OBJECTIVE To present the characteristics of the AKT1E117K gene variant and a description of the clinical application in a patient with metastatic breast cancer. RESULTS 63 y/o woman with Stage IV Invasive lobular carcinoma at diagnosis was treated with Palbociclib and aromatase inhibitors (AI). At progression, tissue was sent for comprehensive genomic profiling to Foundation Medicine (FM) which revealed AKT1E17K mutation. In lieu of available clinical data within the patient's tumor type (HR+ HER2- breast cancer), extrapolated data from the Flatiron Health-FM (FH-FMI) Clinico-genomic Database (CGDB) was discussed at our Molecular Tumor Board (MTB). After multidisciplinary discussion, the consensus recommendation was to start treatment with the combination of mTOR inhibitor everolimus, and AI, exemestane. Patient tolerated treatment without major side effects. By the second clinical visit the patient's breast showed signs of improvement. PET/CT showed diminished left axillary uptake, decreased right paratracheal lymph node PET avidity, and stable bone disease consistent with a partial response. The most recent office visit in January 2021, breast exam revealed a normal-appearing skin with only faint erythema. All other skin lesions have resolved. Although, the role of AKT1 variant described here is not well defined and therapeutic significance of M-Tor inhibitors not established in metastatic breast cancers, comprehensive approach to this case unraveled new and successful therapeutic option in this patient. CONCLUSION This demonstrates that applying available Precision Medicine tools like MTB and real world data sets from patient populations with similar clinical and genomic profiles may provide more options for treatment.

Introduction: The invasion of blood and lymph vessels with tumor tissue represents a negative prognostic factor of the disease course in patients with non-small cell lung cancer. Aim: The aim of the study was to determine the marker value of a preoperatively determined size of pulmonary squamous cell carcinoma and adenocarcinoma and its impact on lymphovascular invasion (LVI) in resected lung tissue. Materials and Methods: The conducted observational cross-sectional study included 322 patients with a complete resection of confirmed squamous cell lung carcinoma and lung adenocarcinoma. Preoperative size and type of tumor were determined by a preoperative chest computed tomography scan and cytological/histological analysis of obtained samples, while LVI status was determined by pathohistological analysis of resected tumor lung tissue. Receiver operating characteristic (ROC) curve analysis was performed to assess whether tumor size could serve as a reliable marker for LVI. P < 0.05 was considered statically significant. Results: A statistically significant difference in the frequency of tumor size (P = 0.580) along with LVI (P = 0.656) was not established between the patients with squamous cell lung cancer and lung adenocarcinoma. A ratio between the size of lung adenocarcinoma and LVI status (P < 0.001) was determined as statistically significant, while such a difference was not established in squamous cell lung cancer (P = 0.052). The ROC analysis revealed that tumor size >39 mm in patients with lung adenocarcinoma has obtained a sensitivity of 70.8% and a specificity of 60.9% to differentiate patients with a LVI (areas under the curve [AUC] = 0.70; 95% CI 0.60‒0.79; P < 0.001). A tumor size >4.6 cm in patients with squamous cell lung cancer obtained a sensitivity of 56.5% and a specificity of 60.3% to differentiate patients with a LVI (AUC = 0.59; 95% CI 0.50‒0.67; P = 0.043). Conclusion: The preoperative size of lung adenocarcinoma could be an acceptable marker of LVI presence in resected lung tissue, while in the squamous cell lung cancer, a potential biomarker role of the preoperative size of the tumor was inadequate.

OBJECTIVES The aim of this systematic review was to critically analyze available data on gene polymorphisms in odontogenic keratocysts and ameloblastomas, including their possible relationship with clinical and histological features of these lesions. MATERIALS AND METHODS A comprehensive search of Web of Science Scopus, PubMed, Cochrane Central Register of Controlled Trials and EMBASE was conducted using relevant key terms and supplemented by a gray literature search. Quality assessment of included studies was performed using criteria from the Strengthening the Reporting of Genetic Association (STREGA) statement. RESULTS Ten studies were included in the final review. Survivin -31G/C, interleukin IL-1α -889 C/T, p53 codon 72 G/C, tumor necrosis factor TNF-α (-308G>A) and its receptor TNF-R1 (36A>G), glioma-associated oncogene homolog 1 rs2228224 and matrix metalloproteinase 2 rs243865 gene polymorphisms were reported to be associated with odontogenic keratocysts. For ameloblastomas, p53 - codon 72 G/C, X-ray repair cross-complementing protein 1 - codons 194 and 399 and matrix metalloproteinase 9 rs3918242 gene polymorphisms were identified as risk factors. It wasn't possible to establish a relationship between specific polymorphisms and clinical and histological features of investigated lesions. CONCLUSIONS Several gene polymorphisms might be considered as a risk factor for the development of these lesions. Future studies should investigate whether these polymorphisms might be used to identify patients with increased risk of recurrence or aggressive disease.

