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.

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.

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" [...].

Abstract Introduction. Physical literacy (PL) and health literacy (HL) are important concepts that are theoretically associated with physical activity (PA), but studies have rarely examined these problems simultaneously in older adults, particularly women. The aim of this study was to evaluate the associations between HL and PL with PA in women older than 60 years from Croatia. Material and methods. The participants were 49 women from an urban center in southern Croatia who were tested on HL (via the validated Croatian version of the European Health Literacy Survey Questionnaire), PL (via the Perceived Physical Literacy Questionnaire for South Eastern Europe), and PA (via the Nordic Physical Activity Questionnaire – short version) in controlled settings. Different facets of PL and HL were univariately and multivariately correlated with weekly moderate-to-vigorous PA (MVPA) and weekly vigorous PA (VPA). Results. Almost 39% of the participants reached the World Health Organization recommendations for weekly PA. The PL variables were not significantly correlated with MVPA, nor with VPA (up to 6% of the common variance). The HL was significantly (p < 0.05) correlated with VPA across several subdomains (9% to 20% of the common variance). Multiple regression analysis revealed a significant multivariate association between HL subdomains and VPA (27% of the explained variance), indicating a positive influence of the higher HL on PA in older women. Conclusions. Promoting HL in older women can enhance PA by improving their understanding of the health risks and benefits of PA. Educational efforts should focus not only on providing information but also on helping women interpret and apply it in meaningful, everyday contexts.

Acute mesenteric ischemia (AMI) is a life-threatening condition characterised by oxidative stress, inflammation, apoptosis, and necrosis of intestinal epithelial cells. Different drugs with vasoactive, antioxidant, and anti-inflammatory properties have been used to treat AMI. Levosimendan is a drug with proven anti-ischemic effects used in the management of acute congestive heart failure. This study evaluated the protective effects of levosimendan pretreatment on intestinal, as well as lung, heart, and kidney tissue in a rat model of mesenteric artery ischemia/reperfusion (I/R) injury. Male Wistar rats (N = 24) were divided into four groups: control, I/R, levosimendan (LS) 1 mg/kg i.p, and LS + I/R (1 mg/kg i.p. 30 min before injury). I/R by itself caused elevation of oxidative markers (thyobarbituric acid reactive species (TBARS), hydrogen peroxide (H2O2), super oxide anjon radical (O2−), and nitrogen dioxide (NO2−)), induced inflammation (macrophage infiltration and Interleukin-6 (IL-6) production), and apoptosis (nuclear factor kappa light-chain enhancer of activated B cells (NF-κB), cleaved caspase-3 (CC3), and terminal deoxy-nucleotidyl transferase (TdT)-mediated dUTP nick end labelling (TUNEL)). Levosimendan pretreatment significantly reduced oxidative stress markers and enhanced antioxidant defences (catalase (CAT), reduced glutathione (GSH), and superoxide dismutase (SOD)). Histological analysis revealed reduced mucosal damage and preserved goblet cells in intestinal tissue. Similar protective effects of levosimendan were observed in other organs such as lung, heart, and kidney. Immunohistochemistry showed reduced epithelial apoptosis and upregulation of antioxidant and anti-inflammatory proteins. These findings highlight levosimendan’s ability to protect mesenteric I/R tissue injury and multi-organ damage by suppressing oxidative stress, inflammation, and apoptosis, emphasising its therapeutic potential in clinical settings.

Although numerous studies have explored the electric vehicles (EVs) adoption, the theory of reasoned action (TRA) is underutilized, while the role of consumer innovativeness in predicting purchase intent and behavior remains unclear. This study focuses on the interplay among attitude towards EVs, subjective norm, consumer innovativeness, purchase intention and actual behavior. A structured survey was applied in 2024 to collect data, and a sample composed of 212 respondents from the United Arab Emirates was properly balanced across various characteristics. TRA was extended using the consumer innovativeness construct, which resulted in a new hypothetical model. Once evidence was provided for both validity and reliability of the measures, the hypotheses were tested. Structural equation modelling (SEM) results show that subjective norm does not have significant direct effects on purchase intention, while the consumer innovativeness affects attitude towards EVs. While both attitude towards EVs and consumer innovativeness appear to be direct predictors of purchase intention, attitude towards EVs played a significant mediating role in a relationship between consumer innovativeness and purchase intention. The results of logistics regression revealed that purchase intention directly affects purchase behavior. The paper contributes to significant theoretical and practical implications, which are further discussed.

Simple Summary Climate change is becoming a serious threat to animal farming, making it important to find animals that can cope well with high and low temperatures. This study focused on two strains of indigenous Pramenka sheep from Bosnia and Herzegovina to determine how they respond to heat and cold. Researchers looked at the activity of specific genes that help animals deal with temperature stress using blood samples from 96 sheep collected in summer and winter across different regions. The results showed that one strain, Hercegovačka sheep, had much higher activity of a gene that protects cells from heat damage, especially during hot weather. Both strains showed strong abilities to control inflammation and protect themselves from harmful effects caused by heat, which helps them stay healthy in challenging climates. This study concluded that Hercegovačka sheep have better natural protection against temperature changes, but both strains have useful traits for surviving in a changing climate. These results can help farmers and scientists choose and protect sheep breeds that are more likely to thrive as weather conditions become more extreme, ensuring food production and supporting rural communities in the future.

Objectives This study aimed to investigate the associations between body mass index (BMI), physical activity levels (PALs) and sociodemographic factors (gender, age, education and marital status) with different outcomes (symptoms) of osteoarthritis (OA) severity, in patients with knee OA. Design Cross-sectional study. Participants The sample included 200 participants from southern Bosnia and Herzegovina (61 males, 65.1±9.01 years of age) who had been diagnosed with primary knee OA. Outcome measures OA symptoms as evidenced by the Western Ontario and McMaster Universities OA Index (WOMAC) scale, including three subscores (WOMAC-pain, WOMAC-stiffness, WOMAC-functionality) and total WOMAC score. The predictors included age (in years), gender (male or female), BMI, PAL, education level, urban/rural living environment and marital status (partnership). Results Female gender was correlated with the WOMAC-pain, WOMAC-stiffness and WOMAC-total. Older age was correlated with the WOMAC-pain and WOMAC-total. Patients who were better educated and reported higher PAL had better WOMAC functionality. BMI was the most significant factor of influence, with higher WOMAC-pain (OR 1.44, 95% CI 1.27 to 1.65), WOMAC-stiffness (OR 1.20, 95% CI 1.1 to −1.33), WOMAC-functionality (OR 1.26, 95% CI 1.13 to 1.40) and WOMAC-total (OR 1.29, 95% CI 1.6 to −1.44) scores in patients with higher BMI. Conclusions Results indicate the necessity of controlling body weight in patients with diagnosed knee OA irrespective of gender. Further prospective studies are warranted in order to establish causality between variables.