Background: Coronary artery disease (CAD) is a major public health issue and a leading cause of death globally. It is one of the most common indications for surgical intervention. There are a lot of different techniques, including CABG, which consists of two approaches: sternotomy and mini-thoracotomy. Different techniques have been developed to improve surgical outcomes, including the use of machine for extracorporal circulation (on-pump) or without it (off-pump). Objective: The objective of this study was to assess whether off-pump CABG offers superior short-term outcomes compared to traditional on-pump CABG in patients undergoing isolated CABG.. Methods: In period between 2022 – 2023, we performed CABG operation in 80 patients. CABG was performed either on- pump or off-pump. Results: The results have shown advantages and disadvantages of one or another type of CABG. We were comparing the duration of surgical procedure, time on mechanical ventilation, drainage volume, neurological incidents, time to discharge, indication for repeat revascularization and mortality between two groups. Conclusion: The choice of surgical technique should be based on individual patient factors, including comorbidities and surgical risks. It is important to say that OPCABG is more challenging than ONCABG, and it is very important that OPCABG is done by skilled, experienced and confident surgeon, which contributes to better outcome and survival.

Background: Cardiosurgical patients can be often anemic, and preoperative anaemia is associated with increased postoperative complications, as well as morbidity and mortality. Objective: The present study was conducted aiming to determine the influence of lower preoperative hematocrit values on the early postoperative recovery of patients undergoing elective off-pump coronary artery bypass grafting (OPCABG). Methods: Our retrospective study included 150 patients who underwent elective OPCABG surgery from September 2021 to December 2022 at the Clinic for Cardiovascular Surgery University of Sarajevo. Patients were divided into two groups, anemic and non-anemic, with anemia defined as hemoglobin level <130g/l males and <120g/l females. Study observed comorbidities and early postoperative data. Results: Overall prevalence of anemia in OPCABG patients was 36,6%, more frequent among older patients. Comorbidities as chronic obstructive pulmonary disease, hypertension, ejection fraction was quite similar in both groups, but body mass index was significantly higher in the group of patients with anemia (29.9% vs 28.4%). In early recovery period, vasopressors were more used in patients with anemia (63.6% vs 42.1%) and their doses were higher. Total drainage was higher in patients with anemia (744.45±45.72 ml vs 681.58±349.06 ml). Number of transfusions was higher in the group of patients with anemia: red blood cells (0.89±1.29 vs 0.29±0.84; p<0,05), fresh frozen plasma (0.65±1.13 vs 0.41±1.15; p<0,05) and platelets (0.11±0.57 vs 0,07±0.42; p>0,05). Duration of mechanical ventilation was longer in patients with anemia compared to non-anemic patients (623-91±259.83 minutes vs 469±191.13 minutes). Atrial fibrillation occurred more often in patients with anemia (12.7 vs 7.4%). Length of stay in the intensive care unit was without significant difference. Conclusion: Based on our findings, patients who underwent elective OPCABG with lower than normal hematocrit, needed more blood and blood products, more vasopressor drugs in higher doses, longer mechanical ventilation, all which can prolong the patient’s recovery and increase the cost of treatment.

Background Waterpipe, also known as a hookah or narghile, is a type of tobacco products consumption device. Recently it has been increasingly popular in Bosnia and Herzegovina and the region. Waterpipe consumers are predominantly adolescents and young adults. Many of them believe in slighter harmful effects of waterpipes, compared to cigarettes. We aimed to determine the DNA damage in oral leukocytes and buccal cells of young individuals who have smoked a waterpipe for more than one year. Methods The study group consisted of 40 cigarette non-smokers who regularly smoked a waterpipe on average of once per week. As a control, 40 non-smoking individuals were selected to match smokers for age. All participants in the study were healthy male and female adults from Bosnia and Herzegovina, 18–30 years of age. Before sampling, detailed survey and informed consent have been provided by each participant. Comet assay in oral leukocytes and buccal micronucleus cytome (BMCyt) assay in exfoliated buccal cells were applied. Results Almost half of waterpipe smokers (WPS) tasted waterpipe at 15–16 years of age. Comet assay analysis showed increased tail intensity, tail length, and tail moment values among WPS compared to non-smokers (NS) (p = 0.0001, p = 0.0067, and p = 0.0001, respectively). Frequencies of the micronucleated (p = 0.0004), binucleated (p = 0.01), karyorrhectic, (p = 0.0036), and pycnotic cells (p = 0.03) were significantly higher in WPS compared to NS group. Conclusions Genotoxicity and DNA damage biomarkers were increased in oral leukocytes and exfoliated buccal cells of young waterpipe smokers from Bosnia and Herzegovina, compared to NS group.

