Background: Laryngeal squamous cell carcinoma (LSC) is the leading malignant tumour of the head and neck. Establishing new biomarkers is extremely important because they can be important for early diagnosis and prognosis of LSC. Objective: The aim of this study was to establish the significance of cytokeratin fragment antigen 21-1 (CYFRA 21-1) in the early diagnosis and prognosis of LSC. Methods: This was prospective research involving 35 patients of both sexes with pathohistologically confirmed LSC, who were treated in the period from 2022 to 2024. The control group consisted of 30 patients who underwent surgery for other non-malignant diseases and who had a normal indirect laryngoscopy findings. The levels of CYFRA 21-1 were determined for three time periods: preoperative, four weeks after surgery, and three months after radiotherapy or concomitant chemoradiotherapy. For the statistical analysis of data we used descriptive statistics methods, the Student T-test and the χ2 test to calculate the significance of the tested differences, where differences on the level of p<0.05 were considered to be statistically significant. Results: Statistically significantly higher mean serum levels of CYFRA 21-1 were found preoperatively in the experimental group in comparison with the control group (p<0.001). Statistically significant lower levels of CYFRA 21-1 were found four weeks after surgery in the experimental group in comparison with preoperative levels (p=0.004). A statistically significant decrease in serum levels of CYFRA 21-1 was also found three months after radiotherapy or concomitant chemoradiotherapy in comparison with the preoperative levels (p=0.001). The serum levels of CYFRA 21-1 were statistically significantly higher preoperatively in patients with stage III/IV of the disease in comparison with stage I/II (p<0.001). Conclusion: Increased levels of CYFRA 21-1 are a significant indication of the presence of LSC, especially in patients with advanced stages of the disease.

Background: Minimally invasive coronary artery bypass grafting (MICS CABG) via left anterior thoracotomy has emerged as a less invasive alternative to conventional open sternotomy (OPEN CABG), offering potential benefits in perioperative outcomes and complication rates. Objective. The aim of this study was to compare procedural characteristics, ventilation duration, drainage volumes, and postoperative complications between MICS CABG and OPEN CABG in a single-center cohort in Bosnia and Herzegovina. Methods. This retrospective cross-sectional study included 262 patients who underwent surgical revascularization between January 2019 and June 2023. Results. MICS CABG was associated with a shorter median procedure time (2.5 vs. 3.5 hours, p<0.001) and reduced mechanical ventilation duration (11.0 vs. 14.0 hours, p<0.001). Although ICU stay was similar (3.0 days, p=0.001), total hospitalization was shorter for MICS CABG (6.0 vs. 7.0 days, p<0.001). Postoperative drainage was significantly lower at all measured time points (p<0.05), and transfusion requirements were reduced for red blood cells (0 vs. 2 units, p<0.001), fresh frozen plasma (0 vs. 2.5 units, p<0.001), and platelets (p=0.035). Use of inotropic agents was less frequent in MICS CABG, both at low (50.4% vs. 62.8%, p=0.043) and medium doses (4.0% vs. 16.0%, p=0.001). Wound infections were numerically lower in the MICS group (p=0.437). Conclusions. Compared to open sternotomy, MICS CABG demonstrated significant advantages in operative time, ventilation duration, blood loss, and complication rates, supporting its role as a safe and effective alternative for coronary revascularization.

Background: Date palm fruits (Phoenix dactylifera L.) are a widely available product that contains numerous macronutrients including a high sugar content. Research has shown that date fruit extracts possess antibacterial and antifungal properties, as well as antimutagenic and antiatherogenic effects. Date fruit can also have a beneficial effect on the female reproductive system. Several studies have examined the impact of date consumption during pregnancy on the outcome of labor, providing useful results. Objective: This study aims to determine the effects of date fruit consumption on the onset and progression of labor. Methods: The study included 120 pregnant women who were pregnant at GAK Sarajevo, in the period from 01.01. 2020 to 31.12. 2020. The patients were divided into two groups, the first group of 60 patients who consumed 6 dates during the last four weeks of pregnancy, and the second group of 60 patients who did not consume dates during pregnancy. Results: There was a significant positive effect of consuming date fruits on maternal outcomes in the first and third stages of labor. The group of pregnant women who consumed dates had a shortened latent phase of labor, which meant that their cervix reached maximum dilation (10 cm) faster. Pregnant women in this group gave birth 8.5 hours faster than pregnant women who did not consume dates, in whom labor lasted about 15 hours. Of the 60 pregnant women in the first group, 60% had a spontaneous natural birth, and only 40% of the patients received oxytocin, because dates enhance the effect of oxytocin, which is responsible for uterine contractions. Conclusion: This study showed a promising effect of consuming date fruits on the duration of the stages of labor. Saturated and unsaturated fatty acids found in dates stimulate the production of prostaglandins, which are necessary for labor. Dates are also rich in folic acid, vitamin K, iron, potassium, and magnesium.

