Background/Objectives: Postoperative bleeding remains a major complication following coronary artery bypass grafting (CABG), contributing to transfusion requirements, reintervention, and morbidity. The objective of this study was to assess the clinical significance of preoperative platelet function testing and postoperative viscoelastic testing in patients undergoing elective isolated on-pump CABG. Methods: This prospective observational study included 708 patients undergoing surgery between January 2023 and January 2025. Preoperative platelet function was assessed with Multiplate® impedance aggregometry (ADPHS and ASPI), and postoperative coagulation was assessed with ClotPro® after cardiopulmonary bypass. The prespecified Multiplate thresholds were population- and assay-specific and were not intended as universal cutoffs. Postoperative bleeding was defined by cumulative chest-tube drainage during the first 24 h. Results: In unadjusted analyses, low ADPHS values (≤602.5 AU·min) were associated with higher platelet transfusion, cryoprecipitate use, and overall transfusion, and ADPHS showed modest discrimination for blood loss > 500 mL/24 h (AUC = 0.61, p = 0.041). Low ASPI values (≤453 AU·min) were associated with increased cryoprecipitate use and showed modest discrimination for blood loss > 1000 mL/24 h (AUC = 0.62, p = 0.005). After multivariable adjustment for baseline differences, neither ADPHS ≤ 602.5 (adjusted OR 1.01, 95% CI 0.74–1.39, p = 0.936) nor ASPI ≤ 453 (adjusted OR 0.89, 95% CI 0.64–1.23, p = 0.475) was independently associated with postoperative bleeding > 500 mL/24 h. Postoperative ClotPro® parameters showed statistically significant associations with transfusion and bleeding, but their discriminatory performance was limited. Conclusions: Perioperative platelet function and viscoelastic test results were associated with bleeding and transfusion outcomes in unadjusted analyses, but discrimination was modest, and the platelet function cutoffs were not independently associated with bleeding > 500 mL after adjustment. These findings support a complementary hemostatic assessment role for combined POC testing but do not establish a standalone predictive model or an implementable transfusion algorithm.

Abstract In armed conflict and other situations of armed violence, people with disabilities, both children and adults, face serious and unique threats to their mental health and psychosocial well-being, including due to being targeted because of their disability, their inability to flee attacks, risk of abandonment, breakdown of services, and lack of access to health care and assistive devices. Unequal access to the sparse mental health services and education that may exist during conflicts exacerbates mental health impacts, and children with disabilities experience multiple and intersecting forms of mental health harms based on their disability and age. Since 2015, Human Rights Watch has documented the mental health harms of armed conflict and armed violence on people with disabilities in Afghanistan, Cameroon, the Central African Republic, Palestine, South Sudan, Sudan, Syria, Ukraine and Yemen. While international mental and psychosocial support services standards call for inclusion and accessible services for all, people with disabilities are often the last to get support – this is especially true in cases of people with intellectual, psychosocial or hearing disabilities due to physical, communication and attitudinal barriers. There is an urgent need for governments, humanitarian donors and humanitarian agencies to change how they provide mental health and psychosocial support services in order to ensure that they are accessible to all.

Physical ability testing is an essential part of police education, as fitness assessments indicate students’ preparedness for police work. Clear documentation and reporting of test protocols and measurement properties are essential for interpreting, evaluating, and comparing the usefulness of different test batteries. Therefore, this scoping review aimed to map the fitness tests used in police education programs internationally, including reporting standards of test protocols, reliability, validity, and sex-based test specificity, thereby providing insight into the physical abilities considered important for police work. The main searches were conducted in the databases CINAHL, PubMed, SPORTDiscus, and Web of Science. The database search yielded 1323 articles, of which 92 met the inclusion criteria. An additional nine articles were included through citation and hand searching. Of the 101 studies, 95 used an average of 4–5 general fitness tests, and 29 included work-related police tests. Test protocols were generally well documented across studies. However, only a few studies included in this review assessed test–retest reliability, and only a limited number of studies, whose primary aim was to validate the tests, evaluated test validity. The most commonly used assessments were upper-body and core muscular endurance (60 s push-up, maximum pull-up, and 60 s sit-up tests), upper-body muscular strength (hand-grip test), lower-body power (standing long jump, and vertical jump tests), and aerobic capacity (20 m multistage fitness, 2400 m Cooper, and 12 min Cooper tests. Only 19 studies reported sex-specific performance standards, including differences in test execution, scoring systems, VO2max estimation, or time limits. The findings indicate that tests of upper-body muscular endurance and strength, lower-body power, and aerobic capacity are among the most frequently measured physical abilities in police education programs internationally, while also highlighting the need for more standardized reporting of test protocols, reliability, and validity.

