Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape for non-small cell lung carcinoma but are associated with immune-related adverse events (irAEs), including thyroid dysfunction. This study examines the incidence and clinical impact of thyroid dysfunction in non-small cell lung cancer (NSCLC) patients receiving ICIs at the Clinic of Oncology, Clinical Center University of Sarajevo. In this retrospective cohort study of 50 patients with metastatic NSCLC treated with ICIs—either in combination with chemotherapy or as monotherapy for those with programmed death-ligand 1 (PD-L1) expression ≥ 50%—we collected data on demographics, treatment regimens, thyroid function tests, and survival outcomes. Thyroid dysfunction occurred in 24 patients (48%), with 12 (24%) developing hypothyroidism, 4 (8%) developing hyperthyroidism, and 8 (16%) experiencing a transition from hyperthyroidism to hypothyroidism. The incidence of thyroid dysfunction was significantly higher in patients treated with atezolizumab compared to pembrolizumab (P ═ 0.04), with 87.5% of affected patients receiving atezolizumab. The median time to onset of thyroid dysfunction was 10 cycles (interquartile range [IQR]: 5) for hypothyroidism and six cycles (IQR: 19) for hyperthyroidism. Progression-free survival (PFS) was significantly longer in patients who developed thyroid dysfunction, with the median PFS not reached, compared to a median PFS of 14 months (95% CI: 9.68–18.32) in patients without thyroid dysfunction (P ═ 0.038). No significant associations were found between thyroid dysfunction and patient age or gender. These findings suggest that thyroid dysfunction is a common irAE in patients with metastatic NSCLC receiving ICIs, particularly atezolizumab, and its development may be associated with improved PFS. Regular monitoring of thyroid function is recommended to promptly identify and manage thyroid abnormalities during ICI therapy, potentially improving patient outcomes.

Background/Objectives: The preschool period plays an essential role in shaping a child’s overall development, which influences physical, emotional, social, and cognitive growth. At this stage, establishing proper postural habits is essential, as it can have lasting effects on health, well-being, helps to prevent future issues, and supports overall development. Therefore, the present work aims to determine the differences in postural status between boys and girls of preschool age. Methods: The sample of participants consisted of 92 children (n = 46 boys and n = 46 girls); the average age for girls was 5.41 ± 0.30 years and for boys it was 5.53 ± 0.31 years. Data were collected using licensed state-of-the-art diagnostic equipment, Contemplas 3D Posture Compact, using 16 variables to assess postural status with a Mann–Whitney U test. Results: The results of this study indicate that boys have more pronounced deformities in the following variables: shoulder displacement (p = 0.047), pelvic obliquity (p = 0.000), sag. distance cervical spine–sacrum (p = 0.029), sag. distance thoracic spine–sacrum (SDTS) (p = 0.016), and sag. distance lumbar spine–sacrum (SDLS) (p = 0.005). Conclusions: This study confirmed gender differences in postural characteristics in preschool children. Boys showed a greater tendency towards postural deviations, indicating the necessity for specific interventions and programs to improve their posture. On the basis of the results of this research, it is recommended to carry out cross-cultural research that would enable the comparison of results among children from different environments and cultural contexts in order to determine possible differences and particularities in the development of postural characteristics. Future research should include larger and more diverse samples of participants, including children from rural and urban areas, in order to ensure the representativeness and generalizability of the results. In addition, conducting a longitudinal study that would monitor the postural characteristics of children through different developmental stages is suggested, aiming to identify critical periods for intervention and to determine, more precisely, development trends within the context of gender differences.

This study explores both pyrometallurgical and hydrometallurgical methods for decarbonizing and recovering valuable metals from bauxite residue, with hydrogen plasma reduction and direct acid leaching as the primary approaches. The goal is to offer innovative techniques for extracting metals from bauxite residue, a by-product of the Bayer process, which cannot be disposed of in an environmentally sustainable manner. Additionally, reducing the volume of bauxite residue through combined treatments is a key objective. In contrast to traditional carbon-based reductive melting, which generated significant CO2 emissions, hydrogen is now being investigated as a cleaner alternative. Through hydrogen plasma reduction, approximately 99.9% of iron is recovered as crude metallic iron, which can be easily separated from the slag containing other valuable metals. Thermochemical analysis was used to predict slag formation and chemical analysis of slag during hydrogen reduction. To further recover metals like aluminum and titanium, the slag is subjected to sulfuric acid leaching under high-pressure of oxygen in an autoclave avoiding silica gel formation. The results demonstrated a leaching efficiency of 93.21% for aluminum and 84.56% for titanium, using 5 mol/L sulfuric acid at 150 °C, with almost complete iron recovery. Assisted ultrasound leaching of slag with sulphuric acid under atmospheric pressure leads to 54% leaching efficiency of titanium.

