This study examines spatial marginalization in Bosansko Grahovo, one of the most depopulated and socio-economically underdeveloped municipalities in Bosnia and Herzegovina, located on the EU border with Croatia. Using a mixed-methods approach, the study integrates a previously developed Geographical Marginalization Index (GMAR) with survey data and interviews. The findings reveal a strong convergence between quantitative indicators of marginalization and residents’ perceptions, supporting the interpretation of Bosansko Grahovo as an example of double periphery defined by geographical remoteness and systemic exclusion. While the border itself is not perceived as the primary driver of decline, post-war legacies, institutional fragmentation and infrastructural deficits interact cumulatively to produce what is conceptualized as a selfreinforcing vicious circle of marginalization. Combining quantitative indicators with perception-based evidence allows for a better understanding of how marginalization persists in peripheral border areas.

Field-of-view (FoV) prediction is critical for reducing device energy consumption and enhancing user quality of experience (QoE) in immersive streaming. To address the high computational and energy costs of standard DL-based FoV prediction, we propose PRECEPT, an energy-efficient, system-oriented two-stage framework. PRECEPT splits the prediction pipeline by adding a lightweight, CPU-based classifier to identify tile change. PRECEPT's classifier successfully filters approximately 80% of “no-change” events. PRECEPT activates the resource-intensive DL model only during identified tile change. This design reduces the average inference delay and energy consumption by up to 69% in a real mobile deployment. PRE-CEPT's two-stage design enables sustainable, high-performance FoV prediction on resource-constrained devices.

The aim of this study was to evaluate outcomes of surgical correction of penile curvature using autologous graft materials in patients with Peyronie’s disease, with emphasis on functional recovery, penile length changes, cosmetic results and patient-reported satisfaction. Due to unavailability of commercial extracellular matrix grafts, autologous materials including buccal mucosa, rectus fascia, fascia of the tensor fasciae latae and saphenous vein were utilized. This study included male patients treated for penile curvature due to Peyronie’s disease at the Department of Urology, Clinical Centre University of Sarajevo between 2018 and 2023. All patients had stable disease for more than 12 months. Preoperative assessment included penile Doppler ultrasonography, curvature measurement and flaccid penile length evaluation. Erectile function was measured using the validated International Index of Erectile Function (IIEF-5), and disease burden was assessed via the Peyronie’s Disease Questionnaire (PDQ). A postoperative patient satisfaction survey was performed combining validated components (Erection Hardness Score and EDITS satisfaction elements) with a graft-specific preference scale. Patients were divided into four groups based on graft type. Groups 3 and 4 demonstrated superior functional and cosmetic outcomes following surgery (p<0.05). There were no significant differences in complication rates among groups (p>0.05). Curvature recurrence was more frequently observed in Group 4, although not statistically significant (p>0.05). Penile shortening occurred more often in Groups 1 and 2 (p<0.05). Improvement in postoperative IIEF-5 scores was most pronounced in Groups 3 and 4. The patient satisfaction survey showed that patients reported higher postoperative satisfaction, better perceived length preservation, and greater overall acceptability when buccal mucosa was used as graft material compared to other autologous grafts. In settings where commercial grafts are unavailable, autologous graft materials represent a viable option for surgical correction of Peyronie-related curvature. Based on postoperative functional outcomes and validated patient satisfaction measures, buccal mucosa and saphenous vein grafts demonstrated the most favorable profiles and should be considered preferred autologous grafting options. No

Objective To evaluate short- and long-term outcomes after modified Stage I palliation for hypoplastic left heart syndrome. Methods This retrospective single-center study analyzed 128 patients with hypoplastic left heart syndrome treated between 1993 and 2023. Patients were divided into 2 groups: Era I (n = 36), from 1993 to 2001, included patients who underwent the classic Norwood procedure, and Era II (n = 92), from 2002 to 2023, included patients who underwent modified Stage I palliation. Postoperative outcomes, including the need for postoperative extracorporeal membrane oxygenation, peritoneal dialysis, recoarctation rate, and overall survival, were compared between eras. Results Median follow-up was 9.7 years, with 100% completeness for survival data, and ranged from 0.9 to 30.9 years. Ninety-day survival improved from 69.4% in Era I to 95.7% in Era II (P < .001). Transplant-free survival improved from 47% to 84% at 5 years (P < .001) and from 42% to 71% at 20 years (P < .001). Only 1 patient in Era II required postoperative extracorporeal membrane oxygenation. The use of peritoneal dialysis decreased from 86.1% to 22.8%, and recoarctation rate decreased from 13.9% to 7.6%. Conclusions On the foundation of important developments in perioperative care across the study period, the introduction of modified Stage I palliation may have contributed to improved survival and reduced postoperative morbidity, and may represent an alternative to centralization of care.

