Introduction: It is suggested that bladder cancer (BC) development is linked to glutathione S-transferase (GST) enzymes. This study aimed to determine the correlation between glutathione S-transferase Mu 1 (GSTM1), glutathione S-transferase Theta 1 (GSTT1), and N-acetyltransferase 2 (NAT2) variants with BC progression and recurrence rating. Materials and methods: This study included 105 Bosnian and Herzegovinian subjects: 60 patients with histopathologically confirmed BC and 45 controls without urological diseases. GSTM1, GSTT1 (rs36631 and rs17856199, respectively), and NAT2 (rs1799929, rs1799930, and rs1799931) were investigated. Results: Both one- and five-year probabilities of progression were not significantly different in GSTM1 and NAT2 polymorphisms. One-year probability of progression was significantly higher in the GSTT1 T-- (null) than the T++ (wildtype) genotype (14.7% (±6.9) vs. 8.9% (±6.7), respectively; p=0.048). Five-year probability of progression was significantly higher in the GSTT1 T-- than the T++ genotype (39.4% (±14.7) vs. 25.5% (±16.6), respectively; p=0.045). THE GSTT1 T-- genotype was an independent predictor in the one-year probability of recurrence and progression (p=0.03 and p=0.01, respectively). GSTT1 T-- genotype and age were independent predictors for the five-year probability of recurrence (p=0.032 and p=0.04, respectively) as well as independent predictors of the five-year probability of progression (p=0.012 and p=0.03, respectively). Conclusions: The GSTT1 T-- genotype was an independent predictor in the one- and five-year probabilities of both recurrence and progression of BC. GSTT1 rs17856199 may be a significant factor in the development of tumors and the course of disease in Bosnian and Herzegovinian BC patients.

Background/Objectives: Renal failure (RF) and systolic heart failure (sHF) are very often associated with each other, and their synergistic influence can affect the prognosis of acute pulmonary embolism (aPE) patients. The aim of this study is to evaluate the associations between RF, sHF, and in-hospital mortality in patients with normotensive aPE. Methods: We analyzed data from the Regional PE Registry (REPER), and 1968 patients with CT pulmonary angiography-confirmed aPE who had a systolic blood pressure of 100 mmHg and higher, and for whom creatinine blood levels and left ventricular ejection fraction (LVEF) were measured at admission to hospital were enrolled. The patients were divided into four groups: the first group comprised patients without renal and systolic heart failure, the second those with RF (creatinine clearance less than 60 mL/min), the third those with sHF (LVEF less than 50%), and the fourth those with both RF and sHF. The primary endpoint of this study was in-hospital all-cause mortality. Results: There are significant differences between in-hospital mortality among the groups: 38/1247 (3.0%) vs. 63/514 (12.9%) vs. 10/99 (10.1%) vs. 20/108 (18.5%) (p < 0.001). In the multivariable regression model adjusted for age, right ventricular dysfunction, and troponin levels, the presence of renal failure, sHF, and both were independently associated with in-hospital all-cause mortality with ORs of 3.59 (95%CI 2.04–6.30, p < 0.001) vs. 3.97 (1.71–9.25, p = 0.001) vs. 6.39 (3.15–12.99, p < 0.001), respectively. Conclusions: The association of renal failure and systolic heart failure has a deleterious prognosis in patients with normotensive aPE.

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.

Background/Objectives: In many low- and middle-income countries (LMICs), including Bosnia and Herzegovina, oncology services are constrained by a limited number of specialists and uneven access to evidence-based care. Artificial intelligence (AI), particularly large language models (LLMs) such as ChatGPT, may provide clinical decision support to help standardize treatment and assist clinicians where oncology expertise is scarce. This study aimed to evaluate the concordance, safety, and clinical appropriateness of ChatGPT-generated treatment recommendations compared to decisions made by a multidisciplinary team (MDT) in the management of newly diagnosed breast cancer patients. Methods: This retrospective study included 91 patients with newly diagnosed, treatment-naïve breast cancer, presented to an MDT in Bosnia and Herzegovina in 2023. Patient data were entered into ChatGPT-4.0 to generate treatment recommendations. Four board-certified oncologists, two internal and two external, evaluated ChatGPT’s suggestions against MDT decisions using a 4-point Likert scale. Agreement was analyzed using descriptive statistics, Cronbach’s alpha, and Fleiss’ kappa. Results: The mean agreement score between ChatGPT and MDT decisions was 3.31 (SD = 0.10), with high consistency across oncologist ratings (Cronbach’s alpha = 0.86). Fleiss’ kappa indicated moderate inter-rater reliability (κ = 0.31, p < 0.001). Higher agreement was observed in patients with hormone receptor-negative tumors and those treated with standard chemotherapy regimens. Lower agreement occurred in cases requiring individualized decisions, such as low-grade tumors or uncertain indications for surgery or endocrine therapy. Conclusions: ChatGPT showed high concordance with MDT treatment plans, especially in standardized clinical scenarios. In resource-limited settings, AI tools may support oncology decision-making and help bridge gaps in clinical expertise. However, careful validation and expert oversight remain essential for safe and effective use in practice.

This study aimed to examine position-specific physical demands among elite U19 football players competing in a 4-3-3 formation, using data collected via STATSports GPS technology. A total of 23 players from a top-tier Bosnian club, FK “Sarajevo”, were monitored during 26 official matches in the 2024/2025 season. Match data included total distance, distance in six speed zones, high-speed running (HSR), sprint distance, number of sprints, maximum speed, and acceleration/deceleration events. One-way ANOVA and Bonferroni post hoc analyses revealed significant positional differences across all performance metrics (p < 0.05). Central midfielders (CMs) covered the greatest total distance and distance per minute, while side defenders (SD) and forwards (FWs) recorded the highest values in sprint distance, HSR, and sprint frequency. Central defenders (CDs) consistently demonstrated the lowest outputs in high-speed and sprint metrics. These findings highlight the distinct physical profiles required for each playing position in a 4-3-3 system and provide practical insights for designing position-specific training and load management strategies in elite youth football.