2-acetoxybenzoic acid, also known as aspirin, is one of the most widespread and important pharmaceutical compound used in the treatment of pain, inflammation, and febrile conditions. In addition to its well-known therapeutic properties, 2-acetoxybenzoic acid is increasingly being investigated in the context of its interactions with metals, leading to new insights into potential applications in medicine, chemistry, and biotechnology. Among the metals that form complex compounds with 2-acetoxybenzoic acid, nickel is one of the most interesting due to its specific electrochemical properties and biological activity. The study of the 2-acetoxybenzoic acid-nickel complex plays a significant role in understanding the molecular mechanisms of interaction between drugs and metal ions, as well as the potential therapeutic benefits of these compounds. This research thoroughly examines the structural, chemical, and biological aspects of the 2-acetoxybenzoic acid-nickel complex, with particular emphasis on its potential application in the pharmaceutical industry and medicine. The structure of this complex was determined by various spectroscopic and analytical techniques, including Fourier transform infrared spectroscopy (FTIR), ultraviolet-visible spectroscopy (UV), mass spectrometry (MS), melting point methods, and optical microscopy. These methods contributed to the understanding of the interaction mechanisms between the ligand and the nickel ion center, opening the possibility for further investigation of the pharmacological properties and potential therapeutic applications of this complex. The antibacterial and antifungal activity of the synthesized Ni(II) complex with 2-acetoxybenzoic acid was investigated, and it was found that the metal complex exhibits varying degrees of inhibitory effects on bacteria.

Fly ash (FA) is a low-cost industrial waste material mostly composed of oxides. These small, hard particles can be used as reinforcements in composite production. In this study, an A356.0 aluminum alloy reinforced with 4 wt.% FA was synthesized by compo casting and subsequently subjected to multiple passes of equal channel angular extrusion (ECAE) to investigate the influence of intense plastic deformation on the composite hardness and microstructure. Microstructure analysis was performed on an optical microscope and by computer tomography (CT). The as-cast alloy contains a relatively homogeneous microstructure with minor FA agglomerations and very low porosity. The severe plastic deformation induced by ECAE results in a directed structure and additional integration of FA into the matrix with the disappearance of pores. Vickers hardness measurement of aluminum/fly ash (Al/FA) composite was carried out with different indentation loads: 0.196 N (HV0.02), 0.490 N (HV0.05), 0.981 N (HV0.1), and 1.960 N (HV0.2). The results showed that hardness increases after each ECAE pass because of microstructure changes. Already after the first pass, a significant increase in hardness is achieved, ranging from 27% (HV0.05) to 62% (HV0.2). A Meyer’s index (n) value greater than 2 indicates that the hardness of single and double extruded composite depends on the indentation load. Extruded samples show a hardness enhancement with increasing applied load, so the examined composite exhibits a reverse indentation size effect (RISE).

This study investigates innovative surface coatings’ effectiveness in enhancing spruce wood’s fire resistance (Picea abies spp.). Spruce wood samples were treated with various agents, including oils, waxes, boric acid, commercial coatings, and fire-retardant agents. The evaluation was conducted using the small flame method (EN ISO 11925-2:2020), surface roughness analysis, hyperspectral imaging (HSI), and contact angle measurements. The results demonstrated significant improvements in fire resistance for samples treated with specific coatings, particularly the Burn Block spray and Caparol coating, which effectively prevented flame spread. The analysis revealed that the Burn Block spray reduced the average flame height to 6.57 cm, while the Caparol coating achieved a similar effect with an average flame height of 6.95 cm. In contrast, untreated samples exhibited a flame height of 9.34 cm, with boric acid-treated samples reaching up to 12.18 cm. Char depth measurements and the surface roughness analysis revealed a clear correlation between the type of treatment and the thermal stability of the wood. Hyperspectral imaging enabled a detailed visualisation of surface degradation, while contact angle measurements highlighted the impact of hydrophobicity on flammability. This research provides in-depth insights into the fire-retardant mechanisms of spruce wood and offers practical guidelines for developing safer and more sustainable wood materials for the construction industry.

