Background: Human papillomavirus is a risk factor in the development of cervical cancer. Other risk factors are frequent vaginal infections, cigarette smoking, use of oral contraceptives, but also lack of lacrobacillus in women with HPV infection. Objective: The objective of our study was to determine the risk factors for the development of cervical intraepithelial lesions in women with normal and pathological Pap test results. Methods: The research is a prospective study conducted in the Gynecology Center "Dr. Mahira Jahić" Tuzla and Dom Zdravlja Tešanj since February. 2023 to March 2024. The research included 200 respondents aged 25 to 50. Tested group: 100 subjects with pathological Pap smear findings (ASCUS, LSIL and HSIL) and a control group of 100 subjects with normal Pap smear findings. Sociodemographic data were obtained from the subjects during interviews and examinations: age, cigarette consumption and frequency of previous vaginal infections and the presence of lactobacilli. The obtained results were processed using the methods of descriptive statistics, student's t test and X2 test. A difference for a value of p<0.5 was considered statistically significant. Results: The mean age of the dpbo examined group was 38.1±1.7, while in the control group it was 39.6±1.9 years. Cigarettes were consumed by 62 (31%), 38 (19%) of the examined group, and 24 (12%) of the control group with a statistically significant difference of p<0.05. Out of a total of 100 in the examined group, 60 subjects had LSIL, 9 subjects had HSIL (CIN 2 two subjects and CIN 3 had 7), and ASCUS 29 and ASC-H 2 subjects. Subjects with pathological findings had significantly more vaginal infections during one year (p<0.05). HPV was positive in 65 (65%) subjects with a pathological Pap smear test, and negative HPV in 35 (35%). HPV 16,18 was present in 19 (19%) test subjects in combined form, and mono-isolate HPV 16 in 14 (14%) and HPV 18 in one case. In the combined form of several HPVs, HPV 16 and HPV 31, 33, 35, 45, 56 were found in 5 (5%), and HPV 18 in 4 (4%) with HPV 36, 59, 68. The most frequently isolated HPV 16 in 38 (38%) as monoisolate and in combined form. Lactobacilli were present in 26 (13%) subjects in the test group and in 60 (30%) subjects in the control group, with a statistically significant difference (p<0.05). The presence of Lactobacillus in subjects with a regular Pap test is significantly more frequent compared to women with cervical intraepithelial lesions (ASCUS, LSIL, ASC-H and HSIL) ) in the finding of the Pap test. Conclusion: Altered microflora of the vagina, lack of lactobacilli, frequent vaginal infections and smoking are risk factors for the development of CIN lesions in women positive for high-risk HPV.

Background: Radical surgical resection for pancreatic head carcinoma offers a chance for cure but unfortunately is only available to a limited number of patients. For a significant number of patients, palliative surgery remains the only option. The question of the most effective approach for patients with borderline resectable pancreatic head carcinoma (BRPHC) remains unresolved. Objective: The aim of the study was to compare the morbidity and mortality following R1 duodenocephalic pancreatectomy and double palliative bypass to explore the most optimal surgical treatment for patients with BRPHC. Methods: Our retrospective cohort study included 64 patients with BRPHC who underwent surgery from 2012 to 2019, with postoperative follow-up for three years. Morbidity and mortality parameters were examined based on the type of surgical treatment: R1 duodenocephalic pancreatectomy or palliative double bypass. Chi-square test, univariate regression, and Kaplan-Meier analysis were used as basic statistical methods in the analysis of the results. Results: Patients undergoing R1 duodenocephalic pancreatectomy had a 3.69 times higher risk of developing biliary leak (p=0.039; 95%CI:1.066, 1.181) and shorter survival compared to those undergoing palliative double bypass (p=0.022). No statistically significant association was found between the type of surgical procedure and other postoperative complications. Conclusion: Our study suggests that the double palliative bypass procedure may be a better option than R1 resection for patients with BRPHC.

