AIM To evaluate the clinical impact of corticosteroids (CS) overuse in inflammatory bowel disease (IBD) patients. Excessive use of CS could delay more efficacious treatment and may indicate poor quality of care. METHOD This is a two-phase study that used Steroid Assessment Tool (SAT) to measure corticosteroid exposure in IBD patients. In the first phase, data from 211 consecutive ambulatory patients with IBD (91 with ulcerative colitis, 115 with Crohn's disease, and five with unclassified inflammatory bowel disease) were analysed by SAT. In the second phase, one year after data entry, clinical outcome of patients with corticosteroids overuse was analysed. RESULTS Of the 211 IBD patients, 132 (62%) were not on corticosteroids, 45 (22%) were corticosteroid-dependent, and 34 (16%) used corticosteroids appropriately, according to the European Crohn's and Colitis Organization guidelines. In the group of patients with ulcerative colitis, 57 (63%) were not on corticosteroids, 18 (20%) were corticosteroid-dependent, and 16 (16%) used corticosteroids appropriately; in the group of patients with Crohn's disease 70 (61%), 27 (23%) and 18 (16%), respectively. Overall, 24 (out of 45; 53%) patients with IBD could avoid the overuse of corticosteroids if they had a timely change of the treatment, surgery, or entered a clinical trial. CONCLUSION An excessive corticosteroid use can be recognized on time using the SAT. We have proven that excessive corticosteroid use could be avoided in almost half of cases and thus the overuse of CS may indicate poor quality of care in those patients.

Crna joha (Alnus glutinosa [L.] Gaertn.) listopadno je drvo iz porodice brezovki (Betulaceae) koje se uglavnom javlja u nizijskim područjima u blizini vodnih tijela različitog režima plavljenja, često prateći riječne i manje vodene tokove, formirajući zajednice azonalnog karaktera u Bosni i Hercegovini. Cilj istraživanja je razvijanje predikcijskog modela rasprostranjenosti staništa crne johe u Bosni i Hercegovini na osnovu poznatih i utvrđenih lokacija staništa crne johe i podataka WorldClim baze. Kao osnovni materijal istraživanja korišteni su podaci sa vlastitih terenskih snimanja i iz drugih relevantnih dostupnih izvora. Klimatski podaci su preuzeti sa WorldClim baze podataka u obliku rasterskih slojeva za 19 bioklimatskih varijabli. Modeliranje je provedeno koristeći metod maksimalne entropije integrisan u MaxEnt računarski program. Izbor modela se zasnivao na predikcijskoj tačnosti modela i koherentnosti sa distribucijom staništa crne johe trenutnog i prethodnih istraživanja. Dobiveni rezultati su potvrdili model veoma dobre predikcijske tačnosti na temelju kalibracije i validacije podataka subseta (AUC > 0,85). Varijable BIO6 (minimalna temperatura najhladnijeg mjeseca) i BIO14 (oborine mjeseca s najmanje padavina) imaju statistički najveći značaj i uticaj za model prostorne rasprostranjenosti ekološke niše crne johe. S obzirom na važne funkcije zajednica crne johe u prevenciji erozije, zaštiti od poplava i očuvanju biološke raznolikosti, dobiveni rezultati mogu doprinijeti upravljanju staništima crne johe. Rezultati predikcije staništa mogli bi se koristiti za daljnja istraživanja vezana za klimatske promjene i praćenje stabilnosti ekosistema.

The aim of this research was to examine the existence of broncho-obstruction of the airways in patients suffering from chronic obstructive pulmonary disease, as well as changes in resistance values in this part of the bronchial tree after inhalation of salbutamol. This study was designed as a prospective, interventional clinical trial that included a sample of 147 patients suffering from COPD. Patients were stratified into four groups of thirty patients each based on the severity of airflow limitation (based on the post-bronchodilator FEV1 value), according to the GOLD grade. The test was conducted at the University Clinical Center Sarajevo, Clinic for Lung Diseases and Tuberculosis “Podhrastovi” The results of our research showed that the average values of FEV1 compared to the predicted values of this parameter in subjects in the GOLD 4 group before the administration of salbutamol were statistically significantly lower than the average values of FEV1 in other subjects of the GOLD group. After the administration of salbutamol, a statistically significant increase in the value of FEV1 was registered in all tested groups. When the response to salbutamol was compared among the GOLD groups, it was assessed that the difference in the percentage increase in predicted FEV1 values after the administration of salbutamol among the tested groups was not statistically significant. Bronchodilation with salbutamol and additional ipratropium had a significant effect on both mentioned parameters, especially in the COPD group, which speak in favor of the presence of increased peripheral resistance in all groups of patients. A statistically significant bronchodilator response was obtained in GOLD 1 and GOLD 2 groups, i.e. in groups of patients with milder forms of the disease.

