This study focuses on the position of civil law research in the Web of Science (WoS) and Scopus scientific databases. Two of the most reputable university rankings, the Shanghai Ranking of World Universities (Shanghai University Rankings) and the Times Higher Education rankings, evaluate the quality of research on the law subject matter directly based on its position in the WoS and Scopus, respectively. This study shows that there are only 13 civil law journals in WoS, while the situation is only slightly better in Scopus. That is why the civil law colleges are ranked much lower in the Shanghai rankings and still very low in the Times Higher Education rankings. This study, in particular, indicates that there are a low number of civil law journals published in languages other than English. Thereby, the most important civil law journals are excluded from the evaluation, and the rankings of civil law colleges are not accurate. The study further focuses on the number of journals included in the WoS and Scopus in a specific area of civil and commercial law. It shows that several core legal areas of civil and commercial law either are not covered at all in WoS and Scopus or are available in very few journals that publish legal research only in the English language. It further reveals that very few languages other than English are represented in WoS and Scopus in the civil law area, and some important civil law nations are not represented by a single law journal publishing in their official languages. This research aims to provide suggestions for university rankings and academic databases on how to evaluate civil law research more appropriately.

Herein, we aimed to analyze the final diagnosis in a well-defined cohort of fever of unknown origin (FUO) cases whose erythrocyte sedimentation rate (ESR) was 100 mm/h or more during the admission. The subgroup of the FUO patients with an ESR of 100 mm/h or more during the FUO evaluation, was extracted from the study database of a previously published multicenter study (European Journal of Clinical Microbiology & Infectious Diseases. April 15, 2023;42 (4):387–98). Data for 139 patients (17.6%, 139/788 of the original cohort) who fulfilled the study inclusion criteria, were obtained from 29 centers from 11 countries. Infections, neoplasms, and noninfectious inflammatory diseases were found to be the reason of fever in [n = 74 (53.2%)], [n = 14 (10%)], and [n = 13 (9.3%)] of 139 patients, respectively. Regardless of the diseases subgroup top 6 diseases that were determined to be the reasons of FUO were tuberculosis [n = 15 (10.8%)], HIV/AIDS [n = 13 (9.3%)], urinary tract infection [n = 9 (6.5%)], infective endocarditis [n = 9 (6.5%)], lymphoma [n = 9 (6.5%)], and abscess [n = 9 (6.5%)]. The most common infectious diseases were tuberculosis (15/74, 20.2%), HIV/AIDS (13/74, 17.5%), and infective endocarditis (9/74, 12.1%), along with urinary tract infection [n = 9 (6.5%)] and abscess [n = 9 (6.5%)]. The most common noninfectious inflammatory diseases were adult onset Still disease (3/13, 23%) and giant cell arteritis, also known as temporal arteritis (3/13, 23%), and followed by polyarteritis nodosa (2/13, 15.3%). The most common neoplasm was lymphoma (9/14, 64.2%), followed by lung cancer (2/14, 14.2%). Reason of fever could not be defined in (29/139, 20.8%) patients. The invasive procedures were performed in (64/139, 46%) patients. Gender, age > 50 or not, and income level (high–middle–low) of the participating country were not associated with a significant difference in the final diagnosis category of the FUO case (P > .05). To the best of our knowledge, this is the first study evaluating the FUO in the subgroup of cases with extreme ESR elevation and infectious diseases comprised the most cause of the FUO in this particular subgroup.

Immune checkpoint inhibitors (ICI) have had a dramatic effect on cancer outcomes with their use increasing as indications expand. Despite impressive efficacy across a range of tumour types, their role in activating the immune system results in frequent immune-related adverse events (irAE). While gastrointestinal, endocrine, respiratory and cutaneous toxicities are common, neurological irAEs (N-irAEs) occur more rarely. N-irAEs have been well reported in the literature, can affect any part of the nervous system and are associated with significant morbidity and mortality. Treating oncologists have a high index of suspicion for irAEs and a low threshold for initiating treatment. The role of the neurologist is to consider the differential diagnosis, direct investigation according to the clinical syndrome and guide management, efficacy monitoring and rehabilitation. Once alternative aetiologies have been excluded, the ICI should be either paused or discontinued depending on clinical severity, and immunosuppressive treatment commenced. There is no high-level evidence for toxicity management in this emerging field, so there is much variation in clinical practice and the medical literature. While describing the range of neurological toxicities related to ICIs and current experience of management and outcome, this review focuses on the potential utility of predictive biomarkers, the risk of re-ignition of pre-existing neurological autoimmune disease and the question of rechallenge after a N-irAE. Given the paucity of data specifically relating to N-irAE, we also discuss cancer outcomes in the context of irAEs and associated immunosuppression and consider some outstanding questions pertinent to ICI-related neurotoxicity and potential future directions for research.

