The advantage of living in cities compared with rural areas with respect to height and BMI in children and adolescents has generally become smaller globally from 1990 to 2020, except in sub-Saharan Africa. Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being^ 1 – 6 . Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m^–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.

Brassica oleracea var. acephala (kale) is a worldwide known vegetable plant, known for its heavy metal accumulation abilities. This study analyzed the phytoremediation potential of domestic BiH kale varieties, grown in a controlled environment and with different concentrations of Cadmium (Cd). Cd is a known pollutant found in small concentrations in soil under normal environmental conditions. Real-Time PCR was used to analyze the gene expression activity of Cd heavy metal correlated genes (MAPK2 and NRAMP6). The root analysis assay confirmed shorter root length after Cd treatment, confirming severe Cd impact on plant cell growth, implying shorter growth in roots in all treated kales. Gene expression results showed that Cd triggers the expression of MAPK2 and NRAMP6 suggesting their significant involvement in Cd metabolizing processes. Based on the combined results, kale from the Stolac region is found to be the most resistant variety, while the only hybrid kale, accumulates the most Cd suggesting its phytoremediation potential.

Background: Heart attack, or cardiac arrest, became a leading cause of death after the turn of the century. Defibrillation is one of the most important medical advances of the twentieth century. Defibrillation is a critical step in the treatment of cardiac arrest as it can be the only way to restore a normal heart rhythm and save the life of the individual. However, it is important to note that defibrillation is only effective if it is performed quickly and in conjunction with other life-saving measures such as cardiopulmonary resuscitation (CPR). The history of cardiac defibrillation therapy is long and fascinating, spanning several centuries, many countries and continents. Objective: The aim of this article was to provide historical information about technical and scientific advances in cardiac devices and the development of today defibrillators. Methods: Review of the available literature, historical data, personal contacts, others and personal experience in this field. Discussion: In 1947, Beck published the first paper describing open chest defibrillation of the human heart. Ten years later, Kouwenhoven demonstrated that the heart could be defibrillated through a closed chest. The first external defibrillator weighed 120 kg and delivered 500 v of alternating current (AC) potential. The mere size of the defibrillator restricted its use to surgical suites or other areas hospital locations. In many cases, cardiac arrhythmias recurred. This was thought to be related to the amount of energy used to defibrillate the heart which it was believed caused myocardial damage. These factors limited the practical application of defibrillators. By 1956, a unit was built that could be wheeled into the emergency room, plugged into a wall outlet, and deliver 1000 volts. By 1962, Lown realized that AC current resulted in a high frequency of cardiac arrhythmias and cardiac damage. A direct current (DC) defibrillator, consisting of a battery, a capacitor to store energy, and a transformer was developed. The therapy spread from operating rooms to coronary care units and emergency departments and in the late 1960s left the hospital and started appearing on mobile intensive care units. The first portable EMS defibrillators (used by paramedics) emerged in the early 1970s. In 1980 the automatic implantable cardioverter-defibrillator was invented. Automated external defibrillators began appearing in the late 1980s allowing the therapy to be delivered by EMTs and lay people. The ‘father’ of the modern automated external defibrillator (AED), Professor James Francis (1916-2004) was a physician and cardiologist from Northern Ireland who transformed emergency medicine and paramedic services with the invention of the portable defibrillator. Conclusion: Defibrillators are critical resuscitation devices. The use of reliable defibrillators has led to more effective treatments and improved patient safety through better control and management of complications during Cardiopulmonary Resuscitation (CPR). The 75th anniversary of the world’s first successful human cardiac defibrillation represents the landmark event that defined the future of cardiovascular medicine and ushered in a new era of advanced cardiac life support.

Introduction Posttraumatic stress disorder in the paediatric population has clinical features. The Clinician-Administered PTSD Scale for DSM-5,child and adolescent version (CAPS-CA-5) is the gold standard for the positive diagnosis. Objectives The objectives of our work were to translate the CAPS-CA-5 into Tunisian dialectal Arabic and to validate it in our Tunisian sociocultural context. Methods This is a descriptive cross-sectional study conducted in the child psychiatry department of Mongi Slim Hospital and the forensic medicine department of Charles-Nicolle Hospital (Tunisia), among children older than seven years who were exposed to a potentially traumatic event at least one month before. We validated the tool through translation, content, construct validity and reliability. The statistical processing for this data was carried out using SPSS 26 software. Results We conducted our study with 150 patients. The validation was made on 146 records after the exclusion of 4 incompleted assessments. We initially translated the CAPS-CA-5 into Tunisian dialect. We validated the content through pre-test and scientific committee evaluation. Afterwards, we validated the construction. We calculated the Bartlett’s sphericity test (p<0.001) .The KMO index that was 0.766. Concerning the reliability study, we found a Cronbach’s alpha coefficient equal to 0.92. We studied also the inter-raters reliability; we found an intra-class coefficient between 0.8 and 1 Conclusions We validated the first Tunisian diagnostic tool for PTSD in children according to the DSM-5 criteria with satisfactory psychometric qualities. Disclosure of Interest None Declared

