Background: Dental documentation which includes main information about a patient and dental treatment provided is a very important asset of each dental office. Objective: This research aims to analyze the way of fulfilling and keeping mandatory dental records and periodic reporting forms by doctors of dental medicine in the Federation of Bosnia and Herzegovina (FB&H). Methods: The study was observational with a cross-sectional design using a questionnaire as a study tool. The questionnaire was distributed electronically to the participants working in public health care facilities and private practice. Results: A total of 426 Doctors of Dental Medicine (DDM) participated in the study, of whom 58.7% of respondents were employed in dental offices in the public health sector and 41.3% in dental offices in the private health sector. Dental records are filled out only manually by 53.5% of respondents, while 9.4% fill out the records only electronically, while 37.1% of respondents fill out records both manually and electronically. The manner of keeping dental documentation between respondents employed in dental offices in the public health sector and dental offices in the private health sector differs significantly (p<0.05). Almost all respondents understand the purpose and significance of keeping dental records. Conclusion: This paper points out that good dental records are of great importance as they allow monitoring the quality of services provided to patients for a longer period.

Mucopolysaccharidoses (MPSs) are known as rare genetic diseases which are caused by mutation in the enzyme heparin sulfate, which normally leads to degradation and accumulation of glycosaminoglycans in the cells. There are 11 types of MPSs, whereby neuropathy may occur in seven of them (MPS I, II, IIIA, IIIB, IIIC, IIID and VII). Accumulation of degraded heparin sulfate in lysosomes causes cellular dysfunction and malfunction of several organs. However, the exact molecular mechanism how protein degradation and storage leads to cellular dysfunction is not understood, yet. Nonetheless, several genetic and biochemical methods for diagnosis of MPSs are available nowadays. Here we provide an overview on known molecular basis of MPS in general, including enzyme defects and symptoms of MPS; however, the main focus is on MPS type III together with potential and perspective therapy-options.

BACKGROUND: Posttraumatic stress disorder (PTSD) is heritable and a potential consequence of exposure to traumatic stress. Evidence suggests that a quantitative approach to PTSD phenotype measurement and incorporation of lifetime trauma exposure (LTE) information could enhance the discovery power of PTSD genome-wide association studies (GWASs). METHODS: A GWAS on PTSD symptoms was performed in 51 cohorts followed by a fixed-effects meta-analysis (N = 182,199 European ancestry participants). A GWAS of LTE burden was performed in the UK Biobank cohort (N = 132,988). Genetic correlations were evaluated with linkage disequilibrium score regression. Multivariate analysis was performed using Multi-Trait Analysis of GWAS. Functional mapping and annotation of leading loci was performed with FUMA. Replication was evaluated using the Million Veteran Program GWAS of PTSD total symptoms. RESULTS: GWASs of PTSD symptoms and LTE burden identified 5 and 6 independent genome-wide significant loci, respectively. There was a 72% genetic correlation between PTSD and LTE. PTSD and LTE showed largely similar patterns of genetic correlation with other traits, albeit with some distinctions. Adjusting PTSD for LTE reduced PTSD heritability by 31%. Multivariate analysis of PTSD and LTE increased the effective sample size of the PTSD GWAS by 20% and identified 4 additional loci. Four of these 9 PTSD loci were independently replicated in the Million Veteran Program. CONCLUSIONS: Through using a quantitative trait measure of PTSD, we identified novel risk loci not previously identified using prior case-control analyses. PTSD and LTE have a high genetic overlap that can be leveraged to increase discovery power through multivariate methods.

BACKGROUND To determine the effect of lockdown measures on lung transplant patients during the COVID-19 pandemic. SUBJECTS AND METHODS We collected data from Croatian lung transplant patients before and after the lockdown and analyzed changes in weight, BMI, lung function and blood lipid status. RESULTS An average increase of 3.74 kg (+4.92%) body weight during the 4 month lockdown period was observed. Lung function values and blood lipid status remained stable. CONCLUSION Such weight gain could have detrimental effects on the morbidity and mortality of lung transplant patients. Further follow up is needed to determine the long term impacts of this observation.

Fiscal sustainability should be defined in the relation between public finances and sustainable economy. It requires a fiscal policy aimed not only at a fiscal balance, but also at the well-being of future generations, while taking the economic, social, environmental and institutional dimensions into account. The objective of this paper is to examine the relationship between fiscal sustainability and efficiency on the example of large cities in Poland in the period from 2008 to 2019. In order to obtain empirical results, a data envelopment analysis and panel data analysis were applied, and a fiscal sustainability index was constructed by means of a multidimensional approach. Based on a sample of 66 large cities in Poland, the results showed that there is a negative relationship between fiscal sustainability and efficiency. These results, however, relate to a specific period in the history of Polish cities when the local debt limits were tightened. The improvement in efficiency allowed local government units to allocate saved local expenditures to the partial repayment of previously incurred local debts. By doing so, Polish cities fulfilled tightened fiscal rules, but their service-level solvency decreased.