Pigmented skin lesions represent localized areas of increased melanin and can indicate serious conditions like melanoma, a major contributor to skin cancer mortality. The MedMNIST v2 dataset, inspired by MNIST, was recently introduced to advance research in biomedical imaging and includes DermaMNIST, a dataset for classifying pigmented lesions based on the HAM10000 dataset. This study assesses ResNet-50 and EfficientNetV2L models for multi-class classification using DermaMNIST, employing transfer learning and various layer configurations. One configuration achieves results that match or surpass existing methods. This study suggests that convolutional neural networks (CNNs) can drive progress in biomedical image analysis, significantly enhancing diagnostic accuracy.

<p><strong>Introduction.</strong> Oral contraceptive pills (OCP) are the most widely used form of reversible contraception globally, although their prevalence of use varies across regions. In Bosnia and Herzegovina, particularly among young women, there remains a significant gap in knowledge regarding sexual and reproductive health, including contraception. Low level of knowledge, limited financial resources, inadequate access to gynecologists, and factors related to religion or nationality&nbsp;<br />have been identified as predictors of OCP non-use. This study focused on a student population to assess knowledge, attitudes, and practices regarding OCP use. We further examined associations between OCP use and demographic, medical, and knowledge-related factors. The investigation aimed to identify determinants promoting positive attitudes and practices toward OCP.<br /><strong>Methods.</strong> A cross-sectional online survey was conducted in 2024 among 162 female students at the University of East Sarajevo. Data were collected using a specially designed questionnaire assessing demographic characteristics, gynecological and medical profiles, as well as knowledge, attitudes, and practices related to OCP.<br /><strong>Results.</strong> Among 162 surveyed students, only 13 (8%) reported current OCP use, while the additional 21 students (14.2%) reported previous use. More than one-third of participants stated that they would never use OCP. Knowledge and positive attitudes emerged as the most significant predictors of OCP use, in contrast to demographic and most medical factors.<br /><strong>Conclusion.</strong> The prevalence of OCP use among students at the University of East Sarajevo is lower than in Western countries. Fear of side effects and insufficient knowledge of the benefits of OCP represent the main reasons for non-use. Although students of medical sciences demonstrated greater knowledge toward OCP, their knowledge was not sufficient to significantly increase OCP use within this population.</p>

Heart failure (HF) and atherosclerosis represent two major cardiovascular diseases that are intricately linked, both contributing significantly to global morbidity, mortality, and healthcare burden. Despite substantial progress in diagnostic methods and therapeutic strategies, the overall impact of these conditions remains considerable. This is largely due to their complex and overlapping pathophysiological mechanisms, persistent residual atherosclerotic risk, and the ongoing challenges associated with implementing guideline-directed medical therapy for HF in routine clinical practice. Recent advancements in the management of diverse HF phenotypes, lipid abnormalities, atherosclerotic cardiovascular disease (ASCVD), and obesity have facilitated the adoption of multidrug regimens. These include β-blockers, renin-angiotensin-aldosterone system inhibitors, sodium-glucose cotransporter 2 (SGLT2) inhibitors, and glucagon-like peptide-1 (GLP-1), which have collectively improved outcomes in HF populations. Lipid-lowering therapy, particularly statins, has demonstrated significant efficacy in reducing ASCVD events and slowing HF progression, as well as lowering the risk of HF-related hospitalizations. Elevated lipoprotein(a) [Lp(a)] has emerged as an independent risk factor for both ASCVD and HF, being associated with increased risk of incident HF, disease progression, hospitalization, and adverse outcomes. However, there remains a lack of conclusive evidence as to whether targeted reduction of Lp(a) leads to a decrease in major adverse cardiovascular events or improves HF incidence or outcomes. In parallel, contemporary therapeutic advances in coronary and peripheral artery revascularization, along with novel pharmacologic treatments for obesity such as GLP-1 receptor agonists including semaglutide and tirzepatide have shown beneficial effects in reducing cardiovascular mortality, HF progression, and body weight, irrespective of HF status. These converging therapeutic strategies underscore the close interrelationship between HF and atherosclerosis. This review aims to elucidate the shared pathophysiological mechanisms linking these conditions and to examine their clinical overlap with ischemic heart disease, cerebrovascular disease, peripheral arterial disease, dyslipidemia, and obesity. A comprehensive understanding of these interrelated cardiovascular entities may offer valuable insights to inform future research directions and optimize the clinical management of patients affected by both HF and atherosclerotic disease.