Background/Objectives: The aim of this study was to explore the differences in physical characteristics, leg strength, and jumping performance between 3 × 3 and 5 × 5 male basketball players. Methods: Twelve elite-level 5 × 5 basketball players (26.0 ± 13.0 years; 201.4 ± 6.6 cm; 95.50 ± 11.50 kg) and twelve elite-level 3 × 3 basketball players (26.7 ± 7.3 years; 193.0 ± 5.1 cm; 98.03 ± 9.77 kg), all male, were enrolled in the study. After anthropometric measurements and standardized warm ups, countermovement jump (CMJ), drop jump (DJ) and isokinetic strength testing were conducted, respectively. Results: An independent two-sample t-test revealed that 5 × 5 athletes were notably (p < 0.005) taller, with a lower body fat percentage (11.9 ± 3.6% vs. 18.6 ± 10.9%) and higher quadricep strength (317.21 ± 36.54 N·m vs. 284.76 ± 29.77 N·m and 313.32 ± 24.08 N·m vs. 285.87 ± 31.2 N·m for left and right leg, respectively). Conversely, 3 × 3 players displayed superior CMJ performance in concentric and eccentric peak forces, peak power, and reactive strength index. In the DJ, 3 × 3 players also excelled in eccentric peak force, reactive strength index, and jump height. Conclusions: The findings indicate that while 5 × 5 basketball players excel in body physique and in the strength of their lower body, 3 × 3 basketball players outperform them in power-related metrics.

INTRODUCTION Antimicrobial resistance (AMR) poses a significant threat, particularly in low- and middle-income countries (LMICs), exacerbated by inappropriate antibiotic use, access to quality antibiotics and weak antimicrobial stewardship (AMS). There is a need to review current evidence on antibiotic use, access, and AMR, in primary care across key countries.Areas covered: This narrative review analyses publications from 2018 to 2024 regarding access, availability and use of appropriate antibiotics. EXPERT OPINION There were very few studies focussing on a lack of access to antibiotics in primary care. However, there was considerable evidence of high rates of inappropriate antibiotic use, including Watch antibiotics, typically for minor infections, across studied countries exacerbated by patient demand. The high costs of antibiotics in a number of LMICs impacts on their use resulting in short courses and sharing of antibiotics. This can contribute to AMR alongside the use of substandard and falsified antibiotics. Overall, limited implementation of national action plans, insufficient resources, and knowledge gaps, affects sustainable development goals to provide routine access to safe, effective and appropriate antibiotics. CONCLUSIONS There is a clear need to focus health policy on the optimal use of essential AWaRe antibiotics in primary care settings to reduce AMR in LMICs.

Background and Objectives There is uncertainty about whether patients with an anterior circulation large vessel occlusion (LVO) and a low NIH Stroke Scale (NIHSS) score (≤5) benefit from endovascular therapy (EVT) in the late time window (6–24 hours). We compared the clinical outcomes of these patients receiving EVT with those receiving medical management (MM). Methods The CT for Late Endovascular Reperfusion multinational cohort study was conducted at 66 sites across 10 countries from January 2014 to May 2022. This subanalysis included consecutive patients with late-window stroke due to an anterior circulation LVO, defined as occlusion of the internal carotid artery or proximal middle cerebral artery (M1/M2 segments), and a baseline NIHSS score ≤5 who received EVT or MM alone. The primary end point was a 90-day ordinal shift in the modified Rankin Scale (mRS) score. Secondary outcomes were 90-day excellent outcome (defined as mRS scores 0–1 or return to baseline mRS score in patients with a prestroke mRS score >1) and favorable outcome (defined as mRS scores 0–2 or return to baseline mRS score in patients with prestroke mRS score >2). Safety outcomes were symptomatic intracranial hemorrhage and 90-day mortality. We used ordinal and binary logistic regression models to test for outcome differences. Results Among 5,098 patients, 318 patients were included (median [interquartile range] age 67 [56–76] years; 149 [46.9%] were female; baseline NIHSS score was 4 [2–5]). A total of 202 patients (63.5%) received EVT and 116 MM (36.5%). There was no difference in favorable 90-day ordinal mRS score shift (adjusted common odds ratio [OR] 0.77, 95% CI 0.45–1.32), excellent outcome (adjusted OR 0.86, 95% CI 0.49–1.50), or favorable outcome (adjusted OR 0.72, 95% CI 0.35–1.50) in the EVT group compared with MM. Symptomatic intracranial hemorrhage risk (adjusted OR 3.40, 95% CI 0.84–13.73) and mortality at 90 days (adjusted OR 2.44, 95% CI 0.60–10.02) were not statistically different between treatment groups. Discussion In patients with an anterior LVO and low NIHSS score in the 6–24-hour time window, there was no statistical difference in disability outcomes or intracranial bleeding risk between patients treated with EVT compared with MM. The retrospective and observational design limits our findings. Ongoing randomized controlled trials will provide further insight. Classification of Evidence This study provides Class III evidence that in adult patients with anterior circulation LVO and low NIHSS score (≤5) presenting in the late time window (6–24 hours), EVT does not improve clinical outcome vs MM. Trial Registration This study was registered at clinicaltrials.gov under NCT04096248.