Background Pharmacogenomics-guided prescribing uses patient genetic information to individualize drug selection and dosing and has attracted interest as a strategy to improve outcomes and reduce adverse drug events in cardiovascular diseases. Several systematic reviews have examined its cost-effectiveness, but their findings have not been synthesized across drug classes and healthcare settings. Objective To identify, critically appraise, and synthesize findings from systematic reviews evaluating cost-effectiveness or cost-utility of pharmacogenomics-guided treatment of cardiovascular diseases. Methods This systematic review of systematic reviews was pre-registered in PROSPERO (CRD420261281565). Five databases were searched from inception, without language restrictions. Eligible studies were systematic reviews that summarized cost-effectiveness evidence on pharmacogenomics-guided cardiovascular drug prescribing. Risk of bias was assessed using ROBIS and methodological quality using AMSTAR 2. Findings were synthesized narratively. Results Ten systematic reviews (2010–2024) were included, encompassing 149 unique primary cost-effectiveness studies. The corrected covered area across reviews was 9.47% (moderate overlap). Most evidence was derived from economic modelling studies and substantial heterogeneity was observed across drug–gene pairs, comparators, and healthcare settings. CYP2C19-guided clopidogrel therapy was frequently reported as cost-effective or cost-saving, although results were less favourable when universal ticagrelor served as comparator. Evidence for CYP2C9/VKORC1-guided coumarin anticoagulation was more heterogeneous with cost-effectiveness varying across contexts. Limited evidence suggested that SLCO1B1-guided statin therapy may be cost-effective, although data were sparse. No review reported pooled incremental cost-effectiveness ratios or net monetary benefit. Risk of bias was low in 7 reviews; AMSTAR 2 confidence was high in 4 and low in 5. Conclusion Cost-effectiveness of pharmacogenomics-guided cardiovascular treatment seems to vary by drug–gene pair, comparator, healthcare context, and modelling assumptions. Further real-world studies and standardized economic evaluations are needed to clarify broader clinical adoption.

Introduction : Older adults with type 2 diabetes mellitus (T2DM) frequently present with multiple comorbidities and complex therapeutic regimens, increasing the risk of potentially inappropriate medication (PIM) prescribing. This study aimed to assess the prevalence of PIM prescribing in geriatric patients with T2DM using the 2019 American Geriatrics Society Beers Criteria. Materials and methods : This observational, retrospective study included 400 geriatric patients (≥65 years) with T2DM. Data on prescribed medications were collected from medical records. Statistical analysis was performed using SPSS 13.0 and Microsoft Excel 2019 ( α = 0.05). Results : At least one PIM was identified in 60.8% of patients. Frequently prescribed PIMs included proton pump inhibitors (13.5%), diazepam (10.3%), and digoxin (6.5%) among medications to be avoided, and diuretics (59.5%) and acetylsalicylic acid (19.0%) among medications to be used with caution. Conclusion : Systematic application of the Beers Criteria may improve pharmacotherapy safety in this vulnerable population.

Biomass-derived porous carbons are promising sustainable adsorbents for wastewater treatment. However, most reported materials require chemical activation, while the relationships between biomass precursor, pore structure, adsorption mechanism, and regeneration remain insufficiently understood. In this work, non-activated carbon materials were prepared from Juglans regia (JR) and Allium sativum (AS) biomass by pyrolysis at 400 and 900 °C and evaluated for the removal of methylene blue (MB), rhodamine B (RB), crystal violet (CV), and malachite green (MG). Carbonization at 900 °C markedly enhanced porosity, yielding a surface area of 790 m2 g−1 for JR900 and 177 m2 g−1 for AS900, together with predominantly microporous structures and negatively charged surfaces at neutral pH. The pseudo-second-order model best described adsorption kinetics, while intraparticle diffusion analysis indicated a multistep adsorption process. Equilibrium data were well fitted by both Langmuir and Freundlich isotherm models. JR900 exhibited the highest adsorption capacities for MB (321 mg g−1) and RB (304 mg g−1), whereas AS900 showed superior performance toward MG (278 mg g−1). Stable dynamic filtration, efficient regeneration, and nearly complete dye recovery demonstrate the potential of these non-activated biomass-derived carbons for sustainable dye removal and recovery from water.

Hematological malignancies remain one of the leading causes of morbidity and mortality despite advances in targeted therapies, immunotherapy, and stem cell transplantation. Emerging evidence indicates that treatment efficacy and toxicity depend not only on the choice of therapy but also on its timing relative to the patient's internal circadian rhythm. The circadian clock orchestrates fundamental processes in hematopoiesis and immunity, such as stem‐cell proliferation, leukocyte trafficking, DNA repair, and drug metabolism, while its disruption promotes malignant transformation, therapeutic resistance, and systemic toxicity. This narrative review synthesizes current understanding of circadian regulation in hematopoietic and immune systems, the mechanistic and preclinical foundations of chronotherapy in blood cancers, and the limited but growing body of clinical evidence linking treatment timing with outcome in leukemia, lymphoma, and transplantation. The review also examines practical challenges, including inter‐individual variability, disease‐induced circadian disruption, and hospital workflow constraints, while highlighting emerging technologies, such as transcriptomic clocks, wearable biosensors, and AI‐driven scheduling algorithms, that are poised to enable personalized, time‐aware therapy. By integrating temporal precision into existing therapeutic frameworks, chronotherapy may represent a promising investigational dimension of precision medicine in hematological oncology. However, its clinical value remains to be defined through prospective studies that incorporate validated circadian biomarkers, predefined timing windows, and clinically meaningful efficacy and toxicity endpoints.

