Abstract Congenital intrinsic obstruction at or near the duodenojejunal junction is exceptionally rare and most commonly results from incomplete embryonic recanalization, leading to the formation of a mucosal web. We report a 7-day-old term male neonate (birth weight 3350 g) who presented with persistent feeding intolerance and intermittent bilious vomiting since birth. Abdominal radiography showed marked dilation of the stomach and duodenum with distal bowel gas. An upper gastrointestinal contrast study revealed a conical narrowing at the duodenojejunal junction. Surgical exploration revealed a mucosal web located immediately distal to the duodenojejunal junction. Given the marked luminal disparity, simple web excision was deemed inadequate, and segmental resection with primary end-to-end jejunojejunal anastomosis was performed. Postoperative recovery was uneventful. Proximal jejunal webs near the duodenojejunal junction are rare but surgically correctable causes of neonatal bilious vomiting and should be considered in the differential diagnosis.

This paper aims to systematically present existing research on cognitive and executive functions, speech and auditory perception, language, literacy, and academic development, and cross-modal reorganization in children with CIs. The methodology included a systematic search of databases (PubMed, Scopus, Web of Science) using keywords related to cognition and CIs. After eliminating duplicates and applying inclusion criteria, an analysis was conducted of relevant references published from 2015 to the present, which were analyzed both in tables and narratively. Research confirms that the cognitive development of children with CIs depends on auditory input and the brain’s ability to integrate information from different sensory modalities. Multisensory and interactive approaches to rehabilitation have the potential to enhance cognitive development and should be further researched and applied in practice.

U ovom radu analizira se odnos socijalne politike prema civilnim žrtvama rata i njihova međusobna korelacija u Bosni i Hercegovini. Krajnji cilj je doći do odgovora na pitanja kako odgovoriti potrebama civilnih žrtava rata kroz kvalitetnu socijalnu politiku u Bosni i Hercegovini. U ostvarivanju socijalne pravde, socijalnih prava, smanjivanju društvene nejednakosti i općoj humanizaciji društva u Bosni i Hercegovini posebnu ulogu ima upravo socijalna politika. S tim u vezi primjenu socijalnih politika u području brige i zaštite civilnih žrtava rata sve više pažnje usmjeravaju na deinstitucionalizaciju i tako nastoje da trendovi u brizi o civilnim žrtvama rata idu prema zbrinjavanju ne na državnom nivou, nego na nivou lokalne zajednice. Ono što bi moglo biti jedno od rješenja ili državnih strateških pravaca jeste razvijanje različitih modela podrške, uz podršku njima najbližih osoba, odnosno podrška primarne socijalne mreže uz podršku države. Činjenica je da se naše društvo mora suočiti sa izazovom kreiranja sistema koji će biti prilagođen i u skladu s potrebama kategorije civilnih žrtava rata. Važan preduslov za poboljšanje statusa i brige o civilnim žrtvama rata jeste kroz primjenu kvalitetne i zakonom utvrđene socijalne politike. Odnos socijalne politike prema kategoriji civilnih žrtava rata je vrlo prisan, samom činjenicom jer se ona bavi raznim društvenim segmentima, a civilne žrtve rata su upravo jedna od najugroženijih društvenih kategorija čija ljudska, socijalna i druga prava, bi se trebala početi primjenjivati onako kako to nalažu i međunarodne konvencije koje su sastavni dio socijalne politike, a ne biti samo mrtvo slovo na papiru.

Generative artificial intelligence (AI) occupies a dominant transformational position in a wide range of fields, including education, business, law, medicine, rehabilitation – among others. Despite the controversies regarding the use and abuse of this technology, it is possible for professionals, especially those in education, to reap its benefits for instruction, research, and administrative endeavors. Keeping in mind the ethical concerns and the current limitations of the system, AI can provide substantial assistance to, for example, teachers, students, and scholars. Setting aside fears of this technology, teachers can save time and become more efficient and productive with their administrative and instructional tasks. Teachers can also use AI to improve the academic, communication, and social skills of students, including—and especially--students in special education programs. Students can learn to use AI independently; in fact, AI can help students to become autonomous and critical seekers of knowledge. After highlighting some challenges of using AI, the present manuscript discusses a few benefits of AI for children and adolescence who are d/Deaf and hard of hearing (d/Dhh). The manuscript also contains recommendations for teacher education and future research endeavors.

