Highlights What are the main findings? In-hospital adverse events were associated with higher 30-day mortality after hip fracture surgery. Baseline-only models, based on the ASA PS Classification, the Charlson Comorbidity Index, and the Elixhauser Comorbidity Index, showed broadly comparable discrimination for 30-day mortality in this cohort. What are the implications of the main findings? Routinely available comorbidity indices provided broadly similar short-term risk stratification, although their discrimination was acceptable rather than perfect. In-hospital adverse events should be interpreted as time-dependent clinical events associated with mortality rather than baseline predictors or evidence of causality. Abstract Background/Objectives: Hip fractures are associated with high short-term mortality in older adults. This study aimed to determine 30-day mortality after hip fracture surgery and evaluate factors associated with short-term mortality, with particular attention to baseline comorbidity indices and in-hospital adverse events. Methods: This retrospective cohort study included 785 patients who underwent surgery for hip fracture at University Hospital of Split, Croatia, between January 2021 and December 2022. Clinical data were extracted from medical records. The primary outcome was 30-day mortality, including in-hospital and post-discharge deaths. Associations with mortality were examined using univariable and multivariable logistic regression. Baseline-only comorbidity models were constructed using the American Society of Anesthesiologists Physical Status Classification System (ASA PS Classification), the Charlson Comorbidity Index (CCI), and the Elixhauser Comorbidity Index (ECI). Exploratory hospital-course models additionally included in-hospital adverse events, which were interpreted as time-dependent hospital-course events rather than baseline predictors. Results: 30-day mortality was 11.0% (86/785). Older age, male sex, higher comorbidity burden, and in-hospital adverse events were associated with mortality. Mortality was 5.7% without documented adverse events, 24.2% with one adverse event, and 42.4% with two or more adverse events. Baseline-only comorbidity models showed acceptable and broadly comparable discrimination, with AUCs of 0.73–0.77. Exploratory hospital-course models showed higher discrimination, with AUCs of 0.80–0.82. Conclusions: 30-day mortality after hip fracture surgery was associated with baseline patient vulnerability and in-hospital adverse events. Baseline-only models based on the ASA PS Classification, the CCI, and the ECI provided broadly comparable short-term risk stratification. In-hospital adverse events should be viewed as markers of an adverse clinical trajectory, not evidence of causality.

This study investigated the role of teaching experience in delivering gymnastics content in Slovak primary schools, offering evidence for future interventions and curriculum development. A total of 1 246 primary school teachers participated in a cross-sectional, quantitative study using an online questionnaire. Participants were divided into two cohorts: teachers with ˂ 10 years (N = 508) of teaching experience and teachers with ≥ 10 years (N = 738) of teaching experience. Descriptive statistics and chi-square tests (χ²) were used to identify significant differences between the groups across various indicators. Both cohorts identified Gymnastics and Dance as among the most demanding areas of Physical Education curriculum. Teachers with ≥ 10 years of teaching experience more frequently used traditional gymnastics apparatus, whereas teachers with ˂ 10 years of teaching experience tended to adopt non-traditional or mixed approaches. Significant differences were found in apparatus use (p < .01) and perceived challenges in specific thematic units (p < .01). Smaller but still significant differences were also observed in the evaluation of material (technical) conditions (p = .02), with most teachers in both groups rating them as “Sufficient” or “Good” and equipment preferences (p = .05). Teaching experience influences teaching gymnastics in Slovak primary schools. While teachers with ≥ 10 years of teaching experience adhere more to traditional methodology, teachers with ˂ 10 years of teaching experience are more inclined toward innovative and blended practices. Despite pedagogical differences, both groups face systemic limitations in infrastructure and equipment. The findings underscore the need for differentiated professional development and improved material support to enhance gymnastics education at the primary level.

