Psoriasis is a chronic inflammatory skin disease with relapsing nature. Estimates are that approximately 2–3% of the world’s population suffers from this disease. More severe forms of psoriasis are conditions of high inflammation, which is confirmed by the clinical picture and numerous inflammatory parameters such as C-reactive protein (CRP), cytokines and homocysteine, which vary with disease activity. The objective of this clinical study was to investigate the effect of GLP-1 receptor agonist semaglutide therapy on pro-inflammatory factors in the serum and the severity of the clinical picture of psoriasis in obese patients with type 2 diabetes mellitus (T2DM) on chronic metformin therapy. This randomized clinical study was conducted on 31 psoriatic patients with T2DM that were randomized into two groups: one that received semaglutide during the 12-week trial (n = 15), while the second was control (n = 16). The results demonstrated that the severity of the clinical picture of psoriasis, determined by the Psoriasis Area and Severity Index (PASI) score, was significantly better after the administration of semaglutide (the median baseline PASI score in patients treated with semaglutide was 21 (IQR = 19.8), while after 12 weeks of therapy the score was 10 (IQR = 6; p = 0.002). Also, the quality of life in the group of patients who received the drug, measured by the Dermatology Life Quality Index (DLQI), improved significantly after 3 months (a median baseline DLQI score in the semaglutide group was 14 (IQR = 5) at the beginning of the study, and after 12 weeks of treatment the median DLQI score was 4 (IQR = 4; p = 0.002)). The use of semaglutide led to a significant decrease in pro-inflammatory cytokines in the serum (IL6), as well as a significant decrease in CRP values (p < 0.05). A significant decrease in the body mass index (BMI) value in the semaglutide-treated group was also identified, as well as a significant decrease in the level of low-density cholesterol (LDL) (p < 0.05). In conclusion, semaglutide, based on its systemic anti-inflammatory characteristics, could contribute to the treatment of psoriatic obese patients with T2DM.

Simple Summary This research considers means of improving the early detection and treatment of colorectal cancer (CRC), a common and deadly form of cancer often identified too late for effective treatment. In our study, we examined AIFM3, VGLL4, and WNT4 in cancerous and healthy tissues at various stages of CRC. We found that these markers behave differently as the cancer advances. AIFM3 appears in healthy tissue and early cancer stages but disappears as the cancer worsens. VGLL4 increases in the affected tissues as the cancer progresses, particularly noticeable from early to more advanced stages. WNT4 is higher in cancerous tissues, but decreases in the supportive tissue surrounding cancer cells as the disease advances. Low VGLL4 levels are linked to better patient survival, unlike the other two markers. This finding suggests that VGLL4 could be useful as an indicator of CRC prognosis, potentially guiding treatment approaches.

Background In addition to age, body mass index (BMI), abdominal circumference, and parity, measuring the mother's pelvic diameters is a non-invasive, cost-effective method that can assist gynecologists in determining the optimal management of labor. Our study aimed to examine the associations between maternal age, pelvic diameters, BMI, abdominal circumference, and parity with delivery outcomes and investigate differences in pelvic diameters in relation to maternal age, BMI, delivery outcomes, parity, and episiotomy. Materials and methods The observational, cross-sectional study included 108 pregnant women in the active phase of labor who were admitted to the Gynecological Clinic at the Clinical Center University of Sarajevo. During admission, maternal data were registered: age, body height, body weight, abdominal circumference, and BMI. Using a pelvinometer, pelvic diameters were recorded: interspinous diameter (DS), intertrochanteric diameter (DT), intercristal diameter (DC), and external conjugate (CE). The Anterior Pelvic Index (API) was calculated by dividing the DS by the participants' height and multiplying the result by 100. Data were analyzed using SPSS Statistics for Windows, Version 17 (Released 2008; SPSS Inc., Chicago, United States). Results Women who underwent cesarean section were significantly older compared to those with spontaneous vaginal delivery. A significant correlation was observed between maternal age, BMI, and delivery outcomes. Obese women had significantly higher DT compared to women with normal or overweight BMI. Primiparous and multiparous women differed significantly in CE, while other pelvic diameters did not differ. Women with episiotomy had significantly lower DS and CE diameters compared to those without episiotomy during vaginal delivery. Conclusion Maternal age, BMI, and pelvic diameters are significant delivery outcome determinants; our findings suggest that these parameters deserve to be included in delivery outcome assessment as they provide substantial information in the journey of achieving personalized delivery care and decision-making.

