Interna revizija, kao nezavisna i objektivna funkcija, ima ključnu ulogu u unapređenju poslovanja organizacija kroz procenu i poboljšanje efektivnosti upravljanja rizicima, kontrolom i organizacionim procesima. Iako nije zakonski obavezna u svim zemljama, njeno uspostavljanje postaje sve važnije, posebno u javnom sektoru i finansijskim organizacijama i korporacijama, kako bi se unapredilo poslovanje, ostvarili ciljevi i smanjili rizici. Kvalitet interne revizije definiše se njenom sposobnošću da ispuni ciljeve organizacije pružajući korisne informacije menadžmentu, osiguravajući usklađenost s propisima, upravljajući rizicima i poboljšavajući sistem internih kontrola i organizacione procese. Njena važnost ogleda se u povećavanju kredibiliteta revizije, poverenja zainteresovanih strana i dugoročne održivosti organizacije. Ključni faktori kvaliteta uključuju profesionalne standarde, podršku menadžmenta, nezavisnost, objektivnost, kompetenciju revizora i efikasnu koordinaciju sa eksternim revizorima. Iako univerzalan model za ocenu kvaliteta interne revizije ne postoji, istraživanja naglašavaju značaj različitih metodoloških pristupa, uključujući SEM metodologiju, faktorsku analizu i regresione modele i strukturalni pregled literature radi preciznijeg razumevanja indikatora kvaliteta. U radu su prezentovana istraživanja koja se bave upravo istraživanjem kvaliteta interne revizije i identifikovanja ključnih faktora koji određuju kvalitet interne revizije.

Restless legs syndrome is a neurological disease from the spectrum of movement disorders, with psychiatric comorbid symptoms and manifestations. Women are affected twice as often as men, and the frequency in the population is 4-10%, while during pregnancy the prevalence triples. This research was conducted as a result of a search and selection of studies on the prevalence of RLS in pregnancy, which include works published in domestic and foreign journals and searches of PubMed, PubMed Central, Web of Science, Scopus and Embase. A primary search of medical databases found 316 publications. In this secondary process, due to the lack of access to the abstract or full text, and due to the poor quality of the articles, 11 relevant publications were finally found and included in this systematic review. The total number of respondents included in this research is 7033, aged 19-45. The lowest prevalence was 4.9% in Japan, and the highest prevalence was 54.7% in Saudi Arabia. In this review, the overall mean frequency of restless legs syndrome during pregnancy was 24.69%. Furthermore, in our ongoing research conducted in 2022 on restless legs syndrome, we recorded a frequency of 26.5% in a population of 266 pregnant women in the third trimester of pregnancy. The frequency of restless legs syndrome is high among the population of pregnant women, and according to its etiology, clinical manifestations and comorbid manifestation, this disorder represents a close link between psychiatry, neurology and gynecology. For this reason, pregnant women should pay extra attention to the early detection of this disorder, which can significantly affect a pregnant woman's daily energy level, poor sleep and daytime sleepiness, and more frequent symptoms of anxiety and depression.

Background Many low-income and middle-income countries have introduced public health insurance systems, whereby, thanks to government subsidies, selected groups are entitled to receive insurance coverage even if not paying direct contributions into the system. These efforts towards achieving universal health coverage were often undermined by difficulties in enrolment and registration, barriers to health service utilisation or complicated rules around service packages. Governmental and non-governmental accountability initiatives have been established to overcome these barriers in order to make health insurance programmes responsive and to empower citizens. This paper examines evidence and synthesizes lessons from 20 accountability initiatives in six selected countries to understand how these achieved (or not) these goals. Methods We systematically analysed six final reports and five published papers which were part of a multicountry research programme from 2019 to end of 2022 studying accountability initiatives. Between June 2023 and September 2024, we systematically extracted data and synthesised findings from the reports and papers based on a conceptual framework, adapted from a framework developed by Molyneux, which had been adopted by the country teams to guide their studies. We coded the extracted data and identified the content, context and process factors that enabled or hindered the accountability initiatives in achieving their intended goals. We present and discuss factors that were present in at least two initiatives. Results Governmental initiatives were in most instances established in conjunction with the health reforms that introduced the health insurance programmes they address. Whereas some of these initiatives were effective, many were undermined by poor outreach to citizens, inadequacy of resources, conflicts of interest and power imbalances and lack of fidelity to original design. Non-governmental initiatives often emerged to fill existing gaps in government services and programmes. Many of the non-governmental initiatives had several features which helped them in contributing to citizen empowerment, and these included embeddedness in and being trusted by the local communities, flexibility in operating and reaching out to people and the underlying motivation of people working in them. Conclusions The effective implementation of accountability initiatives requires transparency, trust-building measures, active outreach and community engagement and adequate resources. These elements can ensure that initiatives achieve their intended goal of enhancing citizens’ access to their health insurance entitlements. Further research is needed to understand how best collaboration between governmental and non-governmental initiatives can be fostered to build synergies between the two toward the achievement of common goals.