Objective Postoperative respiratory complications (PRCs) are a significant concern after cardiac surgery, contributing to increased morbidity and mortality. This study aimed to analyze the incidence and risk factors for PRCs in a tertiary center in Bosnia and Herzegovina and compare findings with data from developed countries. Material and Methods This prospective cohort study included 300 adult patients who underwent open-heart surgery with cardiopulmonary bypass at the Clinic for Cardiovascular Surgery, University Clinical Center Tuzla, between January 2020 and October 2023. Preoperative, intraoperative, and postoperative variables were analyzed, including comorbidities, surgical procedures, mechanical ventilation duration, and intensive care unit stay. PRCs were defined based on standardized clinical and radiological criteria. Multivariate logistic regression identified independent risk factors. Results The most common PRCs were pneumonia (37.3%), atelectasis (29.3%), pleural effusion (22.0%), and respiratory failure (10.7%). Key independent risk factors included oxygen saturation <94%, ejection fraction <45%, diabetes mellitus, anemia, and red blood cell transfusion >500 mL. In contrast to studies from developed countries, intraoperative variables were not significant predictors. Conclusion Our findings suggest that preoperative comorbidities play a more dominant role in PRC development in our setting compared to developed nations. The high incidence of pneumonia may reflect delayed postoperative mobilization and limited access to respiratory therapy. These results underscore the need for optimized preoperative patient management and improved postoperative respiratory care protocols in resource-limited healthcare settings.

The scarcity of high-quality wood encouraged the development of various technological processes for joining wood. The finger joint is one of the most widespread technological processes for wood joining. This study aimed to determine the effect of steaming and heat modification of beech wood, as well as the type of adhesive, on the mechanical characteristics of finger joints. Samples made from un-modified beech, steamed-treated, and heat-treated beech wood were bonded with polyvinyl acetate (PVAC), non-structural, and structural polyurethane (PUR) adhesives. Compressive tests on wood materials were used to evaluate their mechanical performance. The finger joint samples were tested for their bending performance. Modulus of rupture, modulus of elasticity, and compressive strength were calculated. An analysis of variance (ANOVA) was conducted to evaluate the impact of wood modification type and adhesive used on the mechanical characteristics of the finger joints. According to the results of this study, it can be concluded that the steaming process does not influence changes in the mechanical characteristics of the finger joints. Heat treatment of beech and the type of adhesive used significantly influence the tested mechanical characteristics of the finger joints and beech wood. Heat-treated beech had lower values of modulus of rupture (70 MPa) and density (690 kg/m3) and higher values of compression strength (59 MPa) in relation to un-modified (780 kg/m3) and steamed-treated (800 kg/m3) beech wood.

Objective This study aimed to evaluate the functional status of the urethra using uroflowmetry before surgery, as well as three and six months postoperatively in cases of distal hypospadias. Material and Methods Thirty-nine consecutive patients who underwent surgery for distal hypospadias (hypospadias group) between 2016 and 2019 were prospectively included as part of this study. The control group consisted of 40 patients with a normal urethra who underwent surgery due to conditions other than hypospadias (phimosis, undescended testis, hernia). Uroflowmetry was performed preoperatively in these patients. Postoperative uroflowmetry was performed at three and six months following hypospadias surgery. Uroflowmetric results [maximum flow rate (Qmax), average flow rate (Qave), voided volume, void duration, flow start time, time to maximum urine flow rate, post-void residual urine, flow curve] were compared between the groups. Results The mean age for the patients with distal hypospadias was 35.9±29.6 months and 40.8±26.1 months for the control group. Pre- and postoperative Qmax values (three and six months after surgery) were 6.9 mL/s (0.1-15), 6.4 (0.2-14), and 7.5 (2.5-15). Qave values were preoperatively 4.0 (0.1-12.1), 3.8 (0.3-8.1), and 4.7 (1.0-11.1) mL/s three and six months after surgery, respectively. Bell-type flow was the most frequent uroflow flow curve in the preoperative hypospadias and control groups (95% and 66.6%, respectively). Postoperatively, bell-type flow remained the most common pattern, while a significant reduction in plateau-type flow was observed. Four boys (10.3%) had symptoms of obstruction. Conclusion Surgery improved urination dynamics and partial urethral obstruction of hypospadias cases that were present from the baseline. The urinary flow rates improve over time as the reconstructed neourethra regains functionality six months after the tubularized incised plate procedure.

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.

The objectives of this study are to determine the prevalence of Staphylococcus aureus in nasal and throat swab samples collected from healthy individuals within a population of workers and students, analyze its frequency in relation to the gender distribution of partici- pants, and assess the antibiotic susceptibility profile. S. aureus was isolated exclusively from nasal swab samples (111/1403). The findings indicate that nasal carriage is significantly more prevalent in male participants than in females and is independent of age. No statistically significant differences in S. aureus prevalence were observed between the worker and student populations. Resistance was detected for: penicillin, ampicillin, amoxicillin/clavulanate, oxa- cillin, cephalexin, gentamicin, erythromycin, chloramphenicol, trimethoprim-sulfamethoxaz- ole and ciprofloxacin. Further research involving a larger sample size and an extended study period is required to elucidate the influence of geographic and sociodemographic factors on S. aureus carriage, as well as the potential impact of gender on the prevalence of resistant strains.

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.