Polyploidy is a powerful mechanism driving genetic, physiological, and phenotypic changes among cytotypes of the same species across both large and small geographic scales. These changes can significantly shape population structure and increase the evolutionary and adaptation potential of cytotypes. Alyssum moellendorfianum, an edaphic steno-endemic species with a narrow distribution in the Balkan Peninsula, serves as an intriguing case study. We conducted a comprehensive analysis of genetic diversity and population structure across the species’ range, employing an array of genetic techniques (nuclear microsatellites, amplified fragment length polymorphisms, and plastid DNA sequences), flow cytometry (FCM), morphometry, and pollen analysis. The study reveals two genetic lineages: spatially distributed diploid and tetraploid cytotypes. Clear divergence between diploids and tetraploids was shown by AFLP, while plastid DNA sequences confirmed private haplotypes in each of the studied populations. Higher genetic diversity and allelic richness following the north-south pattern were documented in tetraploids compared to diploids, as indicated by nuclear microsatellites. Morphometric analysis via principal component analysis (PCA) and canonical discriminant analysis (CDA) did not reveal any divergence between diploid and tetraploid cytotypes. Nonetheless, a distinction in pollen size was clearly observed. The results suggest an autopolyploid origin of tetraploids from diploid ancestors. Despite the population fragmentation in a very small geographic range, these populations harbour high genetic diversity, which would allow them to remain stable if natural processes remain undisturbed.

Background: CPAP has been shown to be particularly beneficial in the management of acute cardiogenic pulmonary edema by reducing both preload and afterload, thus decreasing the work of breathing and improving oxygenation. Methods: This study was a prospective observational study, conducted in the period from 2022 to 2024, assessing the effectiveness and safety of prehospital CPAP therapy use in patients with acute cardiogenic pulmonary edema, administered alongside standard care. Results: In this study, 50 patients with acute cardiogenic pulmonary edema were treated by physician-led emergency teams in the Canton of Sarajevo. CPAP significantly improved clinical parameters across all time points. Systolic blood pressure decreased from 151.0 ± 41.0 mmHg at initial contact to 138.4 ± 32.0 mmHg before transportation and further to 130.2 ± 28.5 mmHg upon hospital admission (p < 0.001). Diastolic pressure dropped from 85.6 ± 17.2 mmHg to 81.1 ± 15.2 mmHg before transportation (p = 0.018), with a slight further decrease to 80.2 ± 13.9 mmHg (p = 0.083). Heart rate fell from 114 ± 26.4 bpm to 111.3 ± 24.9 bpm before transportation (p = 0.003) and finally to 99.5 ± 18.2 bpm before hospital admission (p < 0.001). Respiratory rate decreased from 31.0 ± 10.2 to 28.0 ± 10.5 breaths/min (p = 0.002) and further to 22.6 ± 7.3 breaths/min (p < 0.001). End-tidal CO2 levels increased from 28.0 mmHg (23.5; 33.5) to 30.0 mmHg before transportation (p < 0.001), and to 35.0 mmHg (32.0; 37.5) before hospital admission (p < 0.001). Oxygen saturation improved from 79.0% (72.0; 81.0) to 84.0% before transportation (p < 0.001) and reached 94.0% (91.0; 98.2) before hospital admission (p < 0.001). VAS scores for dyspnea significantly dropped from 8.0 (6.0; 8.2) at initial contact to 6.0 (4.0; 8.0) before transportation (p < 0.001) and further to 4.0 (3.0; 5.0) before hospital admission (p < 0.001), indicating substantial symptom relief. ECG findings remained stable throughout the intervention. Conclusions: Prehospital CPAP therapy significantly improved clinical outcomes in cardiogenic pulmonary edema, including reductions in blood pressure, heart rate, respiratory rate, and enhanced oxygenation and symptom relief. These findings support its broader use in emergency care, even during short transport times.