Physical activity is important for the physical and mental health of almost everyone. Nordic walking is a physical activity in which participants use specially designed poles while walking, while the term jogging implies light running at speeds less than 10 km/h. PURPOSE: The aim of this research is to monitor the load intensity in real conditions, using a heart rate monitor Team Polar System, during nordic walking and jogging and comparing possible differences in heart rate responses after the fifth minute of activity, at an average speed of 7.5km/h. METHODS: The assessment of heart rate responses for this research was conducted on the 30 male students, at 2 separate days. RESULTS: The results of the variables used in this study show statistically significant differences at the level of significance p=.000. From the mean value results (M) it is obvious that the respondents achieved higher results of heart rate responses during nordic walking compared to the identical tests applied during jogging. CONCLUSION: The results of this study indicate that both Nordic walking and jogging are beneficial but Nordic walking contributes more in achieving higher body loads resulting in increased oxygen consumption and thus calories Key words: load intensity, heart rate, nordic walking, jogging

Abstract Banks and banking business are exposed to the influence of numerous risks, of which the importance of credit risk management stands out, because credit risk is the only risk that banks are obliged to measure, record in accounting and report. Banks monitor credit risk through the segmentation of the credit portfolio according to the level of risk. This paper is focused on research related to the management of the riskiest category of the credit portfolio, for which we will use the term special credit risk (SCR) in this paper.

Background: The book “An Impossible Decision - the Life Interrupted by Uncertainty”has been published by Avicena Publisher in Sarajevo, Bosnia and Herzegovina in 2023 - ISBN: 978-9958-720-76-5. Objective: The aim of this article is to analize what is the most rational and ethical way to treat people facing life-and-death decisions and how do we exactly communicate these inevitable uncertainties that all of us will sooner or later face? Methods: Author of the book shows real-life relevance to patients often left alone to make these difficult decisions. Using the techniques of medical dramaturgy, this text brilliantly bridges science. Results and Discussion: The author of the book explained and proposed how to educate the public on how medical advances are made and how inferences and evidence are generated and appraised - in the best tradition of evidence-based medicine while highlighting uncertainties and inevitable trade-offs that accompany science, policies, and personal choices in the attempt to arrive at most satisfactory decisions. In addition to the general public, this play’s important audiences are students and faculty in humanities disciplines and medical schools. These students are required to read many dense scientific, philosophical, and technical writings (many of which are referenced/annotated in the footnotes in the play). The play provides an exceptional teaching tool, which includes over 35 theoretical concepts to show how they can be applied to decisions relevant to all of us and what shared decision- making entails. Conclusion: Author’s answer on the question “How to make the life and death medical decisions?” coul’d and shoul’d be: The method of using a playwright and Socrates dialogue format to connect the science of uncertainty with personal humanity decision will be appropriate. It will be important and quiet usefull for phisicians and, also, patients in healthcare practice, as joined decision makers.

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Abstract This study classifies local self-government units (local communities) in the Federation of Bosnia and Herzegovina (FBIH) according to socio-economic characteristics by applying the following multivariate methods: principal component analysis (PCA), regression and cluster analysis. The selection of variables was based on literature and adjusted by FBIH specifics, covering the four hypothetical dimensions of regional differentiation: macroeconomic, demographic, infrastructural and socio-cultural indicators. PCA has identified five components: the productivity component, demographic component, component of economic activity potential, spatial component and employment component. Further analysis showed that all identified factors are significant predictors of local communities’ development, measured by the development index. The cluster analysis resulted with four clusters in the FBIH with significant differences in development level. Considering that FBIH municipalities are administrative units of local government and that the classification is based on socio-economic dimensions, identified clusters correspond to the NUTS principles.

Balanced simplicial complexes are important objects in combinatorics and commutative algebra. A d -dimensional simplicial complex is balanced if its vertices can be coloured into d +1 colors, so there is no monochromatic edge. In this article, we establish two results concerning balanced simplicial complexes assigned to tilings of m × n board in a plane and a torus by I p -omino tile

Abstract The main aim of this study is to explore the mediating effect of innovation in the relationship between human resource management (HRM) practices and organizational performance. HRM practices are observed through selective hiring, training, participative decision-making, and rewarding. Innovation is conceptualized over behavioral, product, process, and market innovation. The study relies upon the principles of social exchange theory and resource-based theory. Data were collected from 408 managers in an emerging economy context. The proposed conceptual model is evaluated with structural equation modeling using Lisrel 8.8 and SPSS 22. Study findings suggest that innovation influences the relationship between selective hiring, training, and participative decision-making and organizational performance. However, no mediating effect of innovation was found in a relationship between rewarding and organizational business performances. Since human resources and innovation are among the leading sources for building competitive advantage for companies, the study findings contribute to HRM and innovation.