AIM To evaluate whether treatment approach and Allen's classification are associated with treatment duration after fingertip injury and to identify predictors of prolonged recovery. METHODS We retrospectively reviewed 91 patients treated for fingertip injuries at Cantonal Hospital Zenica (January 2024 - December 2024). Injuries were classified using Allen's system, and treatment duration was grouped as 7-25, 26-35, or 36-90 days. RESULTS The cohort was predominantly male (89.0%), with a median age of 47 years (IQR 36-71). Median treatment duration was 24 days (IQR 15-33). Longer treatment duration was associated with exposed distal phalanx (p = 0.016), type 2 diabetes mellitus (p < 0.001), and treatment approach (p < 0.001). In multivariable analysis, osteosynthesis compared with suture (OR 2.95, 95% CI 1.30-12.63) and type 2 diabetes mellitus (OR 3.78, 95% CI 1.22-11.72) were associated with prolonged treatment in exploratory multivariable analysis (36-90 days). CONCLUSION Treatment approach and selected comorbidities should be considered alongside injury classification when anticipating recovery duration; however, the findings should be interpreted cautiously because of the limited number of prolonged-treatment events and diabetic patients.

Pitanje prevodivosti Kur'ana na nearapske jezike uopće, kao i prevođenje posljednje Božije objave s arapskog na druge jezike teme su kojima su se kroz povijest bavili i muslimani ovog podneblja, a mnogi alimi ostavili veliki broj značajnih djela iz te oblasti. Njihova zaostavština se čuva brižljivo pohranjena u našim bibliotekama, ponajviše u Gazi Husrev-begovoj biblioteci u Sarajevu. Ovaj rad je vezan za jedno takvo poznato ime među Bošnjacima, osobu koja je veći dio svog života provela u Turskoj, u kojoj ostaje na službi nakon više godina naukovanja, Muhammeda ibn Musa-a el-Bosnevija Allameka. Naslonjen na njegovo bavljenje jezičkim analizama kur'anskog teksta, ovaj rad ukazuje na dvije trajno aktuelne teme: jezička nadnaravnost kur'anskog teksta i neophodnost poznavanja arapskog jezika kao sredstva za razumijevanje tog Teksta.

Given the challenges of small and underdeveloped markets, a comprehensive approach to insurance risk analysis is essential. This paper develops and applies an actuarially justified and statistically robust methodology for motor insurance pricing in Bosnia and Herzegovina. The adequacy of Generalised Linear Models (GLMs) is assessed using a portfolio dataset covering 2011-2023, focusing on key policyholder and vehicle risk factors affecting claim frequency and severity. Comparison with existing market tariffs indicates that current premiums are generally underpriced. The proposed approach offers practical guidance for improving pricing accuracy and strengthening actuarial practices in such insurance markets.

For over a decade, the Shared Socioeconomic Pathways (SSPs) have served as the principal framework for quantitative modeling of the socioeconomic dimensions of global environmental change. The SSP scenarios describe many of the ecological and social processes thought to shape pandemic risk, including the emergence of novel pathogens (accelerated by processes such as deforestation, livestock intensification, and land-use change) and their subsequent spread (mediated by factors such as inequality, human mobility, and health system capacity). However, the SSP framework has not been widely incorporated into pandemic risk assessment. Here, we assess how pandemic risk is embedded in the SSP framework, and find that the framework captures most of the social-environmental drivers of pathogen spillover, and many of the social-economic drivers of pandemic spread and impacts. Because climate change and pandemics share many drivers and risk factors-- including ecosystem degradation, animal agriculture, and weak governance--SSP scenarios characterized by higher barriers to climate adaptation also generally imply lower chances of outbreak containment, and greater pandemic impacts on vulnerable populations. Pandemic risk is therefore lowest in SSP1 and highest in SSP3, but SSP5 shows that frequent spillover and effective containment can coexist. These findings suggest that pandemic risk can be understood as part of a broader polycrisis, linking climate change, biodiversity loss, and global health. We suggest that new scenario extensions, or entirely novel frameworks, will ultimately be needed to capture possible shifts in the global health landscape; however, in the meantime, scenario frameworks from the environmental sciences could be valuable tools for initiatives to quantify future pandemic risks.