Introduction. Sentinel lymph node biopsy (SLNB) has significantly advanced axillary staging in clinically node-negative breast cancer, offering lower morbidity compared to traditional axillary lymph node dissection (ALND). Nonetheless, precise prediction of non-sentinel lymph node (non-SLN) involvement remains essential for optimizing surgical decisions and preventing unnecessary ALND. Methods. A retrospective cohort analysis was performed on 176 patients with clinically node-negative breast cancer who underwent SLNB. Clinicopathological data were reviewed to evaluate associations between various predictive factors and non-SLN involvement. Variables analyzed included tumor size, histological grade, lymphovascular invasion (LVI), Ki-67 proliferation index, and sentinel lymph node characteristics. Results. Multivariable logistic regression identified the type of SLN metastasis (OR=21.4; 95% CI 1.7–43.6; p=0.01), the number of positive SLNs (OR=5.66; 95% CI 1.18–36.6; p=0.03), and the number of negative SLNs (OR=0.04; 95% CI 0.006–0.27; p=0.001) as independent predictors of non-SLN metastases. The predictive model demonstrated excellent discriminatory power, with an area under the receiver operating characteristic curve (AUC) of 0.91. Conclusion. Specific clinical and histopathological variables reliably predict non-SLN involvement in SLN-positive breast cancer patients. Incorporation of these predictors into clinical practice may enhance individualized axillary management and reduce unnecessary ALND procedures. Further validation through larger prospective studies is warranted. Key words: Breast Neoplasms, Sentinel Lymph Node Biopsy, Axillary Lymph Nodes, Lymph Node Dissection, Neoplasm Staging.
Background Non-ST-elevation myocardial infarction (NSTEMI) is frequently associated with systemic inflammation and metabolic dysregulation. Indices derived from routine laboratory tests that reflect systemic inflammatory and lipid-inflammatory status may offer better prognostic insight. This study aimed to evaluate the association between selected indices and short-term major adverse cardiovascular events (MACE) and all-cause mortality in patients with NSTEMI treated with dual antiplatelet therapy (DAPT) and statin. The selected indices reflect key mechanisms involved in NSTEMI pathophysiology, including insulin resistance, atherogenic dyslipidemia, and inflammation. Materials and methods This prospective observational study included 171 patients with NSTEMI admitted to the Intensive Care Unit of the Clinic for Internal Medicine at the University Clinical Centre Tuzla between February 1, 2022, and January 31, 2023. Blood samples were collected upon admission and 24 hours subsequently. The following indices were calculated: triglyceride-glucose index (TyG), triglyceride-to-high-density lipoprotein ratio (TG/HDL), atherogenic index of plasma (AIP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and pan-immune-inflammation value (PIV). Outcomes were tracked during hospitalization and up to three months post-discharge. MACE was defined as cardiovascular death, reinfarction, stroke, or unplanned revascularization. All patients underwent coronary angiography; revascularization was performed when clinically indicated. Exclusion criteria included active malignancy, infection, or inflammatory disease. Logistic regression was adjusted for age, diabetes, and other clinical variables. Missing data were handled using the pairwise deletion method. Results High levels of TyG at admission were independently associated with MACE (odds ratio (OR) 1.7; 95% confidence interval (CI) 1.0-2.8; p = 0.037). All-cause mortality occurred in 14.6% of patients (n = 25), while MACE occurred in 60 patients. Independent predictors of mortality included elevated TyG at admission (OR 2.2; 95% CI 1.1-4.4; p = 0.034), TG/HDL at 24 hours (OR 1.4; 95% CI 1.1-1.7; p = 0.007), AIP at 24 hours (OR 5.7; 95% CI 1.1-28.9; p = 0.035), and NLR at 24 hours (OR 1.1; 95% CI 1.0-1.2; p = 0.002). PLR and PIV at 24 hours were also significantly associated with mortality. Optimal cut-off values were TyG ≥ 8.9, AIP ≥ 0.35, and NLR ≥ 4.5. NLR had the highest estimated area under the curve (AUC ≈ 0.78). Conclusion In NSTEMI patients treated with DAPT and statin, several inflammatory and lipid-inflammatory indices were independently associated with short-term mortality. Indices measured at 24 hours had a stronger prognostic value than baseline values. Serial monitoring may aid early risk stratification. Outcomes were assessed during hospitalization and via structured follow-up up to three months post-discharge.
