Pomegranate has shown a favorable effect on gingivitis/periodontitis, but the mechanisms involved are poorly understood. The aim of this study was to test the effect of pomegranate peel extract (PoPEx) on gingiva-derived mesenchymal stromal cells (GMSCs) under physiological and inflammatory conditions. GMSC lines from healthy (H) and periodontitis (P) gingiva (n = 3 of each) were established. The lines were treated with two non-toxic concentrations of PoPEX (low—10; high—40 µg/mL), with or without additional lipopolysaccharide (LPS) stimulation. Twenty-four genes in GMSCs involved in different functions were examined using real-time polymerase chain reaction (RT-PCR). PoPEx (mostly at higher concentrations) inhibited the basal expression of IL-6, MCP-1, GRO-α, RANTES, IP-10, HIF-1α, SDF-1, and HGF but increased the expression of IL-8, TLR3, TGF-β, TGF-β/LAP ratio, IDO-1, and IGFB4 genes in H-GMSCs. PoPEx increased IL-6, RANTES, MMP3, and BMP2 but inhibited TLR2 and GRO-α gene expression in P-GMSCs. LPS upregulated genes for proinflammatory cytokines and chemokines, tissue regeneration/repair (MMP3, IGFBP4, HGF), and immunomodulation (IP-10, RANTES, IDO-1, TLR3, COX-2), more strongly in P-GMSCs. PoPEx also potentiated most genes’ expression in LPS-stimulated P-GMSCs, including upregulation of osteoblastic genes (RUNX2, BMP2, COL1A1, and OPG), simultaneously inhibiting cell proliferation. In conclusion, the modulatory effects of PoPEx on gene expression in GMSCs are complex and dependent on applied concentrations, GMSC type, and LPS stimulation. Generally, the effect is more pronounced in inflammation-simulating conditions.

The implementation of disruptive technologies of Industry 4.0 is carried out in all segments of society, but we still do not fully understand the breadth and speed of its application. We are currently witnessing major changes in all industries, so that new business methods are emerging, as well as transformation of production systems, new form of consumption, delivery and transport. All this is happening due to the implementation of disruptive technological discoveries that include: the Internet of Things (IoT), advanced robotics, smart sensors, Big Data, analytics, cloud computing, 3D printing, machine learning, virtual and augmented reality (AR), artificial intelligence, and productive maintenance. Advanced robotics is one of the most important technologies in Industry 4.0. The robotic application in the automation of production processes, with the support of information technology, leads us to ‘’smart automation’’, i.e., ‘’smart factory’’. The changes are so profound that, from the perspective of human history, there has never been a time of greater promise or potential danger. New generation robots have many advantages compared to the firstgeneration industrial robots such as: they work alongside with workers, workers perform their tasks in a safe environment, robots take up less space, robots do not need to be separated by fences, robots are easy to manipulate and cheaper to implement. The paper analyzes the trend of implementation of collaborative and service robots for logistics, which make the automation of production processes more flexible. Robotic technology is the basic technology of Industry 4.0, because without its application, the implementation of Industry 4.0 would not be possible. The trend of application of new generation robots will have an increasing character in the future, because the goals of the fourth industrial revolution cannot be achieved without collaborative robots. In other words, the objective is to achieve a ‘’smart production process’’ or ‘’smart factory’’.

Since the introduction of the concept of Industry 4.0 until today, the world is facing a series of changes resulting from intensive scientific, technical and technological innovations. Research, innovation and development changes are aimed at improving production, business and everyday life through the application of basic technologies of Industry 4.0. In order for individuals, organizations, communities and states to be able to use the benefits of these improvements, it is necessary to rapidly adapt to all innovative trends: developing the necessary skills of individuals and groups for the adoption and use of these technologies, the implementation of technologies in companies, organizations and institutions, and the development of appropriate strategies that these processes would be managed and directed. In the developed world, these I 4.0 implementation processes are already reaching their maturity: educational programs are adapted to the needs of monitoring technical-technological changes, companies deal with solving challenges related to these processes after the implementation of Industry 4.0 technologies, and states and communities are working on devising further directions of development and a strategy that will further accelerate changes. In Bosnia and Herzegovina, the processes are somewhat slower: educational programs partially follow the needs of education for Industry 4.0, companies struggle with the challenges of adopting and implementing Industry 4.0 without adequate institutional support, and strategies related to exploiting the opportunities of Industry 4.0 have not been developed, both due to the lack of initiative, as well as due to administrative restrictions related to the complex political system of Bosnia and Herzegovina. Considering that, this paper presents the results of research on the representation of Industry 4.0 technologies in the economy and education of Sarajevo Canton. The sample on which the research was conducted included 105 companies and 239 respondents from the general population. The results show that the highest level of application of Industry 4.0 technologies exists in the part related to the advanced management of company resources using planning and management support systems, and in communications. These findings, as well as the results related to the established level of knowledge of Industry 4.0 technologies in the general population, speak in favor of the need for the urgent development of various educational programs that will accelerate the learning of Industry 4.0 among all members of the community, as well as the establishment of state programs to support the implementation of technologies in companies, so that the economy of the Canton and the country as a whole would not fall behind in relation to the world driven by the fourth industrial revolution.