Lubarda, B. & Topalić-Trivunović, Lj.: Alien flora of the city of Banja Luka (Bosnia and Herzegovina). Nat. Croat., Vol. 29, No. 2, 217-226, 2020, Zagreb. In the urban area of Banja Luka, 77 species of alien plants have been found, most of them neophytes (64.94%) while a smaller percentage are archeophytes (35.06%). Most of the plants originate from America (34), and Asiatic species rank second (17). Most of the alien plants belong to the Compositae family, in terms of life form are therophytes, and intention has been involved in their arrival in this area.The anthropogenic change indicator values have been shown to have a significant anthropogenic impact on the overall flora.

A generalized (6DOF) model for evaluating fragment trajectory elements is defined, which incorporates a novel model for estimating the projected surface of the body and novel model for estimating aerodynamic force and moment. This 6DOF model is developed on the basis of differential equations of the center of mass motion and movement around the center of mass (currently no known model incorporates movement of the body around its center of mass), and can model the parameters that play an essential role in movement of the bodies with irregular shape through the atmosphere. In our model the basic parameters (i.e. body dimensions) can be arbitrarily changed in the initial part of the analysis, and based on their values and values of initial kinematic parameters (initial velocity, position, orientation), trajectories can be determined (as well as other parameters: velocities, orientation) in a relatively short amount of time. The calculation of the complete trajectory of the fragments can be used in a number of applications: the analysis of the effects of the fragments (i.e. the safety analysis of the location of the ammunition depots, due to the potential explosion of the projectile) or in the estimation of a danger zones when demining larger quantities of the munition. Also, from the point of view of the parameters of the lethal zone of HE projectiles, it is generally important to estimate the trajectory of the fragments in the range up to 50m, so this model can be used to model such a scenario also. This model could also be potentially used wherever there is a need to calculate flight mechanics parameters of irregularly shaped bodies. Generalized (6DOF) model for estimation of an irregularly shaped body trajectory is implemented in a computer program, written in MatLab. Based on the model, the trajectory calculations were performed for the complete trajectory and for shorter distances to the center of the explosion, with varied geometric-inertial parameters and initial kinematic conditions for the given fragment.

A review of internal blast loads on structures modeling methods is presented in the paper. Also, numerical simulations of the internal explosion were done in software Ansys Autodyn. Critical areas of confined spaces were identified for this type of explosion event. Recommendations were given regarding the use of numerical simulations in blast wave parameter prediction, as well as suggestions for further research.

In the present paper we consider the nonlinear superposition operator \(F\) in Banach spaces of sequences \(l_p\) \((1\le p\le \infty)\), generated by the function \(f(s, u) = d(s) + a^{ku} - 1\), with \(a > 1\) and \(k\in \mathbb{R}\setminus\{0\}\). We find out the Rhodius spectra \(\sigma_R(F)\) and the Neuberger spectra \(\sigma_N(F)\) of these operators, depending on the values of \(k\).

Abstract Background The European Leadership Forum (ELF) of the European Society of Plastic, Reconstructive and Aesthetic Surgery (ESPRAS) previously identified the need for harmonisation of breast reconstruction standards in Europe, in order to strengthen the role of plastic surgeons. This study aims to survey the status, current trends and potential regional differences in the practice of breast reconstruction in Europe, with emphasis on equity and access. Materials and Methods A largescale web-based questionnaire was sent to consultant plastic and reconstructive surgeons, who are experienced in breast reconstruction and with understanding of the national situation in their country. Suitable participants were identified via the Executive Committee (ExCo) of ESPRAS and national delegates of ESPRAS. The results were evaluated and related to evidence-based literature. Results A total of 33 participants from 29 European countries participated in this study. Overall, the incidence of breast reconstruction was reported to be relatively low across Europe, comparable to other large geographic regions, such as North America. Equity of provision and access to breast reconstruction was distributed evenly within Europe, with geographic regions potentially affecting the type of reconstruction offered. Standard practices with regard to radiotherapy differed between countries and a clear demand for European guidelines on breast reconstruction was reported. Conclusion This study identified distinct lack of consistency in international practice patterns across European countries and a strong demand for consistent European guidance. Large-scale and multi-centre European clinical trials are required to further elucidate the presented areas of interest and to define European standard operating procedures.

Nutrients are chemical substances obtained from food. They have different roles in body.  Some are used as energy source, some as structural materials, and regulating agents. Nutrients may reduce the risks of some diseases. There are some recommendations about dietary intake of these nutrients for optimal health. This study aimed to estimate average calcium and magnesium content in day meal in a sample of students from Faculty of Medicine of Sarajevo University. A cross-sectional study was conducted during academic 2015/16 year at Faculty of Medicine of Sarajevo University. The survey covered 44 students. The research instrument was a self-administered questionnaire, by which 3-Day Diet Record was provided. The average intakes of calcium and magnesium were estimated using Nutritional analysis computer program (Nutrics Professional Nutrition Analysis Software). On daily level average intake of calcium was 718.39±311.14 mg in total sample and average intake of magnesium was 292.57±310.10 mg in total sample. Average Ca/Mg ratio was 2.45. In our sample cheese was top source of calcium with Ca/Mg ratio of 32.5, and bread was top source of magnesium with Ca/Mg ratio of 3.1. These results emphasize the importance of monitoring the food nutrition facts in order to achieve adequate nutrients intake.