This work proposes a motion planning algorithm for robotic manipulators that combines sampling-based and search-based planning methods. The core contribution of the proposed approach is the usage of burs of free configuration space ($\mathcal{C}$-space) as adaptive motion primitives within the graph search algorithm. Due to their feature to adaptively expand in free $\mathcal{C}$-space, burs enable more efficient exploration of the configuration space compared to fixed-sized motion primitives, significantly reducing the time to find a valid path and the number of required expansions. The algorithm is implemented within the existing SMPL (Search-Based Motion Planning Library) library and evaluated through a series of different scenarios involving manipulators with varying number of degrees-of-freedom (DoF) and environment complexity. Results demonstrate that the bur-based approach outperforms fixed-primitive planning in complex scenarios, particularly for high DoF manipulators, while achieving comparable performance in simpler scenarios.
Recent technological advances have expanded the use of 3D-printed polymer components across industries, including a growing interest in military applications. The effective defensive use of such materials depends on a thorough understanding of polymer properties, printing techniques, structural design, and influencing parameters. This paper analyzes the ballistic resistance of 3D-printed polymer structures against 9 × 19 mm projectiles. Cuboid targets with different infill patterns—cubic, grid, honeycomb, and gyroid—were fabricated and tested experimentally using live ammunition. Post-impact, CT scans were used to non-destructively measure projectile penetration depths. The honeycomb infill demonstrated superior bullet-stopping performance. Additionally, mechanical properties were experimentally determined and applied in FEM simulations, confirming the ability of commercial software to predict projectile–target interaction in complex geometries. A simplified analytical model also produced satisfactory agreement with experimental observations. The results contribute to a better understanding of impact behavior in 3D-printed polymer structures, supporting their potential application in defense systems.
Sažetak ( sa ključnim riječima): Sažetak: Radni sporovi su pogodni za rješavanje alternativnim načinima rješavanja, pa i mirenjem propisanim Zakona o mirnom rješavanju radnih sporova iz 2021. godine. U radu se obrađuju specifičnosti radnih sporova kao posebnog parničnog postupka. Glavni fokus rada je na analizi postupku mirnog rješavanja kolektivnih radnih sporova, mirovno vijeće, način određivanja miritelja i arbitara te druga pitanja od značaja za mirno rješavanje radnih sporova za teritoriju Federacije Bosne i Hercegovine ako drugim zakonom nije drugačije određeno. Autorica naglašava važnost obveznog mirenja kod rješavanja kolektivnog radnog spora uz analizu sudske prakse te utjecaj mirenja na ishod parnice i značaj jer postignuti sporazum ima pravnu snagu ovršne isprave. Autorica analizira odnos parničnog zakonodavstva te instituta obveznog mirenja kao predstadija prije pokretanja parničnog postupka za kolektivne radne sporove u kontekstu i konvencijskih prava - prava na pristup sudu te prava na udruživanje i prava na štrajk. Poseban naglasak se stavlja na specifičnosti i značaj mirenja u kolektivnim radnim sporovima. Ključne riječi: kolektivni radni spor, Zakon o mirnom rješavanju radnih sporova, mirenje, arbitraža Summary: Labor disputes are suitable for resolution by alternative means of resolution, including mediation prescribed by the Law on the Peaceful Settlement of Labor Disputes from 2021. The paper addresses the specifics of labor disputes as a special civil procedure. The main focus of the paper is on the analysis of the procedure for the peaceful resolution of collective labor disputes, the peace council, the method of appointing conciliators and arbitrators, and other issues of importance for the peaceful resolution of labor disputes for the territory of the Federation of Bosnia and Herzegovina, unless otherwise provided for by other law. The authors emphasize the importance of mandatory mediation in resolving collective labor disputes, along with an analysis of case law and the impact of mediation on the outcome of litigation and its significance because the agreement reached has the legal force of an enforceable document. The authors analyze the relationship between civil proceeding law and the institute of mandatory mediation as a preliminary stage before initiating civil proceedings for collective labor disputes in the context of both convention rights - the right to access to court and the right to associate and the right to strike. Special emphasis is placed on the specifics and importance of mediation in collective labor disputes. Keywords: collective labor dispute, Law on Peaceful Resolution of Labor Disputes, mediation, arbitratio