Teaching assistants are essential for inclusion because they provide individualized support that enables children with developmental disabilities to participate, learn and thrive alongside their peers in mainstream educational settings. The aim of study is to examine differences in the attitudes of parents of children with developmental disabilities and parents of children with autism spectrum disorder (ASD) regarding their children’s inclusive education. The study sample consisted of parents of children with ASD and other developmental disabilities. A random sample include 62 parents of children with different types of disabilities (ASD=30; other developmental disabilities=32). To examine parents’ attitudes, the questionnaire “Attitudes of Parents of Children with disabilities toward Teaching Assistants in the Tuzla Canton” was developed specifically for the purposes of this study. The findings indicate there are no statistically significant differences in attitudes toward teaching assistants between parents of children with ASD and those of children with other developmental disabilities and no significant relationship was found between the child’s age and parental attitudes. By providing insight into parental attitudes, the study contributes to a better understanding of the perceived value and challenges of assistant support in inclusive education and offers a foundation for future research and policy development in this field.

Introduction/Objectives: Patient-centered communication is essential in oncology care, where healthcare professionals often manage emotionally demanding conversations, uncertainty, complex decisions, and patient involvement in care. However, the relationship between communication knowledge, empathic listening, and practical communication skills remains insufficiently examined. This study aimed to examine the associations between communication knowledge, empathic listening, and interpersonal communication skills among healthcare professionals involved in oncology care. Methods: A cross-sectional study was conducted in Croatia from May to November 2025 on a convenience sample of 138 healthcare professionals involved in oncology care. Communication knowledge was assessed using a study-specific questionnaire, empathic listening using an adapted Active Empathic Listening Scale, and interpersonal communication skills using an adapted Interpersonal Communication Skills Inventory. Because the instruments were adapted to the oncology care context, their dimensions were examined using exploratory factor analysis and interpreted as sample-specific exploratory constructs. Descriptive statistics, correlation analyses, and multiple linear regression analyses were performed. Results: Clear message delivery and assertiveness had the highest self-reported score, whereas emotional interaction management had the lowest. Communication knowledge was not an independent predictor of communication skills dimensions. Processing and responding positively predicted clear message delivery and assertiveness (β = 0.361; p = 0.001; R2 = 13.4%), while noticing emotional and nonverbal cues negatively predicted emotional interaction management (β = −0.234; p = 0.032; R2 = 7.6%). The explained variance of the models was low. Conclusions: The findings suggest limited but potentially relevant associations between selected dimensions of empathic listening and self-reported communication skills in oncology care. Communication knowledge, measured using a study-specific exploratory instrument, was not independently associated with communication skills. Because of the exploratory design, self-report measures, adapted instruments, and convenience sampling, the results should be interpreted with caution.

This study explores the drivers of social network site (SNS) users’ purchase intentions for products recommended by influencers. Drawing on social cognitive theory (SCT) and the cognition-affection-behavior (CAB) model, it investigates the factors influencing users’ decisions to follow social media influencers (SMIs) and their affective commitment toward these influencers, which in turn impacts purchase intentions. Specifically, this study examines the roles of social interaction ties, social norms, personal outcome expectations and trust in shaping users’ emotional attachment to influencers. By empirically testing the conceptual framework, this research identifies affective commitment as a key mediator between cognition and purchase intentions. Specifically, the findings show that cognitive evaluations (concretely, trust and personal outcome expectations) significantly drive affective commitment, which in turn strengthens purchase intentions. This evidence underscores the sequential role of cognitive and affective mechanisms in explaining influencer marketing effectiveness. This research contributes to the influencer marketing literature and provides practical insights for selecting influencers who can effectively drive purchase intentions, offering valuable input for brands, influencers, and policymakers in the rapidly growing digital marketing landscape.