Background: Colorectal cancer (CRC) is the third most common malignancy and the second leading cause of cancer-related deaths worldwide. Studies often consider colon and rectal cancers together. The combination of CA 19-9 and CEA markers is used to improve diagnostic accuracy, but there are no reports on the use of this combination as a prognostic predictor for CRC. The study by Kamada et al. was the first to use the "tumor marker index" (TMI), the geometric mean of normalized CEA and CA 19-9 in CRC, demonstrating the prognostic capabilities of this novel marker. However, it is not known how the preoperative value of TMI compares and fits into the current system of prognostic factors for preoperative prediction of overall survival (OS) and disease-free survival (DFS). Objective: The aim was to investigate the significance of preoperatively determined TMI in predicting three-year overall survival (3Y-OS) and three-year disease-free survival (3Y-DFS) in patients with stage III adenocarcinoma of the upper and middle rectum. Methods: Our retrospective cohort study included 93 patients who underwent open anterior resection of the rectum between January 2015 and December 2020. Optimal cut-off values of the markers were determined by ROC analysis. Statistical analysis was performed using IBM SPSS Statistics 22 and R 4.4.0. Results: Patients with TMI ≥1.0158 had a statistically significantly higher likelihood of mortality within three years (p=0.012). Patients with TMI ≥0.979 had a statistically significantly higher likelihood of disease-free survival of less than three years (p=0.003). Compared to CEA and CA 19-9, TMI had the highest AUC for predicting 3Y-OS (0.740, p=0.020) and 3Y-DFS (0.780, p=0.012). Adding TMI to other predictors increased the AUC for predicting both 3Y-OS (from 0.748 to 0.853) (p=0.001) and 3Y-DFS (from 0.711 to 0.850) (p=0.001). Conclusion: Our study confirmed previous findings on the usefulness of preoperative TMI as a prognostic marker, further expanding knowledge about its accuracy by comparing and combining it with established prognostic factors, including CEA and CA 19-9.

Background/Aim: Basal cell carcinoma (BCC) is the most common cancer of the skin. It is believed that increased UV radiation from the sun accounts for almost 90 % of the risk of BCC. There is a growing trend in the incidence of BCC in a younger population. The aim of study was to analyse the initial clinical symptoms of BCC that may be important for the early detection of this skin tumour. Method: The study was a prospective, multicentre study performed in the period from March 2017 to February 2022. A total of 69 respondents with BCC were analysed. Respondents applied for a targeted examination to examine a suspicious skin lesion (due to certain symptoms) or were diagnosed with BCC by accident, when examining other skin changes. Respondents were divided into 2 groups. The first, Group I (35 respondents), consisted of respondents with nodular BCC. The second, Group II (34 respondents), consisted of respondents with superficial spreading BCC. Initially, a careful history and data on the characteristics, shape and character of the tumour were taken from all respondents. Data on all (even the smallest) initial symptoms and relevant signs of evolution, as well as subjective problems related to the tumour were noted. All respondents underwent dermoscopy of suspected skin changes. Results: A significant difference was found between the examined groups in the characteristics of bleeding, crust formation and tendency to injury in lesions, where they occur more often in patients with nodular BCC. Symptoms such as burning and flaking occurred significantly more often in patients with superficial spreading BCC (p < 0.01), as well as the diameter of lesions over 5 mm (p < 0.05). Conclusion: Early clinical diagnosis of BCC is possible with a tumour diameter of only a few mm. The predominant initial (highly susceptible) symptoms of nodular BCC were initial bleeding and / or scab formation on the lesions, as well as propensity to injury. The superficial spreading form of BCC was often larger than 5 mm in diameter, with more frequent scaling of the lesion, as well as burning and stinging sensations in the tumour area. Itching was observed to be a very common previous occurrence in the BCC initial focus zone in subjects of both study groups. Dermsocopy is a highly reliable diagnostic method for early detection of BCC.