The genetic, morphological and taxonomic diversity of the genus Sorbus is due to homoploid and polyploid hybridisation, autopolyploidy and apomixis, which also influence the production and diversity of secondary metabolites, especially flavonoids. The aim of this study was to investigate the relationships and variations of flavonoids in terms of hybrid origin and ploidy level between the parental species and their hybrid derivatives. The sampling design included leaf material of the following Sorbus accessions from ten natural localities: parental taxa (di-, tri- and tetraploids of S. aria; diploid S. torminalis and S. aucuparia) and their di-, tri- and tetraploid hybrid derivatives from crosses of S. aria × S. torminalis (subg. Tormaria) as well as the tetraploid S. austriaca and S. bosniaca, which originate from crosses of S. aria × S. aucuparia (subg. Soraria). We analysed the flavonoid profiles from the leaf fractions by LC-MS. A total of 23 flavonoids were identified, including apigenin and luteolin derivatives, which distinguish the hybrid groups from each other. This profiling highlights the distinctiveness of the Tormaria and Soraria accessions and emphasises the potential of the subg. Tormaria for further research on bioactive compounds in biological studies.

Coronary artery fistulas (CAFs) are rare congenital anomalies, presenting in 0.05–0.9% of cases, characterized by an aberrant connection between a coronary artery and a cardiac chamber or great vessel. Clinical manifestations can include heart failure, myocardial ischemia due to coronary steal, arrhythmias, or infective endocarditis. We report a case of a 39-year-old man initially evaluated in 2016 for peripheral edema and suspected right ventricular (RV) abnormality. Earlier assessments indicated a left anterior descending (LAD) coronary artery–RV fistula, but initial catheterization was nondiagnostic. Transthoracic echocardiography (TTE) revealed a dilated left coronary artery (LCA) and an RV apex aneurysm, confirmed by CT and coronary angiography, showing a 14 mm LAD fistula with large aneurysmal sacs (45.6 × 37.3 mm). Cardiac MRI demonstrated a tortuous LAD fistula draining into RV aneurysmal sacs with preserved biventricular function. Surgical intervention was recommended, but the patient declined and was lost to follow-up until 2022, being asymptomatic. Re-evaluation showed progression in aneurysm size (47 × 45 mm and 16 × 18 mm) without ventricular functional change. Follow-up TTE in 2023 indicated stable findings. This case emphasizes the necessity of multimodal imaging (TTE, CT, MRI, angiography) for CAF diagnosis and management planning. Given the variability in CAF presentation and outcomes, individualized management—including surgical, percutaneous, or conservative strategies—is crucial. Persistent follow-up is essential for monitoring potential complications and guiding treatment, even in asymptomatic patients refusing intervention.

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.

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.

Vehicle-to-everything (V2X) communications is an important part of future driver assistance and traffic control systems that will reduce accidents and congestion. The millimeter-wave (mmWave) band shows great promise to enable the high-data-rate links that are required or at least beneficial for such systems. To design such systems, we first need a detailed understanding of the vehicle-to-vehicle (V2V) and vehicle-to-infrastructure (V2X) propagation channels. This paper provides a systematic account of a series of measurement campaigns for such channels, conducted by the four research institutions of the authors over the past year. After a description of the similarities and differences of the channel sounders used in the campaigns, a description of the measurements in two European and one American city is given, and the scenarios of convoy, opposite-lane passing, and overtaking, are described. This is then followed by key results, presenting both sample results of power delay profiles and delay Doppler (or angular) spectra, as well as the statistical description such as delay spread and size of stationarity region. We also discuss the availability of spatial diversity in V2I connections and the correlation of the channels between different frequency bands.