Climate change is expected to bring higher temperatures, changes to rainfall patterns and in many places increased frequency and severity of extreme weather. Climate change is slated to affect the global food equation both on the supply and demand side as well as local level food systems where small farm com- munities often depend on local and their own production. As climate change has become more pro-nounced, the risk to land-based food security faced by many of the world’s poor, such as rural communities in Ethiopia and Niger, seems to have become more intense and less predictable. To avoid food insecurity in response to climatic and other stressors, adaptation by small-scale, subsistence farms needs to be accelerated. To effectively intervene to do so, there is a need to understand adaptive behavior in terms of its drivers and its relation with welfare outcomes such as food security. In this paper, we develop a conceptual framework of risk and adaptation, use regression and cluster analysis and the most recent version of the Living Standards Measurement Surveys data for rural areas in Ethiopia and Niger, to advance our understanding. We find that adaptation is associated with lower food insecurity in Ethiopia but not in Niger. Formal education appears as a central element of adaptive capacity and is associated with both adaptive production and income strategies. Female-headed households are much less adapted to a changing climate. Perceived risk based on past hazard experience is crucial for adaptation. Results from the cluster analysis confirm that spatial poverty traps exist. To maintain or enhance welfare in the short term and resilience in the long run in the face of a changing climate, policy makers would do well to focus on micro-regions identified as highly food insecure and build adaptive capacity through, for example, gender inclusive education interventions. (cid:1)

The Western Balkan region (WB) small and medium enterprises (SMEs) lag behind the EU-28 counterparts in their export activities. The positive influence of the Enterprise Europe Network (EEN) on local business support organisations and the local businesses is identified as a contributing factor to that improvement. To investigate the EEN's role in the export of the WB SMEs in the period 2014-2017, the authors used available statistical data on export from the WB countries. The survey was conducted in three phases, with the samples of 1,463, 222, and 12 companies. Analysed results of the EEN activities in the WB show that EEN had a positive influence on the firms' performance and their international activities;67% of supported firms increased their turnover, 62% increased their market share, and the EEN services had a positive impact on the jobs in 52% of the examined firms. The survey results about the expected and actual impact of the EEN services proved a positive impact of the Network on the five indicators: market improvement, cost savings, job creation or maintenance, quality improvement, and innovation. The paper contains important practical implications for the policymakers and the SME managers alike, and the implications mentioned above are generalisable.

Background: Lipids and lipoproteins are significantly involved in maintaining structural and functional components of the human brain and neurons, but their role in the development of Alzheimer’s disease (AD) and vascular dementia (VD) remains unclear. Objective: The aim of the present study was to explore the differences in the standard and novel lipid profile parameters in patients with AD and VD, stratified by the degree of cognitive impairment (CI). Methods: Present study included 66 patients with AD, 50 patients with VD, and 60 control subjects. For an evaluation of the global cognitive function the Montreal Cognitive Assessment (MoCA) test was used. In order to distinguish patients with VD from those with AD the Hachinski ischemic score was used. Plasma total cholesterol (TC), high-density lipoprotein -cholesterol (HDL-C), and triglycerides (TG) levels were determined using standard enzymatic colorimetric techniques, whereas the Friedewald formula was used to calculate low-density lipoprotein-cholesterol (LDL-C) levels. The non-traditional lipid indices such as TG/HDL-C, TC/HDL-C, and LDL-C/HDL-C ratio were separately calculated. The differences between the groups were analyzed with the Kruskal Wallis test followed by the Mann-Whitney test or with ANOVA followed by the Tuckey posthoc test. Results: Results of the conducted study have found that the patients in AD group with moderate CI and patients in AD group with severe CI exhibited significantly lower levels of serum TC, TG, LDL-C, VLDL-C, Non- HDL-C, atherogenic index, TG/HDL-C, TC/HDL-C and LDL-C/HDL-C compared to cognitively normal control subjects. Moreover, patients in VD group with severe and moderate CI had significantly lower level of TG compared to control group of subjects. Our results have also shown that patients in AD group with moderate CI had significantly lower level of TC, TG, LDL-C, Non-HDL-C, atherogenic index, TG/HDL-C, TC/HDL-C compared to VD patients with moderate CI. In addition, patients in AD group with severe CI had significantly lower level of TC, LDL-C, Non-HDL-C and TC/HDL-C compared to VD patients with severe CI. Conclusion: The results of this study have shown dysregulation of lipid metabolism in AD and VD patients with different degree of CI. In both moderate and in severe CI, patients with AD had lower levels of majority of standard and novel lipid parameters compared to patients with VD. Further larger prospective studies are required to elucidate the accuracy of standard and novel lipid parameters in the assessment of different degree of CI in AD and VD.