This review is remembrance on occasion of 35 years of MIE ‘90 held in Glasgow which organized by UK and Scottish Association of Medical Informatics, and chaired by John Bryden and his team with support by European Federation for Medical Informatics (EFMI). It was my first participation at MIE Conferences, in that time as General Secretary of Yugoslav Association of Medical Informatics (YAMI) and officially accepted as a member of EFMI and IMIA. Besides our President of YAMI, Professor Gjuro Dezelic, one of founders YAMI (with Izet Masic, Stefan Adamic, Rajko Vukasinovic, as presidents of Bosnia and Herzegovina, Slovenian and Serbian Societies of Medical Informatics in 1987) participants at MIE ‘90 have been, also, our colleagues: Josipa Kern, Nada Dezelic, Silvije Vuletic, Visnja Lovrek, Miroslav Madjaric, etc. It was my first active participation at MIE Conferences, and after this meeting, year by year I continued until today. Let me say some important facts about it as my personal story -„Medical Informatics Journey“, during the last 35 years, from Glasgow 1990 until today.

Background: T Measles is a viral, highly contagious disease from the group of rash fevers, which mainly affects children. Persons suffering from measles are considered contagious four days before and four days during the period of the appearance of measles, which favors its faster spread. Clinical observation and laboratory diagnostics are essential for monitoring the course of the disease in order to prevent complications. Objective: Our study aimed to analyze the significance and usefulness of laboratory tests on admission to hospital in pediatric patients with measles. Methods: This prospective study included children with confirmed measles infection who came accompanied by parents to the Infectious Disease Clinic of the Clinical Center of the University of Sarajevo during nine months. Data on age, sex, symptoms and results of laboratory analyzes (biochemical, hematological and coagulation) were recorded. Results: The study included a total of 302 subjects, including 122 healthy controls and 180 measles patients. Significantly lower values observed for aPTT, absolute number of eosinophils and basophils, RBC, hemoglobin, hematocrit, MCV, MCH, MCHC in measles patients. Significantly higher values were observed for fibrinogen, D-dimer, WBC, neutrophils, lymphocytes, monocytes, RDW and MPV in measles patients in contrast to controls. Significantly higher values were also observed for serum chloride, glucose, CRP, AST, ALT and LDH values. AST/ALT, NLR, PLR, NPR, LMR, LCR, SII and AISI also showed significant differences in measles patients compared to controls. Conclusion: The results of our study showed that laboratory tests have great significance and potential in measles in pediatric patients admitted to the hospital. Lymphocyte/C-reactive protein ratio also showed good diagnostic potential.

Water constitutes a substantial input in food production, exerting a direct influence on the quality of the final product. Water quality affects every stage of the food value chain, from primary production to final consumption. Contaminated water can introduce impurities, unpleasant aromas, and odors, compromise the taste and appearance of the product, and, most significantly, compromise its healthfulness. Pathogens transferred through water pose a grave health risk to consumers. Consequently, ensuring the integrity of water quality is paramount to the overall quality and safety of food. Water from natural sources, including rivers, lakes, and wells, may contain a variety of contaminants that can adversely affect food quality. The treatment of water for food production involves the removal of impurities, contaminants, and bacteria that may be present in water sources. The application of diverse treatment methods can yield water that meets quality and safety standards. It is incumbent upon food manufacturers to prioritize water quality and adhere to regulatory guidelines to ensure the highest standards of food safety and quality.