Dementia is a growing public health problem, particularly in low- and middle-income countries. Bosnia and Herzegovina (BiH), as a post-conflict LMIC with a complex administrative structure, currently lacks national guidelines, epidemiological data, and systematic approaches for dementia care. This study investigates healthcare workers’ attitudes toward dementia care and identifies both obstacles and practical opportunities for improving practice within BiH’s unique healthcare system. A qualitative cross-sectional study was conducted in primary healthcare settings across Bosnia and Herzegovina, with 25 participants, including family medicine doctors (n = 10), nurses (n = 10), and psychologists (n = 5). The data were analyzed using thematic analysis guided by the Consolidated Framework for Implementation Research (CFIR). Dementia care in BiH is predominantly reactive, with healthcare professionals typically responding only after families have expressed concerns. Participants reported inconsistent use of cognitive screening tools (e.g. MMSE, MoCA), largely due to insufficient training, lack of clear national guidelines, and varying institutional practices. Many clinicians felt unprepared and unsupported in managing dementia cases. Cultural stigma and widespread misperceptions of dementia as a normal part of aging contribute to delays in diagnosis and reduce the likelihood that families will seek help early. These barriers are exacerbated by a lack of national prevalence data and fragmented care pathways. The findings of this study indicate the need to change the approach to dementia care in BiH through concrete and realistic measures within the existing systemic frameworks. Practice-based guidelines, culturally adapted tools for early detection, reactivation of community-based care, accessible education, a pragmatic approach to prevention, and local initiatives for awareness-raising and multidisciplinary care are recommended.
Abstract Background Toxoplasmosis, caused by the protozoan parasite Toxoplasma gondii, is often linked with reproductive disorders in humans and animals. Despite this, its presence in animals in the Federation of Bosnia and Herzegovina (FB&H) remains undocumented. Objectives This study aimed to investigate the seroprevalence of T. gondii infection among domestic pigs in FB&H, assess associated risk factors for parasite transmission and provide insights into optimal management and biosafety practices for the pig industry. Methods A two‐phase random sampling approach was employed to select 87 pig farms across 10 administrative regions in FB&H. A total of 437 pigs were sampled and tested for anti‐T. gondii antibodies using an indirect ELISA kit. Epidemiological data on potential risk factors were collected through a standardised questionnaire and analysed using logistic regression models. Results The animal‐level seroprevalence was found to be 13.3% (95% CI = 10.4–16.8), with 44.8% of farms testing positive for T. gondii (95% CI: 34.8–55.3). Identified risk factors included exposure to cats, repeated occurrences of abortions within a single breeding season, swill feeding, type of housing, and type of operation. The robust association observed between recurrent abortions and Toxoplasma seropositivity indicates a significantly greater potential involvement of T. gondii in reproductive disorders among pigs in FB&H than previously acknowledged. Conclusions This study provides the first report on T. gondii infection in animals in FB&H, highlighting the need for further research to explore its presence in other meat animals and meat products consumed in the region. The findings underscore the importance of biosafety measures in mitigating T. gondii transmission and call for enhanced surveillance and management strategies in FB&H's pig industry.