: Bijeli bor (Pinus sylvestris L.) jedna je od najvažnijih i najistraženijih vrsta drveća u evropskim šumama. Cilj istraživanja je utvrditi mogućnosti povećanja proizvodnih mogućnosti i kvaliteta bijelog bora kroz ranu selekciju u testu provenijencija u Bosni i Hercegovini, a rezultati će se koristiti u svrhu što boljeg korištenja staništa pogodnih za bijeli bor. Za potrebe ovog istraživanja 2021. godine mjerene su visine i prečnici u prsnoj visini bijelog bora u testu provenijencije u Žepču, te brojane grane u pršljenu. Test je uspostavljen 2012. godine sadnjom dvogodišnjih sadnica iz 14 evropskih provenijencija (po tri iz Austrije i Italije i po jedna iz Bosne i Hercegovine, Njemačke, Poljske, Rumunije, Slovačke, Norveške, Škotske i Ukrajine). Izračunate su i zapremine, a zatim provedena analiza varijanse i deskriptivna analiza podataka po provenijencijama. Zatim je selekcionirano pet provenijencija sa najvećim prosječnim vrijednostima istraživanih svojstava i izračunate su razlike između prosječnih vrijednosti za selekcionirane provenijencije i ukupnog prosjeka, kao i razlike između prosječnih vrijednosti za provenijenciju sa najvećim prosječnim vrijednostima i ukupnog prosjeka za sva istraživana svojstva. Podaci su obrađeni pomoću Excel 2013 i SPSS 20.0. Analiza varijanse pokazala je statistički značajne razlike između provenijencija po svim istraživanim svojstvima. Najveći prosječan prečnik stabala starih 11 godina imala je provenijencija iz Ukrajine, a najveću prosječnu visinu i zapreminu jedna od provenijencija iz Austrije. Razlika između prosjeka pet provenijencija sa najvećim prosječnim vrijednostima i ukupnog prosjeka po svojstvu zapremine iznosila je 17,4% od ukupnog prosjeka, a razlika između provenijencije sa najvećom prosječnom zapreminom i ukupnog prosjeka iznosila je 41% od ukupnog prosjeka. Rezultati će biti korišteni u procesima selekcije provenijencija bijelog bora sa dobrim visinskim i debljinskim prirastom.

AIM To investigate the risk for falls in elderly patients treated in the Primary Health Care Centre Gradiška, Bosnia and Herzegovina. METHODS This study included 500 patients aged 65 and older. They were chosen randomly by 10 family physicians. Data collection took place every Wednesday and Friday, between January 2022 and July 2022. The patients' gait and balance assessment were performed using the Tinetti Gait and Balance Tool to assess the risk of falls. A supplementary questionnaire was created to record data about the patients' age, sex, chronic diseases, and drugs they take. RESULTS Among the included patients there were 266 females (53.2%) and 234 (46.8%) males, with the mean age of 75.25 years. The Tinetti test showed that the risk of falls was high for patients older than 75 years, 111 patients (69.8%), and 48 patients (30.2%) aged 65 to 74 (p=0.000). The risk of falling was higher for female, 93 (35%), than male patients, 66 (28.2%) (p=0.018). Considering chronic diseases, a high risk of falls was found in 32 (2.1%) patients with heart failure (p=0.029) and 19 (11.9%) patients with osteoporosis (p=0.000). Patients who used antihypertensive drugs had the highest risk for falls, 124 (78.0%) (p=0.757). CONCLUSION About two-thirds of the examinees over the age of 75 had a high risk of falls, which indicates that family doctors should be more involved in fall prevention of elderly patients and constantly educate older patients and their families about it.

Key Points Question What is the current red blood cell (RBC) transfusion practice for preterm infants born before 32 weeks’ gestation in Europe? Findings This cohort study included 1143 infants from 64 neonatal intensive care units across 22 European countries. By day 28 of life, 36.5% of infants had received an RBC transfusion, and most transfusions based on hemoglobin threshold were given above restrictive thresholds tested in recent trials. Meaning These findings suggest that there is a need to address the gap between evidence and practice and to understand factors influencing ongoing variable practices of RBC transfusions among preterm infants.

In hip fracture patients, who are mostly elderly, preexisting anemia can be worsened when combined with trauma and surgery. To this date, there is no unequivocal approach about transfusion thresholds. We analyzed hemoglobin (Hb) and hematocrit (Hct) levels at three time points in surgical patients with proximal femoral fractures (PFF) to see which levels were triggers for transfusions and whether transfusions were related to mortality after hospital discharge. A total of 956 patients were operated on from 1 January 2021 to 31 December 2022 at the University Hospital of Split and included in the study. There were more women (74%); 47% patients had admission Hb < 120 g/L. Transfusion was given preoperatively to 88, intraoperatively to 74 and postoperatively to 309 patients. Transfusion thresholds were as follows: Hb 84 g/L preoperatively, 99 intraoperatively and 83 postoperatively. After hospital discharge, 10.79% of patients died within the 1st month and 23% within 6 months. In the group of non-survivors, 60% of patients had admission Hb ≤ 117 g/L and the proportion of patients transfused preoperatively was two times higher. Preoperative transfusion thresholds could be set to higher levels for patients with surgically treated PFF. However, that could increase mortality even more. Further investigation is necessary.