OBJECTIVE To evaluate perineal length and thickness during labor and to assess their association with any spontaneous perineal tear. STUDY DESIGN This prospective study included 221 women with term singleton pregnancies and cephalic presentation. Perineal length and thickness were measured in early labor (≤4 cm cervical dilatation) and reassessed in the second stage (full dilatation). The primary outcome was any spontaneous perineal tear, including grades I-IV. Multivariable logistic regression analysis was performed to assess these associations, adjusting for parity, body mass index and birth weight. RESULTS Spontaneous perineal tears occurred in 31 women (14.0%). In multivariable analysis, shorter perineal length in the first stage of labor was independently associated with higher odds of spontaneous tear (OR 0.42; 95% CI 0.20-0.86; p = 0.018). In the second-stage model, greater perineal thickness was independently associated with higher odds of spontaneous tear (OR 2.34; 95% CI 1.08-5.05; p = 0.031). BMI, parity, and neonatal birth weight were not independently associated with the outcome. In sensitivity analyses with additional adjustment for episiotomy, perineal morphometric characteristics were no longer statistically significant. CONCLUSION Shorter perineal length in early labor and greater perineal thickness at full dilatation were associated with any spontaneous perineal tear in primary multivariable analyses. However, after additional adjustment for episiotomy in sensitivity analyses, these associations were no longer statistically significant. These findings suggest an association between perineal morphometry and spontaneous perineal tears, but do not support using perineal measurements as standalone markers.

The primary objective of this study was to analyze the frequency of alleles and genotypes of the G894T polymorphism of the endothelial nitric oxide synthase (eNOS) gene and the insertion-deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene in relation to body mass index (BMI) and biochemical parameters. The study included 64 subjects. Analysis of genotype distribution of the eNOS G894T polymorphism in relation to BMI showed that the GT+TT genotype was present in 11 subjects with BMI ≤ 24.9 and in 25 subjects with BMI ≥ 25. For the ACE I/D polymorphism, the ID+DD genotype was detected in 10 subjects with BMI ≤ 24.9 and in 36 subjects with BMI ≥ 25. No statistically significant differences in allele or genotype frequencies were observed between BMI groups (p > 0.05). Regarding biochemical parameters, although the differences lacked statistical significance (p > 0.05), GT+TT genotypes (eNOS G894T) were more frequent in subjects with elevated glucose, total cholesterol, and triglyceride levels compared to the GG genotype. Similarly, the analysis revealed no statistically significant association between the ACE I/D polymorphism and the examined biochemical parameters (p > 0.05). A major limitation of the present study is the relatively small sample size; therefore, these findings should be considered preliminary. Nevertheless, the specific trends observed in genotype distribution represent an important indicator in investigating the potential role of these polymorphisms in the genetic background of the metabolic profile. Thus, further research on larger and more homogeneous cohorts is necessary to elucidate this potential significance.

ABSTRACT Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune, demyelinating disorder of the central nervous system. Clinical manifestations include optic neuritis, longitudinally extensive transverse myelitis (LETM) involving three or more vertebral segments, and, in most cases, seropositivity for anti‐aquaporin‐4 antibodies (AQP4‐IgG). Although longitudinally extensive transverse myelitis (LETM) is a hallmark feature of NMOSD, it is not pathognomonic and may occur in a variety of infectious, metabolic, neoplastic, and autoimmune conditions, including systemic lupus erythematosus (SLE). Here we report the case of a female patient who presented with severe tetraparesis, secondary to transverse myelitis. Serological evaluation revealed positivity for anti‐AQP4 antibodies, anti‐dsDNA antibodies, and ENA antibodies, leading to the simultaneous diagnosis of NMOSD and SLE. Nevertheless, it remained uncertain whether the transverse myelitis represented a manifestation of NMOSD or neurological involvement of SLE.