Background/Objectives: Large language models (LLMs), such as ChatGPT, have emerged as potential clinical support tools to enhance precision in personalized patient care, but their reliability in radiological image interpretation remains uncertain. The primary aim of our study was to evaluate the diagnostic accuracy of ChatGPT-4o in interpreting chest X-rays (CXRs) and abdominal X-rays (AXRs) by comparing its performance to expert radiology findings, whilst secondary aims were diagnostic confidence and patient safety. Methods: A total of 500 X-rays, including 257 CXR (51.4%) and 243 AXR (48.5%), were analyzed. Diagnoses made by ChatGPT-4o were compared to expert interpretations. Confidence scores (1–4) were assigned and responses were evaluated for patient safety. Results: ChatGPT-4o correctly identified 345 of 500 (69%) pathologies (95% CI: 64.81–72.9). For AXRs 175 of 243 (72.02%) pathologies were correctly diagnosed (95% CI: 66.06–77.28), while for CXRs 170 of 257 (66.15%) were accurate (95% CI: 60.16–71.66). The highest detection rates among CXRs were observed for pulmonary edema, tumor, pneumonia, pleural effusion, cardiomegaly, and emphysema, and lower rates were observed for pneumothorax, rib fractures, and enlarged mediastinum. AXR performance was highest for intestinal obstruction and foreign bodies, and weaker for pneumoperitoneum, renal calculi, and diverticulitis. Confidence scores were higher for AXRs (mean 3.45 ± 1.1) than CXRs (mean 2.48 ± 1.45). All responses (100%) were considered to be safe for the patient. Interobserver agreement was high (kappa = 0.920), and reliability (second prompt) was moderate (kappa = 0.750). Conclusions: ChatGPT-4o demonstrated moderate accuracy for the interpretation of X-rays, being higher for AXRs compared to CXRs. Improvements are required for its use as efficient clinical support tool.

Abstract Digital transformation significantly impacts all aspects of the economic system, particularly the functioning of monetary policy and the financial sector. As a key process in modernization, digital transformation encompasses innovations that enable faster, safer and more efficient financial transactions, contributing to greater transparency and better economic integration. This paper analyzes the impact of digital transformation on the monetary policies of Southeast European (SEE) countries, with a particular focus on the development and implementation of digital payment systems. The aim of the research is to examine the potential of digital technologies to improve the monetary policies of these countries, enabling them to achieve greater financial stability and alignment with European Union (EU) standards. The focus is on identifying the benefits of implementing digital payments, including reducing transaction costs, improving trust in monetary institutions, and increasing the transparency of financial flows. The methodological framework of the research is based on multi-criteria decision-making (MCDM), using the CRITIC and MARCOS methods. The CRITIC method was used to evaluate the importance of individual criteria relevant to digital payments, while the MARCOS method enabled the ranking of countries based on their potential for implementing digital payments. The results of the research show that alignment with EU legislation is the most important factor, while Romania has the best potential for implementing digital payments among the observed countries. The contribution of this paper is reflected in the development of a strategic framework and the encouragement of regional cooperation, through which SEE countries could realize the full potential of digital transformation to accelerate economic growth and integration with the EU.

Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital coronary anomaly, with an uncertain prevalence and often diagnosed incidentally. This case report presents a 62-year-old male with ARCAPA diagnosed during an evaluation for chest surgery. The patient had a history of colon cancer and active tuberculosis, complicating the clinical management. He reported chest pain, shortness of breath, and palpitations, with atrial fibrillation observed on a 24 h Holter ECG. Coronary angiography revealed robust collateral circulation and a suspected anomalous origin of the right coronary artery, confirmed by CT imaging. The patient’s stress MRI showed mildly reduced left and right ventricular ejection fractions and perfusion deficits in the apical segments (2/17) of the septal and inferior walls. Given the patient’s comorbidities, including active tuberculosis, the Heart team decided on a non-operative management approach, focusing on careful monitoring and pharmacological management rather than immediate surgery. This case emphasizes the complexity of managing ARCAPA in the context of significant comorbidities, highlighting the importance of individualized, multidisciplinary treatment strategies. Early diagnosis using advanced imaging techniques is crucial, and a non-operative approach can be considered in patients with preserved left ventricular function and no significant ischemia, as demonstrated in this case.

The transition from 5G to 6G networks will catalyze the development of advanced 6G Applications (6G Apps) with enhanced network programmability and intelligence, providing vertical industries and Communication Service Providers (CSPs) with new opportunities to optimize their operations. This article explores the future of the 6G Apps tailored to verticals in the 6G era, highlighting their role as middleware that abstracts network complexities and exposes Application Programming Interfaces (APIs) to enable dynamic interaction and real-time adaptation. Key enablers such as network exposure, Artificial Intelligence (AI), and edge computing are studied in the context of optimizing operations across verticals, and improving Quality of Service (QoS) and fostering innovation. A case study on teleoperated vehicles exemplifies the real-world applicability of these technological enablers for 6G Apps. Furthermore, this article offers insights and explores new research opportunities for 6G Apps tailored to verticals to evolve in the 6G era while addressing key challenges in deploying these applications in real-world commercial networks as a service.

Iron deficiency (ID) is a major problem in heart failure (HF) patients. Iron deficiency is often pressent in patients with rheumatoid arthritis (RA), can be a cause of fatigue and linked with reduced functional capacity. The relationship between ID and right ventricular (RV) systolic function in patients with RA is still not well understood. The aim of this study was to analyze the relationship between ID and RV systolic function. A forty six female patients with seropositive RA were included in our study. Primary goal was to determine association between iron deficiency and echocardiography parameters such as Tricuspid annular plane systolic excursion TAPSE, RV fractional area change (RV FAC), TDI-Derived tricuspid lateral annular systolic velocity (RV TDI S’), Pulmonary artery systolic pressure (PASP); RV free wall global longitudinal strain (RVfwGLS), RV global longitudinal strain (RV GLS) and Right ventriculoarterial coupling (RVAC). The RVAC was determined with the RVfwGLS/PASP ratio. RA was diagnosed according to the ACR/EULAR 2010 classification criteria, without other significant comorbidity. ID was defined as ferritin levels lower than 100 ng/mL and iron levels lower than 10 µmol/L. The mean age of stady population was 57±8 years. Iron deficiency was found in 48% of analysed RA patients. On transthoracic echocardiography the median TAPSE was 18.3 mm, the mean FAC % 38.4±.6.3, the mean RV GLS %-17.2±7.5, the mean RVfwGLS % -20.6±3.8, the mean RV TDI S’ was 10.6±3.9 cm/s, the mean PASP was 29,2±8.7mmHg, the mean RVAC was 0.76. There was no notable difference in demographics or in TAPSE, RV FAC, RV TDI S’, and PASP between patients with iron deficiency and those without. The RVfwGLS (-16.7% vs -21.2%, p = 0.005) was lower in patients with ID. RV GLS (-14.3% vs -18.6%, p=0.005) was lower in patients with ID. Additionally, RVAC (0.65 vs 0.91, p=0.005) was lower in patients with ID. A significant correlation exists between iron deficiency and subclinical RV dysfunction, defined as reduced RV GLS, RVfwGLS and RVAC prior to the decline of parameters commonly used on echocardiography to measure right ventricle systolic function (TAPSE, RV FAC, PASP and RV TDI S'). Screening for iron deficiency in RA patients facilitates early detection and treatment of iron deficiency which may prevent RV dysfunction.