Background: Culturally and Racially Marginalised (CaRM) communities in Australia encounter subtle and covert forms of prejudice, commonly referred to as “new racism”. Within healthcare settings, these experiences can shape trust, engagement, and patterns of help-seeking. Mental health nurses are often the first point of contact in care delivery, and their ability to recognise, respond to, and mitigate the impacts of new racism is critical for fostering therapeutic relationships and supporting equitable access. Understanding how CaRM communities perceive the conditions that influence their mental health service use is fundamental for informing more equitable and culturally responsive care. Objective: This study explored the viewpoints of CaRM community members regarding the factors they consider important for addressing new racism in healthcare systems and supporting engagement with mental health services. Design: Q methodology was used to identify statistically derived viewpoints that reflect shared viewpoints about the conditions perceived as critical for addressing the impacts of new racism on mental health service use. Setting: Participants were recruited from culturally and linguistically diverse communities across Australia through community settings, social media, and professional networks. Participants: Thirty-five individuals from CaRM backgrounds completed the Q-sort. Methods: This Q methodology consisted of five steps: (1) set up of the Q-sorting instrument, (2) selection of participants, (3) data collection, (4) factor analysis, and (5) factor interpretation. Results: Three distinct viewpoints were identified: (1) raising awareness of mental health issues within CaRM communities (community-focused), (2) providing visible anti-racism and culturally safe services (service-focused), and (3) recognising and formally addressing new racism within healthcare systems (policy-focused). Conclusions: This study offers the first empirically derived, community-informed set of viewpoints on addressing new racism in Australian mental healthcare. While exploratory, the findings highlight multi-level considerations that are potentially relevant to mental health nursing practice, and may be useful to inform future research, policy development, and service redesign aimed at strengthening cultural responsiveness and equity in mental health systems.

Background: The diagnosis of urinary tract infection (UTI) remains a clinical challenge, with urine culture as the gold standard. In developing countries like Bosnia and Herzegovina, a high prevalence of antimicrobial resistance and frequent empirical treatment pose significant clinical challenges. Automated urine flow cytometry has emerged as a rapid tool to optimize diagnostic processes. Objectives: To determine the correlation of age, gender, and laboratory parameters—such as white blood cell (WBC) count, neutrophil count, and C-reactive protein (CRP)—with both urinary bacterial counts and urine culture results. Methods: This retrospective study analyzed 200 adult patients (≥18 years) with symptoms suggestive of UTI at the University Clinical Center Tuzla. Data on age, gender, WBC, neutrophils, CRP, and urine flow cytometry (Sysmex UF-4000) were collected. Statistical analysis was performed using R software (version 4.5.1), utilizing logistic regression models via the ‘glm’ function to identify independent predictors, with statistical significance set at p < 0.05. Results: The mean age of the population was 68.61 ± 15.19 years. Logistic regression demonstrated that WBC count (OR = 1.06, p = 0.004), neutrophil count (OR = 1.04, p = 0.014), and patient age (OR = 1.03, p = 0.001) were significant independent predictors of UTI. Furthermore, patients with a urinary bacterial count > 1200/μL had 83 times higher odds of a positive urine culture (OR = 83, 95% CI 32.25–200, p < 0.001). Conversely, CRP levels and gender were not significant predictors (p > 0.05). Conclusions: Patient age, WBC, and neutrophil counts are key factors for predicting UTIs. Integrating these parameters with urine flow cytometry bacterial counts can significantly enhance diagnostic accuracy and rapid screening in clinical practice.

Background: Breast clip marker movement after ultrasound-guided biopsy can negatively affect lesion re-localisation rates and surgical outcomes, underscoring the need for improved understanding of the factors influencing clip displacement. Thus, this study aimed to compare four different breast clip markers and identify risk factors for clip migration and dislocation after ultrasound-guided placement. Methods: This retrospective study included 350 patients who underwent ultrasound-guided biopsy of a newly diagnosed breast lesion with placement of one of four types of breast clips (UltraClip Dual Trigger Biodur 108 Coil Marker [UC], TUMARK Professional [TP], TUMARK Vision [TV] and HydroMARK Breast Biopsy Site Marker [HM]). Clip migration and dislocation were assessed immediately after placement and during follow-up imaging for at least 3 months. A binary logistic regression analysis was performed to identify predictors of clip dislocation including lesional, perilesional and procedural parameters. Results: Clip migration rates were 26.0%, 18.0%, 10.0% and 25.0% and clip dislocation rates were 14.0%, 20.0%, 9.0% and 38.0% for UC, TP, TV and HM, respectively. Features significantly associated with clip dislocation included predominantly fatty surrounding tissue (p = 0.046) with low perilesional shear wave velocities (p = 0.054), smooth lesion contours (p = 0.041), soft lesion strain elastography (p =0.001), low clip-to-lesion-surface distance (p = 0.002) and the use of an HM breast clip (p = 0.032). Conclusions: The type of breast clip-marker, as well as perilesional and lesional characteristics, influence the likelihood of clip dislocation. Notably, the hydrogel-coated clip (HM) exhibited the highest rate of dislocation.