Cancer therapy remains challenged by limited treatment efficacy, cancer-related malnutrition and substantial toxicity, underscoring the need for novel strategies to improve therapeutic responses. Omega-3 fatty acids, particularly docosahexaenoic acid (DHA), exhibit both nutritional and bioactive properties, including anti-inflammatory effects and the ability to enhance tumor cell susceptibility to oxidative stress and ferroptosis. To improve stability and delivery, omega-3 fatty acids can be formulated into nanoemulsions that facilitate cellular uptake and may potentiate anticancer therapies. Therefore, we developed a panel of nanoemulsions with defined omega-3 and 9 fatty acid profiles derived from algae, fish and olive oils. All formulations exhibited high physicochemical stability, nanoscale droplet sizes and compendial quality. While pure oil showed minimal biological activity, nanoemulsification markedly increased cytotoxicity, and the novel DHA-rich algae oil emulsion displayed strong and selective antitumor effects without affecting normal fibroblasts. Combination studies indicated tumor type-dependent enhancement of chemotherapeutic efficacy. RNA sequencing indicated activation of ferroptosis-associated pathways and suppression of DNA replication and cell-cycle progression by the novel DHA-rich algae oil emulsion. To expand translational relevance for tumor specific target therapies, a HER2⁺/ER⁻ patient-derived breast cancer cell line and matched cancer-associated fibroblasts were established and characterized. In conclusion, these findings identify the new formulation prototype as a selective and biologically active nanocarrier for DHA which is capable of enhancing tumor type specific therapies, selective chemotherapeutic efficacy and potentially inducing ferroptosis-driven antiproliferative programs. These results highlight the promising potential of DHA as lipid component in a nanoscale droplet size formulation for future combination cancer therapies.

Acute abdominal pain (AAP) constitutes a frequent presenting complaint in the emergency department (ED). Distinguishing between mild and potentially life-threatening cases requires a structured approach and effective triage. This study aimed to describe the main nontraumatic causes of AAP, assess urgency, and analyze case distribution by age and gender, as well as admission and discharge patterns. All records of adult patients presenting with abdominal pain between August and December 2023 were retrospectively analyzed. The entire patient sample ( n = 257) was classified into 15 different diagnostic groups. From the total count of patients, n = 257, there were 154 females (59.92%) and 103 males (40.08%). According to our study, the leading cause of AAP was renal colic ( n = 67; 26.07%), followed by nonspecific abdominal pain (NSAP) ( n = 48, 18.68%), urinary tract infections (UTIs) ( n = 38, 14.79%), and biliary colic and cholecystitis ( n = 32, 12.45%). In terms of hospitalization, 195 patients (75.88%) were discharged, and 62 patients (24.12%) were admitted. Logistic regression analysis revealed that the likelihood of hospitalization was approximately twofold higher in males (odds ratio [OR] = 2.03), whereas females exhibited a reduced probability (OR = 0.49). A higher proportion of AAP cases was observed among females in our ED sample, with renal colic, NSAP, UTI, and biliary disorders being the most common diagnoses. A high discharge rate (75.9%) reflects that most AAP cases were non-emergent; however, careful triage remains essential, particularly in male patients due to their higher admission risk.

Aim To assess the prevalence of burnout syndrome and its association with occupational stressors among physicians and medical technicians/nurses in the Federation of Bosnia and Herzegovina (FBiH). Methods This cross-sectional study was conducted between February 12 and April 12, 2025, using an anonymous online survey. Structured self-administered questionnaire scales were used to assess burnout (Copenhagen Burnout Inventory) and workplace stressors (Occupational Stress Questionnaire). The association of personal, work-related, and patient-related burnout with occupational stressors was assessed. The survey was sent to the members of the Union of Physicians and Dentists in the FBIH, who were asked to forward the link to their medical technicians and nurses. Results Overall burnout symptoms were reported by more than half of the respondents (53.0%), with 75.7% experiencing at least one form of burnout. Personal burnout was the most prevalent (70.9%), followed by work-related burnout (54.2%) and patient-related burnout (40.1%). In multiple regression analysis, overall burnout was driven by the cumulative impact of multiple stressors rather than by any single factor. All stressors were positively correlated with burnout, but conflicts and communication at work (for personal and work burnout) and public criticism (for patient-related burnout) stood out as the strongest predictors. Conclusion This study observed a high prevalence of burnout among physicians and medical technicians/nurses in the FBiH. All examined domains of professional stressors were correlated with all burnout dimensions. Given the importance of preventing and alleviating burnout among health care professionals, this research provides insight into key factors contributing to burnout.