OBJECTIVES In this international, multicenter study, using third-generation dual-source computed tomography (CT), we investigated the diagnostic performance of dynamic stress CT myocardial perfusion imaging (CT-MPI) in addition to coronary CT angiography (CTA) compared to invasive coronary angiography (ICA) and invasive fractional flow reserve (FFR). BACKGROUND CT-MPI combined with coronary CTA integrates coronary artery anatomy with inducible myocardial ischemia, showing promising results for the diagnosis of hemodynamically significant coronary artery disease in single-center studies. METHODS At 9 centers in Europe, Japan, and the United States, 132 patients scheduled for ICA were enrolled; 114 patients successfully completed coronary CTA, adenosine-stress dynamic CT-MPI, and ICA. Invasive FFR was performed in vessels with 25% to 90% stenosis. Data were analyzed by independent core laboratories. For the primary analysis, for each coronary artery the presence of hemodynamically significant obstruction was interpreted by coronary CTA with CT-MPI compared to coronary CTA alone, using an FFR of ≤0.80 and angiographic severity as reference. Territorial absolute myocardial blood flow (MBF) and relative MBF were compared using C-statistics. RESULTS ICA and FFR identified hemodynamically significant stenoses in 74 of 289 coronary vessels (26%). Coronary CTA with ≥50% stenosis demonstrated a per-vessel sensitivity, specificity, and accuracy for the detection of hemodynamically significant stenosis of 96% (95% CI: 91–100), 72% (95% CI: 66–78), and 78% (95% CI: 73–83), respectively. Coronary CTA with CT-MPI showed a lower sensitivity (84%; 95% CI: 75–92) but higher specificity (89%; 95% CI: 85–93) and accuracy (88%; 95% CI: 84–92). The areas under the receiver-operating characteristic curve of absolute MBF and relative MBF were 0.79 (95% CI: 0.71–0.86) and 0.82 (95% CI: 0.74–0.88), respectively. The median dose-length product of CT-MPI and coronary CTA were 313 mGy·cm and 138 mGy·cm, respectively. CONCLUSIONS Dynamic CT-MPI offers incremental diagnostic value over coronary CTA alone for the identification of hemodynamically significant coronary artery disease. Generalized results from this multicenter study encourage broader consideration of dynamic CT-MPI in clinical practice. (Dynamic Stress Perfusion CT for Detection of Inducible Myocardial Ischemia [SPECIFIC]; NCT02810795)

Background: The accessory deep peroneal nerve (ADPN) is as an anomalous nerve derived from the superficial peroneal nerve or its branch and supplies motor innervations for extensor digitorum brevis (EDB) and sensory innervations for the lateral part of the ankle and foot regions. It is the most common anomalous innervation present in the lower limb. Objective: The aim of this study was to determine the prevalence of ADPN electrophysiologically in a sample of Bosnia and Herzegovina subjects who referred to an electromyography lab. Methods: This cross-sectional descriptive study included 316 lower limbs from 171 subjects referred for electrodiagnostic studies to Electromyography Lab, Department of Neurology, University Clinical Center Tuzla (Bosnia and Herzegovina) (102 females/60% and 69/40%) males). Motor nerve conduction studies for the peroneal nerve and ADPN were done. Compound muscle action potential (CMAP) and nerve conduction velocity (NCV) of deep peroneal nerve (DPN) were measured by using EMG machine by stimulating DPN at knee, ankle and lateral malleolus areas accordingly, with recording from extensor digitorum brevis (EDB) muscle. Results: ADPN was found in 46 (14.5%) of 316 legs. ADPN was found in 18 (39.1%) right lower limbs and 28 (60.9%) left lower limbs. Ten subjects (5.8%) had bilateral ADPN. There was no statistically significant difference between the occurrence of ADPN in women versus men (p=0.757), as well as in right versus left legs (p=0.237). Conclusion: This study demonstrated that ADPN prevalence, in a sample of Bosnia and Herzegovina subjects who referred to an electromyography lab is 14.5%. Recognition of ADPN is very important for proper interpretation of lower limbs electrophysiological data.