Abstract Introduction. COVID-19 pandemic increased consumption of alcohol (including harmful drinking – HD), and decreased physical activity levels (PAL) globally, but there is an evident lack of studies examining the problem in the post-pandemic period. This study aimed to evaluate gender-specific associations between sport participation and PAL (independent variables), and HD (dependent variable) among college/university students during the first post-pandemic year of the COVID-19 pandemic. Material and Methods. The participants were college/university students, aged 18 to 21 years (n = 788; 409 females) from Croatia and Bosnia and Herzegovina. They were tested on socio-demographic factors, HD (using the AUDIT scale), sport participation and PAL (using the IPAQ questionnaire). Analysis of variance, Chi square test, and t-test for independent samples were used to evaluate differences, while logistic regression with dichotomized criterion (HD vs. non-harmful drinking – NHD) was calculated to establish associations between independent and dependent variables. Results. T-test indicated significant differences between HD and NHD in PAL (t-test = 2.16, p = 0.02), but only in males. Also, logistic regression indicated a significant correlation between PAL and HD in males (OR: 1.41, 95%CI: 1.11-1.76), while no association was evidenced: (i) between sport participation and HD (in both males and females), and (ii) between PAL and HD (in females). Conclusions. Results indicated that an overall increase in PAL could be helpful in decreasing HD among college/university students; however, to evaluate it more specifically, prospective analyses are needed.

Crop insurance is used to reduce risk in agriculture. This research is focused on selecting an insurance company that provides the best policy conditions for crop insurance. A total of five insurance companies that provide crop insurance services in the Republic of Serbia were selected. To choose the insurance company that provides the best policy conditions for farmers, expert opinions were solicited. In addition, fuzzy methods were used to assess the weights of the various criteria and to evaluate insurance companies. The weight of each criterion was determined using a combined approach based on fuzzy LMAW (the logarithm methodology of additive weights) and entropy methods. Fuzzy LMAW was used to determine the weights subjectively through expert ratings, while fuzzy entropy was used to determine the weights objectively. The results of these methods showed that the price criterion received the highest weight. The selection of the insurance company was made using the fuzzy CRADIS (compromise ranking of alternatives, from distance to ideal solution) method. The results of this method showed that the insurance company DDOR offers the best conditions for crop insurance for farmers. These results were confirmed by a validation of the results and sensitivity analysis. Based on all of this, it was shown that fuzzy methods can be used in the selection of insurance companies.

The subject of this research is the evaluation of electric cars and the choice of car that best meets the set research criteria. To this end, the criteria weights were determined using the entropy method with two-step normalization and a full consistency check. In addition, the entropy method was extended further with q-rung orthopair fuzzy (qROF) information and Einstein aggregation for carrying out decision making under uncertainty with imprecise information. Sustainable transportation was selected as the area of application. The current work compared a set of 20 leading EVs in India using the proposed decision-making model. The comparison was designed to cover two aspects: technical attributes and user opinions. For the ranking of the EVs, a recently developed multicriteria decision-making (MCDM) model, the alternative ranking order method with two-step normalization (AROMAN), was used. The present work is a novel hybridization of the entropy method, full consistency method (FUCOM), and AROMAN in an uncertain environment. The results show that the electricity consumption criterion (w = 0.0944) received the greatest weight, while the best ranked alternative was A7. The results also show robustness and stability, as revealed through a comparison with the other MCDM models and a sensitivity analysis. The present work is different from the past studies, as it provides a robust hybrid decision-making model that uses both objective and subjective information.