Ensuring the quality, safety, and functional performance of stem cell cultures remains a critical challenge in biomedical research, drug development, and emerging cell-based therapies, as early metabolic disturbances can compromise outcomes and therapeutic efficacy. Glucose (Glu) consumption and L-lactate (LA) production serve as central indicators of cellular bioenergetic state, stress, and viability. However, conventional analytical approaches rely on discontinuous, labor-intensive assays that disrupt workflows and limit early intervention. Here, we report a miniaturized electrochemical biosensing platform for serial time-resolved analysis of Glu and LA in human induced pluripotent stem cell (hiPSC) culture media using a micropillar array (MPA)-based microfluidic electrochemical device (MED). The device exhibits linear detection ranges of 0.5-35 mM for Glu and 0.5-40 mM for LA, with limits of detection (LODs) of 0.18 ± 0.01 mM and 0.19 ± 0.01 mM, respectively. Using serially collected culture media, the MED quantifies dose-dependent metabolic responses to mitochondrial inhibition with oligomycin, revealing suppressed metabolic turnover and altered Glu-LA coupling prior to observable morphological changes. By enabling paired metabolic readouts from small-volume, undiluted culture-media samples, this platform provides a practical analytical route toward earlier recognition of culture-state deviations and more informed monitoring of stem-cell culture quality and drug-induced metabolic responses.

Context: This paper explores the potential of transformative learning theory (TLT) to serve as a framework for career counsellor training. Currently, due to the lack of a study program in career guidance and counselling (CGC), lack of standard in this regard, as well as the underdevelopment of the profession in Bosnia and Herzegovina (BiH), practitioners working in CGC have different professional backgrounds ranging from education sciences, psychology, social work or related disciplines who develop competencies in career counselling either through non-formal programs or self-directed learning. This diverse entry into the practice of CGC highlights the need for a well-founded training program developing relevant competencies and professional ethics. Approach: TLT is found to be particularly relevant in this context as it fosters personal development by encouraging individuals to revise their perspective and frames of reference. To empirically explore this assumption, the study employed Interpretative Phenomenological Analysis (IPA) to examine the experiences of trainees coming from diverse professional backgrounds who participated in training programs for career counsellors. In-depth interviews were conducted with ten participants who completed the training capturing their subjective interpretations and meaning-making processes. Findings: Analysis revealed that trainees experienced transformative learning across three key processes. First, they expanded and revised their existing systems of knowledge related to CGC. Second, they engaged with new meaning schemes associated with CGC and attempted to internalize them. Finally, participants recognized the limitations of their previous frames of reference and reported a conscious effort to reorganize and transform them in the context of CGC. The findings suggest that the training programs created conditions that facilitated transformative learning, which participants described as both professionally and personally empowering. Conclusions: Data show that TLT provides a valuable theoretical and practical framework for training career counsellors, especially in such contexts where trainees come with already formed professional identities. By focusing on meaning-making and personal development, TLT encourages deep, reflective learning that enhances counsellors’ capacity to support others in career learning. This research offers a theoretically-relevant insight and practical implications for the design of a training program in CGC.

The photoacid 8-hydroxypyrene-1,3,6-trisulfonate (HPTS) is one of the most widely used fluorescent probes for studying proton transfer and local pH in systems from advanced materials to plants, environmental sensors to medicine. HPTS exists as two different species: the acid and its conjugate base, which lead to unique protonation-state-dependent translocation of the molecule when it is nanoconfined within anionic AOT reverse micelles. Using steady-state and time-resolved optical spectroscopy, molecular simulations, and IR solvation shell spectroscopy, we report that the protonated HPTS species associates strongly with the micelle interface via hydrogen bonding. In contrast, its deprotonated species resides in the micelle's aqueous interior. Our results show that photoexcitation of the acid species and its subsequent deprotonation leads the conjugate base to rapidly move away from the interface into the water pool. This light-induced translocation, an effect observed for a range of micelle sizes, challenges the prevailing view where molecular probes are assumed to be static reporters of their environments, remaining in a fixed location for the duration of an experiment. This is especially relevant for interpreting results in the numerous studies enlisting optical spectroscopy of HPTS to report on complex systems. Our findings reveal the potential for molecular probes as dynamic explorers capable of mapping environmental heterogeneity on the timescale of the very processes they are designed to measure.