Pathological gambling and alcoholism are addictions with many common characteristics. Unfortunately, this suggests that a person who is prone to developing an addiction very often develops another addiction, or addictive behavior, over time. In this way, a person with a gambling problem can very often develop an addiction to alcohol, just as an alcoholic can develop a pathological gambling problem over time. Factors influencing the development of addiction, alcoholism in gamblers or gambling in alcoholics, are not only characteristics of an individual prone to addiction, but also external, social factors; gambling sites most often include bars while many bars have gambling machines. In this case report, we present one such example, through all stages of its development to treatment, and this includes diagnosis, treatment and post-hospital follow-up. The treatment for these addictions differs, because alcoholism also requires detoxification. However, when realistic and achievable goals are set, as well as triggers identified and the person's awareness is enhanced, alongside educating and engagement of the individual through functional and adequate behaviors, treatment can be very successful. The probability of relapse exists in both forms of addiction, however, it increases significantly if a person has both addictions.

Introduction: Human papillomaviruses (HPVs), Epstein-Barr virus (EBV), and mouse mammary tumor virus-like virus (MMTV-like virus) can be present and contribute to breast cancer development and progression. However, the role of these oncoviruses and their crosstalk in breast cancer is still unclear. Methods: We explored the co-presence of high-risk HPVs, EBV, and MMTV-like virus in 74 breast cancer samples from Qatar using PCR. Results: We found the presence of HPV and EBV in 65% and 49% of our cancer sample cohorts; 47% of the samples are positive for both oncoviruses. The MMTV-like virus alone was detected in 15% of the samples with no significant association with clinicopathological features. The three oncoviruses were co-present in 14% of the cases; no significant association was noted between the co-presence of these viruses and the clinicopathological features. Conclusion: Despite the presence of the oncoviruses, additional studies are necessary to understand their interactions in human breast carcinogenesis.

Self-inserted urethrovesical foreign bodies are rare in children. A 7-year-old boy inserted a hairpin into the urethra seven days before admission, a diagnosis that was made on the basis of the appearance of blood in the urine, palpation of the base of the penis and two directional X-ray imaging. Cystourethroscopy and suprapubic cystotomy were used to remove the foreign body.The presentation of urethrovesical foreign bodies can vary widely, as can the type of object inserted. Definitive treatment is usually the endoscopic removal, however occasionally surgical intervention may be required. Our novel approach enabled less traumatic removal of the hairpin

Introduction: Quality assessment of healthcare services in medicine today represent a perfectly justified request. Objective: Investigate patient satisfaction with healthcare services provided in the County Hospital "Dr fra Mihovil Sučić" Livno. Subjects and methods: A cross-sectional study was study was conducted on a sample of 200 respondents (n = 200). A questionnaire from the FBiH Agency for Quality and Accreditation in Healthcare (AKAZ) was used as a research instrument. Results: The majority of subjects, 90% of them, were satisfied with nurses’ attitude, without a statistically significant difference between the sexes. No statistically significant difference was found in the assessment of physical health (p = 0.392) and mental health (p = 0.088) between older and younger age groups. Conclusion: The results of the study show a very high level of satisfaction of with the services provided, which is contrary to the general public attitude towards the healthcare system in the Federation of Bosnia and Herzegovina.