3117 Background: TAPUR is a phase II basket study evaluating antitumor activity of commercially available targeted agents in pts with advanced cancers with genomic alterations. Results in cohorts of pts with breast cancer (BC) and other solid tumors with PIK3CA mut treated with T are reported. Methods: Eligible pts had BC or other solid tumors, measurable disease, ECOG performance status (PS) 0-2, adequate organ function, and no standard treatment (tx) options. Genomic testing was performed in CLIA-certified, CAP-accredited site selected labs. After antihistamine pre-tx, 25 mg of T was infused over 30-60 minutes once weekly until disease progression. Primary endpoint was disease control (DC), defined as complete or partial (PR) response, or stable disease of at least 16+ weeks (wks) duration (SD16+) per RECIST v1.1. For the BC cohort, Simon’s optimal 2-stage design with null DC rate of 15% vs. 35% (power=0.85, α=0.10) was used with stage 1 (n=10) stopping for futility if < 2/10 pts had DC. Low accruing histology-specific cohorts with PIK3CA and T tx were collapsed into 1 histology-pooled (HP) cohort. For the HP cohort, the hypothesized null DC rate of 15% was evaluated by a 1-sided exact binomial test with α=0.10. Secondary endpoints were progression-free survival (PFS), overall survival (OS), and safety. Results: 12 pts with PIK3CA mut with BC and 29 pts with PIK3CA mut in other solid tumors (across 9 tumor types) were enrolled. 2 pts (1 in each cohort) were found to be ineligible after enrolling and were not included in efficacy analyses. Demographics and outcomes for each cohort are shown. At the end of stage 1 in the BC cohort, 1 PR was observed for DC and OR rates of 9%; the cohort was closed for futility (p=0.83). For the HP cohort, 3 PR and 5 SD16+ were observed for DC rate of 29% (p=0.049) and OR rate of 11%; the null hypothesis was rejected. Cancer types in pts with OR or SD16+ included cervical, ovarian and head/neck; most common muts were H1047R/L (3), E545K (2) and E542K (2). 1 pt with ovarian and H1047R has ongoing PR at 86 wks. 11/41 pts had ≥1 tx-related grade 3-4 adverse or serious adverse event, including anemia, headache, hyperglycemia, hypertension, hypertriglyceridemia, mucositis oral, lymphocyte, neutrophil or platelet count decrease, pneumonitis, and sepsis. Conclusions: Although T does not appear to have antitumor activity in pts with BC with PIK3CA mut, it does show antitumor activity in pts with other solid tumors with PIK3CA mut and warrants further study. Clinical trial information: NCT02693535 . [Table: see text]

3115 Background: TAPUR is a phase II basket study evaluating antitumor activity of commercially available targeted agents in pts with advanced cancers with specific genomic alterations. Results in a cohort of pts with solid tumors with BRCA1/2 mut treated with Tala are reported. Methods: Eligible pts had measurable disease, ECOG performance status (PS) 0-2, adequate organ function, and no standard treatment (tx) options. Genomic testing was performed in CLIA-certified, CAP-accredited site selected labs. Pts received 1 mg of Tala orally daily until disease progression. Primary endpoint was disease control (DC) per investigator defined as complete (CR) or partial (PR) response or stable disease (SD) of at least 16+ weeks (wks) duration (SD16+) per RECIST v1.1. The hypothesized null DC rate of 15% was evaluated by a 1-sided exact binomial test (alpha 0.10; 82% power). Secondary endpoints were progression-free survival (PFS), overall survival (OS), duration of response (DOR) and SD, and safety. DOR is defined as time from pt’s first documented objective response (OR) to progressive disease (PD). Duration of SD is defined as time from tx start to PD. Results: 28 pts with 16 solid tumors (6/28 pts had lung cancer) with BRCA1 (n=9) , BRCA2 (n=16) , or BRCA1/2 (n=3) mut were enrolled from Dec 2019 to Sept 2021. All pts were included in efficacy analyses. Demographics and outcomes are shown. 1 CR, 9 PR and 6 SD16+ were observed for a DC rate of 57% (1-sided 90% CI: 43% to 100%) and an OR rate of 36% (95% CI: 19% to 56%); the null hypothesis of a 15% DC rate was rejected (p<0.001). 11/16 pts with OR or SD16+ had a BRCA2 mut, 4 had BRCA1 mut, and 1 had both. The pt with a CR (duration of 93 wks) had non-melanoma skin cancer, with BRCA2 and ATM muts, and was microsatellite instability high with 41 muts per megabase. Pts with PR had various solid tumors; 6/9 pts had BRCA2 mut, 2 had BRCA1 mut , 1 had both. Of pts with DC, 11 had tumor types for which PARP inhibitors are not yet FDA approved. Median duration of PR was 20 wks (range, 11-80). 10/16 pts with DC had a co-alteration in the 24 homologous recombination-related genes examined, mainly ATM (3) or ARID1A (2). 13 pts had ≥1 grade 3 tx-related adverse or serious adverse events including: anemia, AST or bilirubin increase, hyponatremia, nausea, vomiting, neutrophil, platelet, or white blood cell decrease. Conclusions: Tala demonstrated antitumor activity in heavily pretreated pts with advanced solid tumors with BRCA1/2 mut. Additional study is warranted to confirm the efficacy of Tala in non-breast, non-ovarian cancer pts with BRCA1/2 mut. Clinical trial information: NCT02693535 . [Table: see text]