This study aimed to explore how Dab1 functional silencing influences the expression patterns of different connexins in the developing yotari (yot) mice eyes as potential determinants of retinogenesis. Using immunofluorescence staining, the protein expression of Dab1, Reelin, and connexin 37, 40, 43, and 45 (Cx37, Cx40, Cx43, and Cx45) in the wild-type (wt) and yot eyes at embryonic days 13.5 and 15.5 (E13.5 and E15.5) were analyzed. Different expression patterns of Cx37 were seen between the wt and yot groups. The highest fluorescence intensity of Cx37 was observed in the yot animals at E15.5. Cx40 had higher expression at the E13.5 when differentiation of retinal layers was still beginning, whereas it decreased at the E15.5 when differentiation was at the advanced stage. Higher expression of Cx43 was found in the yot group at both time points. Cx45 was predominantly expressed at E13.5 in both groups. Our results reveal the altered expression of connexins during retinogenesis in yot mice and their potential involvement in retinal pathology, where they might serve as prospective therapeutic targets.

Simple Summary Patients with chronic lymphocytic leukemia (CLL) are more susceptible to infections, which are also the most common cause of death in these patients. Previous studies in patients with CLL described elevated levels of FOXP3+ regulatory T cells (Tregs), which also correlated with decreased T cell responses to microbial antigens. As the activation of the STAT5 transcription factor induces the expression of FOXP3 and human CD4+FOXP3+ T cells that also contain nonsuppressive T cells, we analyzed STAT5 phosphorylation (pSTAT5) and suppressive subpopulations, including activated Tregs (aTregs). We found a significantly increased frequency of aTregs in patients with advanced stages, which significantly correlated with the total tumor mass score. aTreg expansion in vitro was associated with significantly higher aTreg pSTAT5 responses to SARS-CoV-2 antigen-specific stimulation in vitro. Finally, a subgroup of patients characterised by an increased aTreg percentage among CD4+FOXP3+ T cells experienced a more severe disease course with serious grade ≥3 infections during follow-up. Abstract Introduction: Advanced chronic lymphocytic leukemia (CLL) is accompanied by increased circulating regulatory T cells (Tregs) and increased susceptibility to severe infections, which were also shown to entail a striking induction of FOXP3 expression in Tregs. As homeostasis of the most suppressive CD45RA−FOXP3high activated Treg (aTreg) subset differs, it is critical to analyse homeostatic signalling in Treg subsets. Materials and Methods: In this study, by using conventional and imaging flow cytometry, we monitored STAT5 signalling/phosphorylation (pSTAT5) and investigated Treg subsets in relation to the Binet stage, the total tumor mass score (TTM) and the disease course during a follow-up of 37 patients with CLL. Results: The aTreg percentage was significantly increased among CD4+ T cells from patients with advanced disease and significantly correlated with the TTM. A subgroup of patients with higher aTreg percentages among CD4+FOXP3+ T cells at the start of therapy was characterised by more frequent episodes of severe infections during follow-up. Conclusions: The results suggesting that an aTreg fraction could represent a possible marker of a severe disease course with infectious complications. Augmented homeostatic STAT5 signalling could support aTreg expansion, as higher pSTAT5 levels were significantly correlated with an increased aTreg frequency among CD4+FOXP3+ T cells during the follow-up of patients on therapy, as well as following SARS-CoV-2 antigen-specific stimulation in vitro.

Using AI through industries and business processes is increasingly becoming the subject of theorists and practitioners. In the HRM process, the use of AI gives companies numerous advantages in employee performance, and processes, but also presents them with organizational, financial, technical, legal, and personnel challenges. This paper explores the application of AI systems in recruitment and selection through gamification strategies, people analytics, talent intelligence, AI platforms, video interviews, and conversational AI. It provides an overview of the benefits and challenges associated with their implementation. Additionally, the paper delves into ethical considerations and legislation, focusing on the EU Act, domestic laws, and ISO AI standards. The primary goal of this paper is to provide a comprehensive understanding of AI's role in HR processes and the complexities of implementing AI solutions in recruitment and selection.

In this study, we develop an in silico model of a neuron’s behaviour under demyelination caused by a cytokine storm to investigate the effects of viral infections in the brain. We use a comprehensive model to measure how cytokine-induced demyelination affects the propagation of action potential (AP) signals within a neuron. We analysed the effects of neuron-neuron communications by applying information and communication theory at different levels of demyelination. Our simulations demonstrate that virus-induced degeneration can play a role in the signal power and spiking rate, which compromise the propagation and processing of information between neurons. We propose a transfer function to model the weakening effects on the AP. Our results show that demyelination induced by a cytokine storm not only degrades the signal but also impairs its propagation within the axon. Our proposed in silico model can analyse virus-induced neurodegeneration and enhance our understanding of virus-induced demyelination.