Background: The genetic structure of each population can be explained according to the frequency of genes and their allelic variants, genotypes, and phenotypes. Objective: To analyze the genetic heterogeneity of the working-age population from the area of Sarajevo Canton based on classic genetic markers. The studied parameters of genetic heterogeneity were assessed by the relative frequency of the recessive allele for static-morphological traits (earlobe shape, chin shape, hairiness of the middle digital phalanx, bending of the distal phalanx of the little finger and digital index) and dynamic-morphological traits (rolling of the tongue into a groove, extensibility of the proximal thumb knuckle, extensibility of the distal thumb knuckle, the way the forearms are crossed, and the way the fists are made). Results: The results of the t-test showed a significant difference in the manifestation of the recessive homozygote for the observed parameters of qualitative variation in the subsamples of men and women. Only for two traits (attached earlobe and hyperextensibility of the distal knuckle of the thumb). The selected sample represent a relatively genetically homogenous population. Conclusion: This study serves as a valuable source of data for future research and the formation of a genetic database in Bosnia and Herzegovina.

Heat-related biomarkers: Focus on the correlation of troponin I and 70 kDa heat shock protein Abstract Introduction: There is intensive research related to the forensic importance of biomarkers that would be the standard for postmortem damage to cardiomyocytes and the mechanism of the resulting damage. The aim of the research was to examinate the forensic-medical significance of serum levels of biomarkers as detectors of terminal hyperthermic damage to the myocardium. MATERIAL AND METHOD 40 laboratory animals were divided into groups: the first group was the control (n = 8) exposed to a physiological temperature of 37 °C, the second group was divided into two subgroups: antemortem (n = 8) and postmortem (n = 8), which included a exposure temperature of 41 °C and the third group was divided into two subgroups: antemortem (n = 8) and postmortem (n = 8), which included a exposure temperature of 44 °C. The concentration of cardiac TnI and Hsp70 was resoluted in serum by immunochemical enzyme-labeled immunoabsorption method. RESULTS A positive correlation was found between the temperature measured at the time of death and the serum values of cTnI (p = 0.02), in G41, and Hsp70 values did not significantly correlate with the core temperature in this group, p > 0.005. A positive correlation was significant between the concentration of Hsp 70 and the body temperature of rats in the group of rats with a fatal outcome was determined, p = 0.03. CONCLUSION Changes in the concentration of cTnI and Hsp70 in rat serum may indicate hyperthermic damage to the myocardium in the Wistar rat model of heat stroke.

Background: It is crucial to evaluate children’s motor coordination and strength to identify possible motor deficits on the right or left side of the body. However, whether a distinction exists in children aged 3–6 must be clarified. The goal of the current research was to investigate the differences in motor skills between preschool boys and girls, dominant and non-dominant hands or legs, in children of preschool age. (2) Methods: The present study was conducted on a sample of children (boys, n = 52; girls, n = 52; age range, 3–6 years). Three motor tests evaluated on both sides of the body served as the sample of factors used to measure athletic performance. Leg tapping (15 s), hand tapping (15 s), and a maximal hand grip strength (HGS) test kg. (3) Results: The study’s findings show no statistically significant variations in preschool boys’ and girls’ motor skills. Preschool girls had better results in the right leg tapping than preschool boys t (98) = 2.08; p ≤ 0.04. We found a significant difference between genders aged 3–4, 4–5, and 5–6 years. No correlation was found between the girls’ three variables and age. A small but significant positive correlation was found between dominant hand tapping and age r2 (52) = 0.21; p ≤ 0.01, dominant leg tapping and age r2 (52) = 0.20; p ≤ 0.01 and dominant HGS and age r2 (52) = 0.17; p ≤ 0.01. No noticeable differences were identified when comparing the dominant side with the non-dominant side in each group. The results show that most children prefer to use their right hand and right leg as their dominant sides. (4) Conclusion: The authors of this study focus on the functional (frequency of movements) and dynamic (differences in muscle strength between body sides) elements of asymmetry. Future studies should examine the influence of morphology on performance with the dominant or non-dominant body side.