The water distribution system is a critical infrastructure aiming to deliver safe and clean drinking water, with pipeline materials significantly influencing water quality and efficiency. One critical factor in selecting pipeline materials is the potential for biofilm formation on the inner surfaces of pipes. This study investigates the effects of three iron salts—iron (II) sulfate heptahydrate, iron (III) nitrate nonahydrate, and iron (III) chloride on biofilm formation by Escherichia coli and Enterococcus faecalis in pipeline environments, focusing on water distribution systems. While previous research has examined the effects of iron on various bacterial species, there are limited data on E. coli and E. faecalis biofilm formation in the context of water distribution systems. Results reveal that iron (III) chloride significantly inhibited E. coli biofilm formation by up to 80%, while E. faecalis biofilm growth was promoted by iron (II) sulfate heptahydrate, with an increase of approximately 45%. These findings underscore the critical role of managing iron concentrations to mitigate biofilm-related issues, which influence water quality, infrastructure durability, and microbial resistance. The study highlights the importance of integrating these insights into sustainable water management practices and advancing pipeline material innovations to enhance public health and environmental resilience.

Today, as technology and games have become integral to everyday life, challenges arise in maintaining and enhancing the focus on learning. Although digital games offer excellent opportunities for innovative ways of acquiring knowledge, distraction and how best to balance the entertainment side with the education objectives also create problems. In such an environment, the main goal is to utilize games as motivational tools that engage students while contributing to the development of critical thinking, problem-solving, and creativity. Research is based on a survey among students and teachers from three partner countries, targeting their perception of Serious Games and AI as an educational means in which barriers and obstacles may arise when including it in the teaching and learning process. These data will help formulate recommendations on how to optimize the use of Serious Games within educational systems across three diverse cultures and educational practices.

This study investigates and compare the students’ entrepreneurial mindset dimensions and intentions from EU member countries Italy, Austria, Sweden, and Greece, and an EU candidate country Bosnia and Herzegovina, which are important for fostering start-ups, economic development, and job creation. By analyzing students’ entrepreneurial mindset dimensions, demographic and academic characteristics, and availability of resources, the research aims to identify factors that impact students’ entrepreneurial intentions. Findings provide valuable insights into how these factors vary across different educational, economic, and social contexts with guidance for enhancing education to better support students’ entrepreneurial aspirations.Machine learning Random Forest was used to analyze the impact of entrepreneurial mindset dimensions, resources, and demographic and academic characteristics on students’ entrepreneurial intentions of students from EU member countries and Bosnia and Herzegovina. SHapley Additive exPlanations (SHAP) values were utilized to analyze feature importances and contributions to the model’s predictions. Statistical hypothesis tests were also conducted to compare differences of students’ entrepreneurial mindset dimensions, intentions and availability of resources between the EU member countries and Bosnia and Herzegovina.High values of entrepreneurial mindset dimensions have positive impact on entrepreneurial intentions in both EU member countries and Bosnia and Herzegovina. The availability of resources and orientation to innovations were the most impactful features for students in EU and Bosnia and Herzegovina, respectively. Gender and academic characteristics showed minimal influence. There are no significant differences in all dimensions between EU member countries and Bosnia and Herzegovina, except for confidence dimension and entrepreneurial intentions, which are significantly greater in Bosnia and Herzegovina.Findings suggest that tailored educational interventions focusing on key entrepreneurial mindset dimensions and resource access could significantly enhance entrepreneurial intentions among students. For policymakers and educators, this study provides a foundation for developing targeted strategies that align with the specific contexts of both EU member countries and Bosnia and Herzegovina. In this way higher education institutions can better support students’ entrepreneurial aspirations, contributing to broader economic development and job creation. This research offers recommendations for improving entrepreneurship education across diverse educational, economic, and social contexts and more balanced and inclusive economic development in Europe.