Digital twins represent a new paradigm that brings fundamental changes to business and asset management. The proliferation of connected devices and sensors has generated vast amounts of data from physical assets and processes. Digital twins leverage this data to create a virtual counterpart that reflects the behavior, performance, and characteristics of their physical counterparts in real-time. The definition of digital twins encompasses a wide range of applications and contexts. This paper provides an overview of existing literature on digital twins, including their definition, key characteristics, and classification. Additionally, it highlights potential challenges and limitations associated with digital twins and identifies the technologies that enable their implementation. By understanding the fundamental concepts and technological advancements in the field of digital twins, organizations can harness their potential to enhance their business, optimize resources, and foster innovation. Numerous examples of digital twin applications in various industries are highlighted in this paper, with a particular focus on the elevator industry. Therefore, this paper serves as a comprehensive source of information for researchers, practitioners, and decision-makers who wish to explore the application of digital twins in different industries and domains.

This paper presents an effective approach to enable performance improvement in human-robot collaboration scenarios. The problem is tackled from the perspective of speed and separation monitoring principle, which stems from the recently instituted safety standard. The proposed approach attempts to seek for performance gains, measured by the speed-up of the production cycle, without compromising the safety constraints consistent with the standard. The approach is based on the notion of braking surface - an abstraction of the swept volume described by the manipulator during braking motion. We address two types of braking behavior: general and path-consistent. In both cases, the braking surface can be evaluated in a receding horizon manner. The robot velocity is continuously scaled such that, in case of a controlled stop, the corresponding volume spanned by the robot (braking surface) does not interfere with the surrounding obstacles. The approach is entirely kinematic and does not require the knowledge of the robot's dynamic model. Simulation study indicates that the pro-posed approach offers performance improvements compared to other state of the art methods. Moreover, the experiments demonstrate the real-time applicability of the method with the real robot in human-shared environment.

. Screening for lymphedema and accurate quantitative assessment of dermal backflow patterns on ICG represents a major shift in current clinical practice paradigms, putting an emphasis on early detection of lymphedema rather than palliative treatments and symptomatic relief. These findings set the stage for the development of a practical, universal, ICG-based quantification system for the staging of lymphedema, a significant advancement in the field of plastic surgery.

Purpose Lean Management (LM) is a process improvement approach with growing interest from healthcare organizations. Obtaining a culture of continuous improvement is a primary objective of LM, and a culture of continuous improvement indicates a mature LM approach, and here leadership plays a central role. However, a comprehensive overview of leadership activities influencing LM maturity is lacking. This study aims to identify leadership activities associated with continuous improvement and, thus, LM, maturity. Methods Following the PRISMA guidelines, a scoping literature review of peer-reviewed articles was conducted in twenty healthcare management journals. The search provided 466 articles published up until 2023. During the selection process, 23 studies were included in the review. The leadership activities related to continuous improvement maturity were identified using the grounded theory approach and data coding. Results The analysis highlighted a total of 58 leadership activities distributed across nine themes of LM leadership. Next, analysing leadership activities concerning the different maturity levels revealed three maturity stages: beginner, intermediate, and expert. Based on the findings, we propose a framework that guides suitable leadership activities at the various stages of LM maturity. The framework provides leaders in healthcare with a practical overview of actions to facilitate the growth of the LM approach, and the related propositions offer academics a theoretical basis for future studies. Conclusion This review presents the first comprehensive overview of LM leadership activities in relation to continuous improvement and LM maturity. To enhance LM maturity, leaders are encouraged to consider their leadership style, (clinical) stakeholder involvement, alignment with the organizational strategy, and their role in promoting employee autonomy.

: Within the evolving landscape of modern business, a proficient logistics sector stands paramount in fostering regional and global competitive edges. A country's logistics performance, gauged aptly, can influence not just the business outcomes of individual enterprises but also shape the nation's holistic logistics efficacy. This study delves into an examination of logistics standards in European Union (EU) countries, viewed through the lens of the Logistics Performance Index (LPI) as reported by the World Bank. The primary focus is on the LPI data for 2023, with a subsequent exploration of the EU’s performance trajectory from 2007 to 2018. The findings illuminate that specific EU countries consistently uphold superior logistics proficiency, while striving for advancements. Beyond these front runners, many EU countries manifest commendable logistics outcomes, positioning themselves favorably on the global stage.

Introduction: Aging is a natural, irreversible physiological process that depends on genetic, environmental, and lifestyle factors. Many physiological, biological, psychological, and other factors play a major role. According to the World Health Organization, falls are the second leading cause of unintentional injury death in the world and represent a major global public health problem. Falls are most commonly caused by intrinsic and extrinsic risk factors. A comprehensive assessment of fall risk is critical to the development of effective fall prevention programs. The screening protocol is brief, easy to use, and multifactorial and allows the identification of risk factors for falls. The aim of this study is to investigate the importance of the presence of risk factors in the home environment and the impact on increasing the risk of falls in people in the third age. Methods: The study was conducted in the municipality of Podgorica. 109 elderly people from urban and rural areas were included in the study using the snowball method. The instruments used in our study are a standardized checklist for assessing risk factors in the home environment, inside and outside the home (HASSAT), and a self-assessment scale of one’s own concern about a possible falls efficacy scale international. The survey was conducted from the end of October to the end of November 2023. Results: There is a statistically significant difference in social and physical activities of daily living in the area of concern about falling. When analyzing the overall result of the fear of falling scale in relation to gender, a significant statistical difference is found. The analysis of the individual rooms in relation to the age of the respondents shows that there is a significant statistical difference. Conclusion: The results obtained show that the high risk of falling is present in all rooms of the home environment for people in their 3rd year of life and that fear of falling increases with age.