<p>Das Ziel dieser Arbeit ist es herauszufinden, wie Sprache funktioniert und welche Formen sie im<br />Bereich der &ouml;ffentlichen Kommunikation hat. Die Besonderheit &ouml;ffentlicher Kommunikation in der<br />modernen Gesellschaft spiegelt sich in mehreren Sprachstrategien wider, wie in der Verwendung von<br />Metaphern und Symbolen, politisch korrekter Sprache oder Euphemismen, Dysphemismen, (Um-)<br />Benennung und Modifikation bestehender Namen, Toponyme. Solche sprachlichen Ph&auml;nomene in der<br />Kommunikation sind zunehmend Gegenstand zeitgen&ouml;ssischer semantischer, pragmalinguistischer,<br />soziolinguistischer und Diskursforschung. &Ouml;ffentliche Kommunikation h&auml;ngt mit der Sprachpolitik in<br />einem bestimmten Kontext zusammen und umfasst somit die soziale &Uuml;berwachung, Zensur und normierte<br />soziale Situationen. Der Beitrag analysiert drei Texte zum Thema Fl&uuml;chtlingskrise, die in<br />unterschiedlichen (Medien-) Kontexten stehen. Hierbei wird angenommen, dass singul&auml;re Texte immer<br />Teil eines gr&ouml;&szlig;eren sprachlich-kommunikativen gesellschaftlichen Kontextes sind, den man dann als<br />Diskurs begreifen kann.</p>

En-bloc tumor resection is the standard treatment for locally advanced colorectal cancer (CRC). An extensive histopathological assessment is necessary to evaluate the metastatic spread and adjuvant therapy. Sentinel lymph node biopsy decreases the histopathological burden when only sentinel lymph nodes (SLNs) are examined. This study aims to evaluate the spread of a magnetic tracer throughout the lymphatic system after ex vivo injection in en-bloc resected specimens of patients with CRC. To achieve this, lymph nodes (LNs) were quantified using a new magnetic detection method. Fifteen patients with CRC diagnosed with clinically negative LNs were included in this study and received 2–4 ex vivo magnetic tracer injections (total volume of 2[Formula: see text]mL). Magnetic sample series were acquired to create a look-up table for magnetic tracer quantification. In 80% of the patients, at least one magnetic LN was detected. A total of 33 LNs were marked as magnetic, containing an average of 8.1[Formula: see text][Formula: see text]g iron. In 71% of the patients, metastases were found in nonmagnetic LNs. Ex vivo injection leads to sub-optimal tracer spread and therefore inaccurate diagnosis. This study presents a novel magnetic detection method to quantify magnetic tracer in lymph nodes. Detecting the SLNs in en-bloc resected specimens and involving only these LNs in histopathological investigation enable a decrease in healthcare costs or an increased diagnostic potential.

Circular peptides are attractive lead compounds for drug development; this study investigates the immunomodulatory effects of defined root powder extracts and isolated peptides (called cyclotides) from Carapichea ipecacuanha (Brot.) L. Andersson (‘ipecac’). Changes in the viability, proliferation and function of activated human primary T cells were analysed using flow cytometry-based assays. Three distinct peptide-enriched extracts of pulverised ipecac root material were prepared via C18 solid-phase extraction and analysed by reversed-phase HPLC and mass spectrometry. These extracts induced caspase 3/7 dependent apoptosis, thus leading to a suppressed proliferation of activated T cells and a reduction of the number of cells in the G2 phase. Furthermore, the stimulated T cells had a lower activation potential and a reduced degranulation capacity after treatment with ipecac extracts. Six different cyclotides were isolated from C. ipecacuanha and an T cell proliferation inhibiting effect was determined. Furthermore, the degranulation capacity of the T cells was diminished specifically by some cyclotides. In contrast to kalata B1 and its analog T20K, secretion of IL-2 and IFN- γ was not affected by any of the caripe cyclotides. The findings add to our increased understanding of the immunomodulating effects of cyclotides, and may provide a basis for the use of ipecac extracts for immunomodulation in conditions associated with an exessive immune responses.