<p><strong>Introduction. </strong>Optic nerve head drusen (ONHD) is one of the most common congenital disorder of the optic nerve with prevalence from 0,5-2% in general population. Idiopathic intracranial hypertension is a condition that occurs in children, unlike adults, regardless of gender or the presence of obesity. Both conditions in children present on the eye as swelling of the optic disc, which is difficult to distinguish by clinical examination. They are extremely rarely associated.</p> <p><strong>Case report. </strong>A 15-year-old girl was urgently admitted due to decreased vision in both eyes for the past 7 days. Computerized visual field (CVP) testing revealed annular scotoma in both eyes, with a residual of 10 degrees and decreased sensitivity. Fundus examination showed an edematous both ONH. Echo B scan showed highly reflective changes corresponding to drusen in ONH. Acetazolamide 250 mg orally three times a day was introduced into the therapy. Neurological examination and MRI of endocranium was normal. After 3 weeks, VA in both eyes was 0.5 corrected with -0.50 Dsph to 1.0. ONH significant regression with unclear boundaries temporally, superiorly and inferiorly. The follow-up period over the next year, visual acuity was stable, and normal CVP, only slightly unclear boundaries of the ONH.</p> <p><strong>Conclusion. </strong>The diagnosis of optic nerve drusen is possible in children with benign intracranial hypertension. For this reason, it is necessary to thoroughly diagnose the patient in order to start treatment in a timely manner and prevent the development of visual impairment.</p>

<p><strong>Introduction. </strong>Pressure ulcers are frequent complications among immobile neurological patients, particularly those with stroke. Nursing knowledge and consistent implementation of preventive measures play a crucial role in reducing their occurrence. The aims of this study are to assess nurses&rsquo; knowledge, attitudes and self-reported competence in pressure ulcer prevention and care, and to describe the prevalence and short-term healing outcomes of pressure ulcers&nbsp;<br />among hospitalized stroke patients.<br /><strong>Methods.</strong> A descriptive cross-sectional study was conducted among 40 nurses/medical technicians using a structured, non-validated questionnaire. Medical records of 375 consecutively hospitalized patients with ischemic or hemorrhagic stroke were reviewed to determine the occurrence and management of pressure ulcers.<br /><strong>Results. </strong>Nurses demonstrated good knowledge of fundamental preventive principles, although gaps were identified in epidemiology and recognition of certain complications. Pressure ulcers were documented in both ischemic and hemorrhagic stroke patients, with an overall prevalence of 5.1%. Conservative treatment was most frequently applied, and most ulcers were recorded as healed at discharge.<br /><strong>Conclusion.</strong> Nursing knowledge appears generally adequate, but specific gaps indicate the need for targeted educational interventions. Interpretation of prevalence and outcomes is limited by the absence of validated assessment instruments and standardized documentation.</p>

<p><strong>Introduction. </strong>This study analyzed the factors influencing the outcome of assisted reproductive technology (ART) in women with infertility issues. The investigation focused on endometrial thickness, the number of retrieved oocytes, and the number of obtained embryos as potential predictors of ART success.<br /><strong>Method.</strong> A health-epidemiological questionnaire of general data was created for the purposes of this study. Various statistical methods were applied for data analysis. Descriptive statistical parameters for the observed parameters were pre<br />sented, including the arithmetic mean (M), standard deviation (SD), skewness (Sk), and kurtosis (Ku), to examine deviations from the normal distribution. Multiple regression analysis was applied to investigate the relationships of the independent variables with the dependent variable.<br /><strong>Results. </strong>The study included 100 women of reproductive age. Endometrial thickness was not a significant predictor of ART&nbsp;<br />outcome. Conversely, the number of retrieved oocytes and the number of obtained embryos were identified as significant predictors of ART success. Participants with positive ART outcomes demonstrated a lower number of retrieved oocytes&nbsp;<br />but a higher number of obtained embryos.<br /><strong>Conclusion.</strong> These findings highlight the importance of embryo quality in the implantation process. Further research is&nbsp;<br />needed to better understand this dynamic and to improve infertility treatments.</p>