Large language models (LLMs) have demon-001 strated powerful capabilities in natural lan-002 guage processing, yet their vast number of pa-003 rameters poses challenges for deployment and 004 inference efficiency. Structured model pruning 005 emerges as a viable approach to reduce model 006 size and accelerate inference, without requir-007 ing specialized operators and libraries for de-008 ployment. However, structured pruning often 009 severely weakens the model’s capability. De-010 spite repetitive fine-tuning can restore the capa-011 bility to a certain extent, it impairs LLMs’ util-012 ity as versatile problem solvers. To address this 013 issue, we propose a novel structured pruning 014 algorithm tailored for LLMs. It derives the im-015 portance of different components, namely rows 016 and columns in parameter matrices, based on in-017 termediate data dependencies. Then it removes 018 coupled components across different layers si-019 multaneously and preserves dependency rela-020 tionships within remaining parameters, avoid-021 ing significant performance degradation. The 022 pruned model requires only few epochs of fine-023 tuning to restore its performance, ensuring the 024 model’s ability to generalize. Empirical eval-025 uations on LLaMA, Vicuna, and ChatGLM3 026 demonstrate our algorithm’s efficacy, yielding 027 20% parameter reduction while retaining at 028 least 94.4% of original performance metrics. 029

Background: The term stress refers to the internal state of the organism (sometimes labeled as "load"), an external event ("stressor"), an experience created by the transaction of a person and the environment. Stress is an extremely used term in all areas of human activity. It is a natural phenomenon and a companion of mankind since its very existence. Although a large number of professional and scientific articles related to the concept of stress and reaction to stress have been published during the last 60 years, various authors state that not all concepts are clearly and unambiguously defined in this field. Objective: The aim of this paper is to present different theories of stress and to familiarize the reader about the consequences of everyday stress on human health. Methods: The subject of research is stress and its impact on health in today's modern world. The type of research on this topic is based on a retrospective and descriptive method based on the use of published articles in the PubMed and Scopus index databases. Results and Discussion: Therefore, different theories of stress define differently the concept of stress, reactions to stress, coping with stress and the consequences of a stressful event. Studies on stress was started by Hans Selye in the thirties of the 20th century. Understanding stress as the organism's reaction to various physical and physiological stressors, Selye also became the originator of the first, so-called of the reductionist model in the study of stress. Another theoretical approach in the concepts of stress boils down to the explanation that stress is determined by the nature of the stressor. This paradigm has been offered since the late sixties of the 20th century and is called the interactionist model of stress. At the same time as the interactionist model, a third, transactional model in the study of stress appeared, created by Richard Lazarus. According to this model, the consequences of a stressful transaction are the result of the interplay of personal and external factors that continuously affect each other. Conclusion: The stress is a state in which the psychophysical balance of the organism is disturbed and which, in order to adapt, requires additional efforts. Circumstances that cause stress are also called stressors. Among the psychological changes characteristic of stress, the most pronounced are changes in the sphere of emotional processes. Emotional reactions characteristic of stress are most often anxiety, anger and sadness, and shame, guilt, oversaturation can also occur. After a traumatic or other intense stress (related to losses or diagnosed with an incurable disease), emotional flattening can occur. Changes in psychological functioning during stress can be so intense that they take on the dimensions of a psychological crisis.

The aim of the research was to examine the prevalence of unpleasant emotional states among students. An online survey was conducted in the month of April, 2023, and the participants were students of public universities in Bosnia and Herzegovina (N=170). Among the measuring instruments used was the DASS-21questionnaire (The Depression, Anxiety and Stress Scale-21, Lovibond and Lovibond 1995) and a sociodemographic questionnaire, constructed for the purposes of this research. It is expected that students will experience unpleasant emotional states such as anxiety, depression and stress, and that there will be certain differences in the manifestation of symptoms with regard to gender and age. The obtained findings showed that 34.3% of the subjects are in the category of moderate, severe and extremely severe depressive symptoms, then 49,9% of the subjects feel moderate, severe or extremly severe anxiety, while 38.2% of the subjects show moderate, severe and extremly severe symptoms of stress. As for gender and age differences, the results show that female students are more susceptible to the prevalence of unpleasant emotional states, while the hypotesis related to age differences was not confirmed. Namely, the findings indicate that there are no age differences in the manifestation of unpleasant emotional states. Considering the obtained findings, we believe that it is necessary to raise awareness about the significant growing problems of mental health among students and to highlight the need for preventive and intervention programs at universities.