Background and objective Type 2 diabetes mellitus (T2DM) is a global health issue that has seen a significant increase in prevalence worldwide. Oxidative stress plays a crucial role in the pathogenesis of numerous chronic diseases. Oxidative stress induced by hyperglycemia has a central role in the development of insulin resistance, as well as micro- and macrovascular complications of diabetes mellitus. This study aimed to investigate the influence of the duration of T2DM on blood glucose levels, glycated hemoglobin (HbA1c), renal function parameters, oxidative stress, and von Willebrand factor (vWf) activity in individuals with diabetes. Methodology A total of 135 participants from both genders with T2DM were included in this study. The participants were divided into three groups based on the duration of their disease: up to five years (46 participants), from 6-10 years (49 participants), and over 10 years (40 participants). The investigated parameters were as follows: fasting glucose, two-hour postprandial glucose, HbA1c, total antioxidant capacity (TAC), glomerular filtration rate (GFR), and vWf activity. Statistical analysis was performed using SPSS Statistics (IBM Corp., Armonk, NY). The Kolmogorov-Smirnov test was applied to assess the normality of distribution. Differences between the groups were analyzed using the Kruskal-Wallis test and analysis of variance (ANOVA), with appropriate post-hoc tests. A p-value <0.05 was considered statistically significant. Results The average age of the participants was 60.86 ± 8.87 years, the average weight was 86 ± 14.6 kg, the average height was 168 ± 9.18 cm, the waist circumference was 99 ± 11.4 cm, the systolic blood pressure was 127 ± 15.6 mmHg, and the diastolic blood pressure was 77 ± 6.7 mmHg. The study revealed statistically significant differences between the groups (p<0.05) for the following parameters: two-hour postprandial glucose (p=0.001), HbA1c (p=0.048), GFR (p=0.038), and vWf activity (p=0.006). No statistical significance was found for TAC values (p>0.05). Conclusions Higher levels of vWf activity were found in people who had been treated for type 2 diabetes for more than 10 years. These findings indicate that the level of vWf activity in people with type 2 diabetes 10 years after the onset of the disease can be used as a marker of vascular pathology.
Background and Objectives: Resilience and perceived social support are crucial factors influencing the psychological well-being among breast cancer survivors. Understanding their levels and interrelations can inform psychosocial interventions aimed at improving survivorship outcomes. This study aimed to examine the relationship between resilience and perceived social support, evaluate the psychometric properties, and explore their associations with key sociodemographic factors among breast cancer survivors. Materials and Methods: A total of 253 women in clinical remission, at least six months post-primary treatment, were recruited from the University Clinical Center of Vojvodina. Participants completed sociodemographic and clinical questionnaires, the Connor–Davidson Resilience Scale (CD-RISC-25), and the Multidimensional Scale of Perceived Social Support (MSPSS). Results: Participants reported moderate levels of resilience (Mdn = 75, IQR = 19). Among resilience domains, Hardiness (Mdn = 22, IQR = 7) and Coping (Mdn = 14, IQR = 4) scored highest, while Optimism (Mdn = 6, IQR = 3) was the lowest. A significant positive correlation was found between resilience and fertility-related quality of life (ρ = 0.454, p < 0.01), while a negative correlation was observed between resilience and fertility-related stress (ρ = −0.275, p < 0.01). Adaptive coping strategies, particularly from the Practical Management Branch of the CIQ, were positively associated with resilience and quality of life, while avoidance coping was linked to higher stress and lower well-being. Conclusions: Breast cancer survivors in this Serbian cohort reported moderate resilience and social support, with a strong interrelationship between the two. These findings underscore the importance of strengthening social support networks as a potential pathway to enhance resilience and psychological well-being in cancer survivorship care.
Background and Objectives: Idiopathic normal-pressure hydrocephalus (NPH) is a treatable, but diagnostically challenging condition in the elderly marked by gait disturbance, cognitive decline, and urinary incontinence. Ventriculoperitoneal (VP) shunting is effective, but the prognostic significance of symptom duration before surgery remains unclear. This systematic review evaluates symptom duration in NPH patients with postoperative outcomes. Methods: A systematic search of PubMed, Scopus, and Embase was conducted per PRISMA guidelines. Studies were included if they assessed clinical or radiological outcomes of VP shunting in adult NPH patients, reported symptom duration, and had a follow-up of at least one month. Clinical outcomes (MMSE, TUG, NPH score) were qualitatively analyzed due to study heterogeneity. Results: Twenty-four studies comprising 1169 patients were included (mean age: 72.45 years; mean symptom duration: 33.04 months). Most studies reported clinical improvement after VP shunting. However, few directly evaluated the effect of symptom duration, yielding inconsistent findings: some suggested better outcomes with shorter symptom duration, while others found no clear correlation. Larger studies often lacked conclusive data, and no randomized controlled trials were identified. Conclusions: VP shunting remains an effective intervention for NPH; however, evidence supporting the predictive value of preoperative symptom length is inconclusive. This review highlights the need for standardized diagnostic protocols and larger prospective studies to clarify this association and optimize surgical timing.