Aim: Orthodontic brackets during their wear cause demineralization of enamel, which is the initial step in caries development. The prevention of such spots is crucial to ensure healthy teeth, but patients’ compliance is not the most optimal way. The aim of this study was to compare the antimicrobial properties of fluoride-containing orthodontic materials to the materials without additional fluoride. Materials and Methods: Antibacterial effectiveness of orthodontic materials with fluoride – Transbond Plus SEP Bonding agent, Transpond Plus Adhesive agent, Fuji I Band cement, Fuji Ortho LC Adhesive agent, Ortho Solo Bonding agent, and without antimicrobial substances – Transpond XT Bonding agent, Transbond XT Primer were tested with the inhibition on most common causes L. achidophilus (ATCC 4356) and S. mutans (ATCC 10449) and compared to negative control. Antimicrobial effectiveness of each material was measured with the agar diffusion method and expressed with the diameters of inhibition zones around the disk. Results: Materials containing fluoride showed more antimicrobial effectiveness compared to materials without fluoride or negative control (p<0.001), respectively. Materials from the group with no antibacterial substances were not statistically different compared to the negative control (P>0.05). Conclusion: Materials containing fluoride showed more significant antimicrobial effectiveness when compared to the materials without antimicrobial substance and thus might have the potential of antimicrobial properties in vivo.

Background: Sleep is a complex process involving the interactions of several brain regions, which play a key role in regulating the sleep process, particularly the brainstem, thalamus, and anterior basal brain regions. The process of sleep is accompanied by a change in body functions, as well as a change in cerebral electrical activity, which is under the control of the autonomic nervous system. Objective: The aim of the study was to analyze the frequency of stroke recurrence and disability of patients with stroke and apnea. Methods: It was analyzed 110 acute stroke patients with sleep apnea. All patients were evaluated with: Glasgow scale, The American National Institutes of Health Scale Assessment, Mini Mental Test, The Sleep and snoring Questionnaire Test, The Berlin Questionnaire Test, The Epworth Sleepiness Scale, The Stanford Sleepiness Scale, and The general sleep questionnaire. Results: The largest number of patients with apnea on admission had a degree of disability of 4, and on discharge of 1. There was a statistically significant difference between the mean values of incapacity for admission and discharge. The student’s t - test did not determine a statistically significant difference in disability according to the Rankin scale between patients with and without apnea at admission (t = 0.059, p = 0.95) and discharge (t = 0.71, p = 0.48). According to the NIHS scale, patients of both sexes with apnea had a neurological deficit of 7.55 ± 5.22 on admission and 7.1 ± 4.3 without apnea. Statistically significant difference was not found on the neurological deficit of both sexes, with and without apnea, at admission and discharge. With apnea, there were 13 relapses of stroke during one year, and without apnea in only 3 patients. Conclusion: Patients with acute stroke have a significantly higher correlation rate according to sleep apnea. There is no significant correlation in the degree of disability between patients with and without apnea.

Gender inequalities could lead to grave human and economic consequences, especially amid global health crises of the coronavirus 2019′s (COVID-19) scale. The COVID-19 pandemic exacerbated gender inequalities women face and introduced new challenges that are unprecedented to society at large. Adverse effects of COVID-19, compounded by unintended consequences caused by public health policies such as lockdowns (e.g., delayed or canceled health services), have forced women to face issues ranging from COVID-19 infections and deaths, prolonged unemployment, to unparalleled scale and severity of domestic violence. However, though women face a canopy of debilitating challenges, there is a shortage of research that examines health solutions that can mitigate, if not offset, challenges women experience amid COVID-19. In this paper, we aim to shed light on why timely solutions are needed to mitigate gender inequalities and health disparities women face amid COVID-19 promptly. Furthermore, we underscore the imperative for cost-effective interventions that could shed light on the current health crisis and future pandemics.

Highlights • The overall severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) secondary attack rate in this study was 17%.• Adults were more likely to be secondary cases than children.• Particular care should be taken if primary cases present with cough and rhinorrhoea.• Kissing a SARS-CoV-2 case or sharing a meal with a SARS-CoV-2 case increased the risk of infection.• Reducing contact in the household immediately is key to prevent onward transmission.

Legacy landmines in post-conflict areas are a non-discriminatory lethal hazard and can still be triggered decades after the conflict has ended. Efforts to detect these explosive devices are expensive, time-consuming, and dangerous to humans and animals involved. While methods such as metal detectors and sniffer dogs have successfully been used in humanitarian demining, more tools are required for both site surveying and accurate mine detection. Honeybees have emerged in recent years as efficient bioaccumulation and biomonitoring animals. The system reported here uses two complementary landmine detection methods: passive sampling and active search. Passive sampling aims to confirm the presence of explosive materials in a mine-suspected area by the analysis of explosive material brought back to the colony on honeybee bodies returning from foraging trips. Analysis is performed by light-emitting chemical sensors detecting explosives thermally desorbed from a preconcentrator strip. The active search is intended to be able to pinpoint the place where individual landmines are most likely to be present. Used together, both methods are anticipated to be useful in an end-to-end process for area surveying, suspected hazardous area reduction, and post-clearing internal and external quality control in humanitarian demining.