The aim of the study was to examine the effects of eccentric- and concentric-based plyometric programmes on the strength, speed, and tensiomyography (TMG) parameters of female athletes. The study included twenty junior female participants from three different sports equally divided into two experimental groups of n = 10. Two plyometric programmes with contrasting designs were conducted for a period of six weeks, with sessions held twice per week. The first plyometric programme (ECC-CON-G) was based on exercises with eccentric, and the second (CONC-CON-G) with concentric contractions. TMG was used to evaluate neuromuscular performances of six muscles of both legs – vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), semitendinosus (SM), gastrocnemius lateralis (GL), and gastrocnemius medialis (GM)) – and two strength and speed tests: countermovement jump (CMJ), and sprint test at 10 m and 20 m. The results show that both groups had significant effects between pre-post measurements in CMJ (Diff, ECC-CON-G = 9.02%, and CONC-CON-G = 5.59%, p < 0.05), at 10 m (Diff, ECC-CON-G = 9.23%, and CONC-CON-G = 9.35%, p < 0.001), and 20 m (Diff, ECC-CON-G = 6.16%, and CONC-CON-G = 5.35%, p < 0.001), and TMG parameters in ECC-CON-G (all 6 left leg muscles, and right leg-VL, BF, GL, GM, p < 0.05), in CONC-CON-G (left leg-BF, SM, GL, GM, and right leg-VL, BF, GL, GM, p < 0.05). There were significantly better effects in ECC-CON-G compared to CONC-CON-G for CMJ height and time, for only time in 20 m sprint, and TMG parameters for left leg VL and VM, and right leg BF and GM. A plyometric programme based on exercises with eccentric contractions proved more beneficial for strength, speed, and TMG parameters in young female athletes compared to a programme based on concentric contractions.

The rapid increase in electricity demand and peak load consumption has led to rising energy costs and grid instability. This paper proposes an adaptive control strategy for peak shaving, integrating energy storage (ES) and electric vehicles (EV) with real-time power supply-demand monitoring. The proposed system dynamically estimates household demand, including EVs as a load, and adjusts ES and EV charging and discharging schedules based on energy availability, load conditions, and time-of-use (TOU) pricing. By leveraging photovoltaic (PV) generation, surplus energy is stored in the ES and EV during low-demand periods and discharged during peak-demand hours, thereby reducing grid dependency and electricity costs. A real-time simulation model is developed to validate the effectiveness of the proposed strategy. The results demonstrate significant improvements in load balancing, cost reduction, and peak-shaving efficiency, ensuring optimal utilization of renewable energy sources and storage assets.

Deep learning has significantly advanced the field of medical image classification, particularly with the adoption of Convolutional Neural Networks (CNNs). Various deep learning frameworks such as Keras, PyTorch and JAX offer unique advantages in model development and deployment. However, their comparative performance in medical imaging tasks remains underexplored. This study presents a comprehensive analysis of CNN implementations across these frameworks, using the PathMNIST dataset as a benchmark. We evaluate training efficiency, classification accuracy and inference speed to assess their suitability for real-world applications. Our findings highlight the trade-offs between computational speed and model accuracy, offering valuable insights for researchers and practitioners in medical image analysis.

Abstract Background Being able to estimate the risk of metachronous disease in a patient with colorectal cancer (CRC) could enable risk-appropriate surveillance. The aim of this study was to develop a risk-prediction model to estimate individual 10-year risk of metachronous disease following a CRC diagnosis. Methods A population-based cohort of patients with CRC was recruited soon after diagnosis between 1997 and 2012 from the United States, Canada, and Australia. Cox regression with the least absolute shrinkage and selection operator penalization was used to identify factors that predicted the risk of a new primary CRC diagnosed at least 1 year after the initial CRC diagnosis. Potential predictors included demography, anthropometry, lifestyle factors, comorbidities, personal and family cancer history, medication use, age at diagnosis, and pathological features of the first CRC. Internal validation through bootstrapping was used to evaluate the discrimination and calibration. Results We included 6085 CRC cases; 138 (2.3%) of these cases were diagnosed with metachronous disease over a median of 12 years (IQR = 5-17 years). Metachronous CRC risk was predicted by body mass index; smoking status; level of physical activity; family history of cancer and synchronous CRC; stage, grade, histological type, and DNA mismatch repair status; and age at diagnosis of the first CRC. The model was valid with a C statistic of 0.65 (95% CI = 0.63 to 0.68) and a calibration slope of 0.873 (SD = 0.087). Conclusions Metachronous CRC can be predicted with reasonable accuracy using a prediction model that consists of clinical variables collected as part of routine practice.

In patients with heart failure, alterations in electrical fields generated within the myocardium have been associated with myocardial oedema which can act as a substrate for left ventricular dysfunction. Safety and efficacy of a direct microcurrent therapy using an implanted generator (C‐MIC) remain uncertain.

Parkes-Weber Syndrome is a rare congenital vascular abnormality characterized by aneurismatic illness of blood arteries in the afflicted limb, as well as hypertrophy, ulceration, ischemia, and high-output heart failure. Imaging investigations are required to provide a diagnosis, with contrast arteriography being the gold standard. The majority of treatment options are endovascular, with surgical excision for arteriovenous malformations and limb amputation as alternatives. We describe a 73-year-old male patient with mainly asymptomatic PWS, coronary disease, and borderline EF (45%) who had CABG surgery. In individuals with established CAD and other cardiac disorders, it is critical to identify additional diseases or syndromes that might have a compounding effect on the heart, such as PWS and high-output heart failure.