ABSTRACT Introduction: Repaired TOF (rTOF) is a common condition in adult congenital heart disease care. The aim of this article is to investigate how inflammatory markers and volume overload affect rTOF, and how these factors correlate with echocardiographic findings in the right heart cavities. Methods: This study included 32 adult patients (mean age, 27.44 ± 6.22 years) who had undergone surgical correction of TOF during infancy. All participants underwent transthoracic echocardiography, and laboratory assessments included measurements of N-terminal pro-B-type natriuretic peptide (NT-proBNP; reference range ≤125 pg/mL) and high-sensitivity C-reactive protein (hs-CRP; reference range ≤2.0 mg/L). Results: Significant correlations were found between NT-proBNP levels and right ventricular (RV) fractional area change (FAC) (r = −0.55, P = 0.001), tricuspid annular plane systolic excursion (TAPSE) (r = −0.35, P = 0.04), RV basal diameter (r = 0.47, P = 0.006), and right atrium (RA) area (r = 0.50, P = 0.003). Similarly, hs-CRP levels showed strong associations with RV FAC (r = −0.58, P < 0.001), TAPSE (r = −0.45, P = 0.009), RV basal diameter (r = 0.43, P = 0.01), and RA area (r = 0.43, P = 0.01). NT-proBNP had a significant impact (P = 0.017; EXP B = 0.982) on RV FAC. A decrease of 10 units in NT-proBNP was associated with a 17% reduction likelihood of having RV FAC <35%. Conclusion: The proinflammatory response (hs-CRP) and volume load (NT-proBNP) are directly correlated with echocardiographic parameters of the right heart cavities in patients with rTOF, suggesting that patients may benefit from treatment with anti-inflammatory drugs, as well as medications targeting diastolic dysfunction.

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by debilitating pain and progressive joint destruction. Tumor necrosis factor-alpha (TNF-α), a key pro-inflammatory cytokine, has been implicated in modulating both peripheral and central pain pathways. TNF-α inhibitors, initially developed to halt structural damage in RA, have demonstrated substantial efficacy in pain relief, independent of their anti-inflammatory properties. This narrative review explores the mechanistic pathways through which TNF-α contributes to pain sensitization and highlights the role of TNF-α inhibitors in disrupting these pathways. Evidence suggests that these biologics not only reduce synovial inflammation but also modulate neuroinflammatory circuits, altering pain perception at the spinal and supraspinal levels. Despite their clinical success, variability in patient response and concerns regarding long-term safety necessitate further research into personalized therapeutic strategies. Identifying biomarkers predictive of pain relief could enhance treatment precision. Ultimately, the integration of TNF-α inhibitors into multidisciplinary pain management approaches holds promise for improving clinical outcomes and quality of life in RA.

Introduction: Cognitive impairment is the most common neurological disorder associated with brain tumors, which leads to linguistic communication damage. Anxiety and depression are among the most prevalent psychiatric comorbidities in this population. Objectives: To determine the level of cognitive functioning, anxiety, and depression in patients with intracranial tumors with and without aphasia. Subjects and methods: A prospective study was conducted on 91 patients with verified brain tumors which were hospitalized at the Clinic for Neurosurgery for one year period. The patients were assessed with Mini Mental State Examination, Beck’s depression inventory, and Beck’s anxiety inventory. The type and severity of aphasia were determined by the Boston Aphasia Test. Results: The highest number of patients, a total of 31 (37.3%), had moderate anxiety disorder. 30 patients (36.1%) had shown symptoms of moderate depression, and 33 (39.7%) had shown mild and moderate cognitive dysfunction. Conclusion: Anxiety, depression, and cognitive dysfunction were significantly more pronounced in subjects with aphasia.