/mL) inhibited MoDC differentiation and maturation by reducing the expression of CD1a, CD83, CD40, CD86, HLA-DR, Dectin-1, CD206, CD209, HIF-1α, and proinflammatory cytokines (IL-12, IL-23, IL-27, IL-1β, IL-6, TNF-α). EA 575®-treated mMoDCs suppressed allogeneic T-cell proliferation and reduced Th1 (IFN-γ), Th17 (IL-17A, IL-22), Th9 (IL-9), Th21 (IL-21), TNF-α, and IL-6 responses. Effects were dose-dependent, with higher concentrations (100 µg/mL) showing stronger inhibition. At lower concentrations (20 µg/mL), EA 575® increased Th2 (IL-4, IL-5) and IL-10 responses, and the frequencies of CD4+ T cells with Treg properties, such as CD25hiFoxp3+, Tr1 (IL-10+Foxp3−), and IL-35+ Foxp3+ cells. Immunoregulatory mechanisms mediated by EA 575®-treated mMoDCs correlated with the upregulation of tolerogenic markers (PD-L1, ILT3, ILT4, IDO1) on mMoDCs and the increased frequency of exhausted CD4+ T cells (PD-1+CD69+) and cytotoxic T cells (Granzyme B+PD-1+). Conclusions: EA 575® induces tolerogenic DCs with significant anti-inflammatory and immunoregulatory properties, a previously undescribed phenomenon. Lower concentrations primarily enhance immunoregulatory responses, while higher concentrations exert more pronounced anti-inflammatory effects.

Abstract The present study explores linkages between the relational driver (brand involvement) and relationship outcomes (affective brand commitment and brand community identification) of consumer brand engagement among luxury and neo-luxury brands. The sample consisted of 616 consumers, compromising 311 owners of the Hugo Boss brand and 305 owners of the Massimo Dutti brand. Structural equation modelling (SEM) and multi-group analysis were used to test the proposed hypotheses. Findings suggest that brand involvement positively influences the three facets of consumer brand engagement - cognitive, affective, and behavioural, in the context of luxury and neo-luxury consumption. Moreover, the affective component of consumer brand engagement strongly predicts affective brand commitment for luxury and neo-luxury brands. Our findings indicate that the brand community identification with luxury and neo-luxury brands is only driven by affective consumer engagement.