Objective: Sacrococcygeal teratoma is an extragonadal germ cell tumor that develops during fetal and neonatal periods and is associated with significant perinatal morbidity and even mortality. This study aimed to determine the clinicopathologic characteristics, the clinical outcomes, and postoperative complications of sacrococcygeal teratoma cases in the low-volume pediatric surgery service in a developing country. Materials and Methods: The study included data from all sacrococcygeal teratoma cases diagnosed from 2011 to 2020. All the relevant clinicopathologic data were recorded and analyzed. Results: A total of 7 pediatric (5 females and 2 males) patients with sacrococcygeal teratoma were identified, ranging in age from 3 to 222 days. A prenatal diagnosis was made in 57.1% of cases. The mean gestational age for all cases was 37.1 weeks (34-38 weeks), and the mean birth weight was 3285 g (range, 2300-4700 g). Preoperative alpha-fetoprotein levels had a mean value of 24.327 ng/mL (range, 649.7-110.600 ng/mL). The surgery involved resection of the primary tumor and coccygectomy in all cases. Three (42.9%) tumors were classified as Altman type II lesions, 2 (28.6%) tumors were type IV, and 2 remaining cases were types I and III, respectively. Histology was benign in 4 (57.1%) and immature in 3 patients (42.9%). The mean follow-up time was 101.4 months (30-146 months), with 2 recurrences of high-grade immature teratomas at 11 and 30 months following the surgery. Three patients had postoperative bladder and rectal dysfunctions. Conclusion: Sacrococcygeal teratomas are rare tumors associated with frequent postoperative dysfunctions. Recurrences may also be seen, particularly in immature, high-grade forms of sacrococcygeal teratomas.

Background: Cerebrovascular accidents (CVI) are considered the second most serious complication in cardiac surgery patients with a frequency of 10%. By preventing complications of surgical treatment, using a Color Doppler ultrasound (CDU) device, in the population of cardiac surgery patients, the unplanned costs of prolonged postoperative treatment would be reduced. Objective: To prove that the acquisition and use of the newly developed CDU device “Affinit 30” is completely economical, profitable and medically justified. Methods: Numerical parameters of the treatment of cardiovascular patients were analyzed (number of procedures, number of days in the intensive care unit, cost of additional consultative services of the clinic for radiology and neurology), and the calculated economic value of the potential investment, as well as the cost of preventing surgical complications, by purchasing and installing a new modern CDU device. Results: The profitability of the investment was assessed using the economic parameters Net Present Value (NPV) of the investment, Internal rate of return (IRR) and Profitability Index (PI). A mathematical calculation with the given parameters yields NPV = 948,850 KM and IRR of 273% when applied to the given parameters. The PI value is 12.6, which matches the previously calculated NPV and IRR values. Conclusion: The acquisition and use of the newly developed CDU device “Affinit 30” is economically profitable and medically justified. This is shown by the calculated values of the economic parameters Net Present Value of the investment (NPV), Internal rate of return (IRR) and the Profitability Index (PI).

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Abstract Anti-proliferative effects of halogenated boroxine – K2(B3O3F4OH) (HB) – have been confirmed in multiple cancer cell lines, including melanoma, but the exact mechanism of action is still unknown. This study aimed to determine its cytotoxic effects on human Caucasian melanoma (GR-M) cell growth in vitro as well as on the expression of cell death-related genes BCL-2, BECN1, DRAM1, and SQSTM1. GR-M and peripheral blood mononuclear (PBM) cells were treated with different HB concentrations and their growth inhibition and relative gene expression profiles were determined using the Alamar blue assay and real-time PCR. HB significantly inhibited cell growth of both GR-M and PBM cells but was even more effective in GR-M melanoma cells, as significant inhibition occurred at a lower HB concentration of 0.2 mg/mL. GR-M BCL-2 expression was significantly downregulated (P=0.001) at HB concentration of 0.4 mg/mL, which suggests that HB is a potent tumour growth inhibitor. At the same time, it upregulated BCL-2 expression in normal (PBM) cells, probably by activating protective mechanisms against induced cytotoxicity. In addition, all but the lowest HB concentrations significantly upregulated SQSTM1 (P=0.001) in GR-M cells. Upregulated BECN1 expression suggests early activation of autophagy at the lowest HB concentration in SQSTM1 cells and at all HB concentrations in PBM cells. Our findings clearly show HB-associated cell death and, along with previous cytotoxicity studies, reveal its promising anti-tumour potential.