Traditional medicinal plants are valued for their therapeutic potential, yet the full spectrum of their bioactive compounds often remains underexplored. Recent advances in multiomics technologies, including metabolomics, proteomics, and transcriptomics, combined with in vitro culture systems and elicitor-based strategies, have revolutionized our ability to characterize and enhance the production of valuable secondary metabolites. This review synthesizes current findings on the integration of these approaches to help us understand phytochemical pathways optimising bioactive compound yields. We explore how metabolomic profiling links chemical diversity with antioxidant and antimicrobial activities, how proteomic insights reveal regulatory mechanisms activated during elicitation, and how in vitro systems enable controlled manipulation of metabolic outputs. Both biotic and abiotic elicitors, such as methyl jasmonate and salicylic acid, are discussed as key triggers of phytochemical defense pathways. Further, we examine the potential of multiomics-informed metabolic engineering and synthetic biology to scale production and discover novel compounds. By aligning traditional ethnobotanical knowledge with modern biotechnology, this integrative framework offers a powerful avenue to unlock the pharmacological potential of medicinal plants for sustainable and innovative therapeutic development.
Introduction. Chronic kidney insufficiency presents a progressive decline in renal function. Long-term hemodialysis treatments lead to biochemical parameter imbalances like an altered level of homocysteine (Hcy). Hcy can contribute to oxidative stress and endothelial damage, which promotes the accumulation of low-density lipoprotein (LDL) cholesterol and the development of atherosclerosis. It can also affect lipoprotein metabolism and trigger inflammatory processes that alter the lipid profile, especially increasing triglycerides and lowering high-density lipoprotein (HDL) cholesterol. Methods. This cross-sectional, clinical and descriptive-analytical study included 83 patients, 40 patients on hemodialysis, and 43 subjects in healthy control group. Results. The hemodialysis group had significantly higher Hcy values compared to the control group of seemingly healthy subjects (p<0.05). The control group had significantly higher values of total cholesterol, LDL and very low-density lipoprotein (VLDL) compared to the hemodialysis patients (p<0.05). There was non significant correlation between Hcy and lipid parameters in the hemodialysis group, neither in the control group. Conclusion. Patients undergoing hemodialysis had significantly higher total homocysteine levels compared to the control group. However, total homocysteine did not demonstrate an association with lipid status parameters in either the hemodialysis patients or the healthy subjects. Keywords: homocysteine, hemodialysis, cholesterol, triglycerides, metabolism.
Due to an epidemic of risk factors, such as hypertension, and an increase in life expectancy, cardiovascular disease (CVD) has an overwhelming morbidity and mortality burden worldwide. Various treatment options are available to disrupt pathophysiological processes along the cardiovascular continuum by focusing on distinct regions of the renin-angiotensin-aldosterone system (RAAS). As a RAAS inhibition, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are recommended first-line treatments for hypertension and CVD. Both ACE inhibitors and ARBs prevent CVD by lowering blood pressure (BP). Furthermore, a number of studies have shown that RAAS blockade can lower cardiovascular risk in ways that go beyond what could be predicted from lowering blood pressure alone. However, the ARBs are not all equally effective. Telmisartan is a long-lasting ARB that effectively controls BP over the full 24-hour period. In high cardiovascular risk patients, telmisartan reduces cardiovascular events in a manner comparable to that of the ACE inhibitor ramipril beyond lowering blood pressure alone, but with better tolerability. Research points to possible benefits for adipose tissue activity, neurovascular function, and enhancements in glucose and lipid metabolism. According to several studies, telmisartan has partial peroxisome proliferator-activated receptor gamma (PPARγ) agonist activity, which improves insulin resistance in diabetic patients by modifying adipokine levels. The combination of telmisartan and indapamide as metabolically neutral diuretic has an additional positive antihypertensive as well as cardioprotective effects. In addition to reviewing current CVD management guidelines, this article will examine important clinical trial and clinical practice data that assess the role of telmisartan/indapamide in CVD. Keywords: arterial hypertension, angiotensin II receptor blocker, telmisartan, cardiovascular risk.
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