Introduction: The need for this study on the prevalence of hypodontia in a sample of orthodontic patients from Bosnia and Herzegovina arises from the fact that in the state of Bosnia and Herzegovina, there is a lack of data on the prevalence and distribution of hypodontia as a previously defined, growing global problem and that it could emphasize the importance of its early diagnosis, as this is still the best standard for preventing the occurrence of complications due to a lack of teeth. The aim of this retrospective study was to determine the prevalence and distribution of hypodontia in orthodontic patients in Bosnia and Herzegovina. Methods: The study was conducted in the Orthodontic Department of the University of Sarajevo, Faculty of Dentistry, with the Center for Clinical Dentistry. The study included all patients who presented to the Orthodontic Department in the period from January 2020 to March 2023 and whose diagnostic protocol included panoramic radiographs, which were analyzed for the purposes of this study. The sample consisted of the orthopantomography radiographs of 5084 patients (2031 males and 3053 females). Results: Hypodontia was found in 6.77% of orthodontic patients, of which 38.4% were male patients and 61.6% were female. The teeth most frequently affected by hypodontia were the second premolars (68.15%). After stratifying the sample by jaw, the most common hypodontic tooth was the second premolar in the mandible and the lateral incisor in the maxilla. Conclusion: We can conclude that the prevalence of hypodontia in orthodontic patients in Bosnia and Herzegovina and its distribution are very similar to the general population. The results of this study may help to improve the early diagnosis of hypodontia as a growing problem, which may reduce the complications that may arise from missing a tooth.

Introduction: Insulin resistance (IR) is a complex pathophysiological condition multifactorial etiology characterized by diminished responsiveness of insulin target tissues. Today, various diagnostic approaches involving different laboratory parameters are available, but simple and non-invasive indices based on mathematical models are increasingly used in practice. This study aims to assess the effectiveness of various clinical surrogate indices in predicting IR across a population with varying body weights. Methods: The matched case-control study was conducted between January 2021 and December 2022. Secondary data extracted from the medical records of 129 subjects was analyzed, including demographic characteristics (age and gender), anthropometric measures (height and weight), and biochemical laboratory test results. y further divided into two subgroups based on body mass index (BMI): overweight (BMI between 25 and 29.9 kg/m2) and obese (BMI of 30 kg/m2 or higher). Using laboratory data values for six widely used clinical surrogate markers were calculated: Homeostatic model assessment for IR (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), Mcauley index (MCAi), metabolic score for IR (METS-IR), Triglyceride to Glucose Index (TyG), and TyG to BMI (TyG-BMI). Results: Significant differences in HOMA-IR levels were observed between the groups (p < 0.001). A similar pattern was found for the TyG-BMI, with notable differences (p < 0.001). The obese participants had the highest mean levels for METS-IR and the TyG index while the control group had the highest mean values for the QUICKI and MCAi indices (p < 0.001). According to the analysis, three indices showed statistical significance in predicting IR independent of BMI (p < 0.05). Sensitivity and specificity were higher in the obese group (0.704 and 0.891) than in the overweight group (0.631 and 0.721). Conclusion: Given that IR is a multifactorial disease, using derived indices based on a combination of biochemical parameters and anthropometric indicators can significantly aid in predicting and mitigating numerous complications.

Introduction: The diagnosis of coronavirus disease 2019 (COVID-19) disease is necessary for the further treatment of patients with the present symptoms, and molecular diagnostics is considered the gold standard. However, it is already known that patients with symptoms of the disease can have a negative test due to various factors. The purpose of this study is to evaluate the laboratory parameters in patients with symptoms of COVID-19 infection who have both positive and negative test results. Methods: The study included 101 samples from patients who tested positive for COVID-19 and 101 samples from patients who tested negative, both groups presenting symptoms of COVID-19. Data on the complete blood count, the absolute values of the differential blood count, and the D-dimer values were collected from the samples that were taken. Using blood count data, neutrophil-to-lymphocyte ratios, platelet-to-lymphocyte ratios, and systemic immune-inflammatory index (SII) were calculated. Results: Based on the examination and research, a significant increase and change in the values of inflammatory indices and D-dimer were determined. In addition to the increase of these values above the reference value, a positive correlation was confirmed between the inflammation index value and the D-dimer value. Conclusion: COVID-19-negative patients with characteristic symptoms of COVID-19 had higher values of lymphocytes and the determination of platelets and SII in these patients can be added to the diagnostic algorithm.