The management of locally-advanced, resectable head and neck squamous cell carcinoma (HNSCC) is undergoing a major shift driven by the integration of neoadjuvant immunotherapy (nIO). The rationale for nIO lies in its administration within an immunologically active, treatment-naïve microenvironment that enhances immune priming and anti-tumor response. Despite encouraging clinical data, including the pivotal KEYNOTE-689 trial and multiple phase II studies, methodological heterogeneity in trial design, endpoint definitions, and response criteria currently hampers data comparability and the establishment of new standards of care. This expert narrative review proposes a structured framework for standardizing clinical, pathologic, imaging, and translational endpoints in HNSCC nIO trials, highlighting harmonized definitions of pathologic response, practical reporting templates, and methods to evaluate immune priming. Standardization of response evaluation, biomarker integration, and trial methodology is essential to accelerate the translation of neoadjuvant immunotherapy into routine clinical practice for HNSCC.

Introduction First onset of mania in older adults is unusual, and not often mentioned in literature. Studies suggest that new-onset mania in older adults is most commonly secondary due to pharmacological, metabolic or neurologic causes. Objectives Present the case report of a 70-year-old patient with an acute manic episode without previous health issues. Methods Psychiatric interview, laboratory tests, neuroradiological, microbiological and immunological examinations. Results A 70-year-old patient was admitted to a psychiatric hospital for treatment due to altered behavior accompanied by agitation, thought process disorder, presence of paranoid delusions and increased sexual urges. The family provides information that the symptoms have lasted for about a year, but were intense 10 days before admission. In the first days of hospitalization, in addition to psychotic symptoms, strong affective irritability to the level of affective incontinence was noted, which led us to suspect the development of brain damage in the frontotemporal lobe. Information was obtained from family members that the patient had never previously had mental difficulties or been treated by a psychiatrist or other specialists. So far, he has been mostly healthy. Diagnostic tests were performed. Brain CT is completely normal. Laboratory findings show significantly elevated eosinophil values. The patient told us that approximately 8 months ago he ate pork that was not sufficiently heat-treated. An infectious disease specialist was consulted. Microbiological tests for trichinosis, leptospirosis, borreliosis, brucellosis and Q-fever were performed, as well as a series of immunological tests, of which IgE was elevated up to 160. All other tests were negative, except for elevated IgM antibodies to leptospirosis. Further infectious treatment is ongoing. The patient was treated with a mood stabilizer and antipsychotic in lower doses, which resulted in the cessation of psychomotor restlessness, reduction in delusional content and stabilization of affect. A double diagnosis of mania with psychotic symptoms and leptospirosis was made. Conclusions Although rare, first episodes of mania with or without psychotic symptoms also occur in the elderly population and are most often secondary, therefore a detailed diagnostic work-up and careful titration of psychopharmacotherapy is required. Disclosure of Interest None Declared

The use of unmanned aerial vehicles (UAVs) in recent conflicts and growing threats to critical infrastructure has made reliable automatic drone detection an urgent security priority. Ensuring detection performance across diverse lighting conditions, especially nighttime scenarios where electro-optical (EO) visible-spectrum sensors are limited, remains a key challenge. This paper presents a controlled comparative study of EO and infrared thermal (IR) imaging modalities for UAV detection using the YOLO11n architecture, conducted within the NATO Science for Peace and Security Ai4CUAV project. A synchronized EO-IR dataset was collected under real-world daytime and nighttime conditions. The experiment uses paired daytime EO-IR data for direct EO-IR modality comparison, together with separate IR night-only and IR day-night datasets. Four YOLO11n models were trained under the same configuration. IR achieved higher performance than EO on paired daytime data (mAP@0.50: 0.946 vs. 0.905, F1: 0.950 vs. 0.912), supported reliable nighttime detection (mAP@0.50: 0.874, F1: 0.881), and achieved mAP@0.50 of 0.912 (F1: 0.915) when evaluated across combined day-night conditions. For the scenes and conditions represented in the evaluated dataset, both modalities perform strongly during daytime, while IR remained necessary for nighttime operation.

Computed tomography (CT) is widely used for evaluating renal anatomy and pathology, with multi-phase contrastenhanced imaging providing critical diagnostic information. However, acquiring multiple contrast phases requires repeated scans, in turn increasing radiation exposure. In addition, the development of AI methods for medical imaging is limited by the scarcity of datasets, often due to privacy and data sensitivity concerns. To address both of these limitations, we propose PhaseDiff, which learns the relationship between non-contrast and contrast-enhanced renal CT scans to synthesize arterial, portal venous, and delayed phases directly from non-contrast inputs. The framework is based on a conditional latent diffusion model that operates in a learned latent space, where a variational autoencoder encodes images into compact latent representations. Diffusion is applied only to the target contrast-enhanced latent, while the non-contrast latent is incorporated via channel-wise concatenation to provide spatial guidance. In addition, the desired contrast phase is introduced through cross-attention, enabling phase-controlled image synthesis. Trained on paired multi-phase CT data, PhaseDiff generates anatomically and phase-consistent contrast-enhanced images, highlighting the potential to reduce radiation exposure in renal CT workflows while also creating realistic synthetic datasets.