Introduction: The risk of cognitive impairment, including dementia and moderate cognitive impairment (MCI), is higher in patients with diabetes and prediabetes. The need for early diagnosis biomarkers has increased due to the rise in the prevalence of type 2 diabetes mellitus (T2DM) and its related cognitive problems worldwide, as well as the lack of clear biochemical indicators and efficient treatments for dementia or cognitive decline. Chronic low-grade inflammation, reflected by elevated complete blood count-derived inflammatory indices (CBCIIs), has been implicated in both metabolic dysregulation and neurodegeneration. However, their relationship with cognitive impairment in T2DM remains insufficiently explored. The objective of this study was to investigate the association between CBCIIs and cognitive function in patients with T2DM. Methods and materials: This cross-sectional observational study included 116 patients with T2DM recruited from diabetes counseling centers in the Public Institution Health Center of Sarajevo Canton, Bosnia and Herzegovina. Based on the assessed cognitive status, patients with T2DM were divided into two groups: with cognitive impairment (n= 76) and without cognitive impairment (n=40). A validated assessment tool, the Montreal Cognitive Assessment (MoCA), a quick test designed to screen for milder forms of cognitive impairment, was used for cognitive screening. Venous blood samples were analyzed for standard complete blood count parameters, from which 11 CBCIIs were calculated: neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), neutrophil-to-platelet ratio (NPR), neutrophil-to-lymphocyte-to-platelet ratio (NLPR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), aggregate index of systemic inflammation (AISI), systemic inflammation response index (SIRI), lymphocyte-to-monocyte ratio (LMR), and monocyte-to-neutrophil ratio (MNR).. Results: The results of our study showed that NLR, dNLR, NPR, NLPR, PLR, MLR, SII, AISI, and SIRI were significantly higher in the group of T2DM patients with cognitive impairment compared to the group without cognitive impairment. On the other hand, LMR and MNR were significantly lower in the group of T2DM patients with cognitive impairment compared to the group without cognitive impairment (p<0.05). The MoCA score was significantly negatively correlated with NLR, dNLR, NPR, NLPR, and SII, and positively with MNR (p<0.05) Conclusion: Elevated CBCIIs are significantly associated with cognitive impairment in patients with T2DM. These inexpensive and widely available indices may serve as adjunctive markers for early cognitive screening in this population.

The journal retracts the article titled "Resilience and Perceived Social Support in Cancer Survivors: Validity, Levels, and Sociodemographic Correlates of CD-RISC-25 and MSPSS Scales" [...].

Anomalous origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA), also known as Bland-White-Garland syndrome, is a rare congenital coronary anomaly with an estimated incidence of 1 in 300,000 live births. While commonly diagnosed in infancy, adult presentations are exceedingly rare and pose significant diagnostic challenges. Delayed diagnosis may result in progressive myocardial ischemia, heart failure, arrhythmias, or sudden cardiac death. Surgical correction is the definitive treatment, with the goal of restoring a dual coronary artery system and preventing irreversible myocardial damage. We present the case of a 30-year-old male with a prior history of non–ST-elevation myocardial infarction who was referred for evaluation of exertional angina and symptoms of heart failure. Transthoracic echocardiography revealed a dilated left ventricle with an ejection fraction (LVEF) of 35%. Coronary angiography and cardiac MDCT identified an anomalous origin of the left circumflex artery (LCx) from the right pulmonary artery (RPA) and a coronary–pulmonary artery fistula involving the LAD. The patient underwent successful surgical correction with reimplantation of the LCx into the ascending aorta. Postoperative recovery was uneventful. At 3-month follow-up the patient was symptom-free, though echocardiography revealed persistent LV dilation and reduced LVEF, necessitating continued pharmacologic therapy and monitoring. This case highlights the importance of maintaining a high index of suspicion for ALCAPA in adult patients with unexplained cardiomyopathy or ischemic symptoms. Early diagnosis and surgical intervention remain crucial for improving long-term outcomes and preventing life-threatening complications.

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.

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.

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.

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.

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.

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.