The concept of decision making is considered as one of the key topics in the field of strategic management and related fields. According previous theoretical considerations and discussions of the main contributors, there is no single routine/path used by managers in strategic decision-making. Mintzberg, Raisinghani and Théorêt define strategic decisions with regard to the decision-making level as a combination of entrepreneurial activities and efficient use of resources. The process of making strategic decisions is often described as unstructured, non-routine associated with uncertainty, defining it as a set of activities, which includes the collection of information, the development of alternatives and their evaluation, and ultimately the selection of the best alternative. It is clear, therefore, that it is difficult to talk about strategic decision-making exclusively in the context of a logical sequence of activities by division makers. This type of presentation of strategic decision-making, based on the idea of rational action by top management, as the strategic management executives, is also shown in numerous management text books. In their editorial in a special issue of the prestigious Strategic Management Journal, Cyert and Williams synthesized the conclusions of the special issue contributors. Analysing the cause-and-effect relationship between strategy, strategic decision-making and the organization, emphasis is put on the importance of organizational learning. In the conditions of creating an economy based on information and knowledge, a connection is created between information, organizational structure and strategic decision-making. In complex systems, such as companies, one of the key problems that occurs when making decisions is to find out where the decision comes from and how it is realized. Strategic decisions are most often a collection of some individual decisions in the organization or a consequence of informal conversations or actions that lead to collective action. The focus of this paper is an attempt to identified a key theoretical underpinning, through an overview of relevant theories and strategic management schools. In so doing, this paper will use the concept of strategic management schools, presented by Mintzberg, Ahlstrand and Lampel in their popular book Strategic Safari.

Summary Explosive energy can be used in metal forming processes, e.g. for bulk forming, sheet forming and for other processes. This paper presents the experimental research and numerical modelling of the process of sphere deformation by explosive forming. The assembly for forming a sphere with a diameter of 210 mm was welded from flat segments and annealed after welding. The material of the sphere was steel St12 according to DIN 1629/3. The thickness of the sheet metal was 2.0 mm. The sphere was modelled in the SolidWorks program and 3D-printed with the polylactic acid (PLA) material. The Poladyn 31ECO explosive was used for the experimental investigation into the process of deep drawing of the sphere by explosion, while the LS-DYNA hydrodynamic software was used for simulation. The pressure in the sphere was measured with a pair of copper crushers. It is shown that the simulation satisfactorily reproduces the experimentally measured pressure.

Background/Aim. Patients classified as belonging to simplified pulmonary embolism severity index (sPESI) class 0 are considered to have low-risk pulmonary embolism (PE). Yet, certain laboratory and echocardiographic parameters not accounted for in the sPESI score might suggest a likelihood of worse outcomes in PE cases. This study seeks to determine if the prognostic value of the sPESI score in acute PE can be improved, refined, and optimised by incorporating brain natriuretic peptide (BNP) and troponin I (TnI) levels, echocardiographic parameters, or glomerular filtration rate. Methods. The study encompassed 1,201 consecutive patients diagnosed with PE, confirmed by multidetector computed tomography (MDCT). Upon admission, each patient underwent an echocardiography exam, and blood samples were taken to measure B-type natriuretic peptide (BNP), troponin I (TnI), creatinine, and other routine laboratory markers. Results. The in-hospital mortality rate was 11.5%. The patients were categorized into three groups using the three-level sPESI model: sPESI 0, sPESI 1, and sPESI ≥ 2. Statistically significant differences were found among these groups regarding mortality rates, TnI values, BNP levels, estimated glomerular filtration rate (eGFR), and the presence of right ventricular dysfunction (RVD). Cox regression analysis identified eGFR as the most reliable predictor of 30-day all-cause mortality [HR 2.24 (CI 1.264-3.969); p = 0.006] across all sPESI categories. However, incorporating TnI, BNP, or RVD did not improve risk prediction beyond the three-level sPESI model. Conclusion. Renal dysfunction at the time of admission is closely related to an elevated risk of in-hospital mortality in patients with acute PE. The three-level sPESI score offers a more accurate method for prognostic stratification in these patients.

Background/Aim. Postoperative cognitive dysfunction (POCD) occurs very often in operated patients. This increasingly frequent complication compromises the recovery of operated patients, impairs the quality of life of patients and their families, prolongs the length of hospital stay, and increases the cost of treatment. The aim of the study was to examine the association between the apolipoprotein E (APOE) ?4 allele and sociodemographic and clinical characteristics with the occurrence of POCD seven days and three months after colon cancer surgery (CCS) under general anesthesia (GA). Methods. A total of 113 patients aged 18 to 87 years who underwent CCS under GA in the period from 2021 to 2023 participated in the study. Preoperative preparation, anesthesia, and postoperative treatment were uniform and standardized for all patients. The assessment of cognitive status was conducted using the Mini Mental State Examination psychometric test on the day before surgery, on the seventh postoperative day, and three months after surgery. Results. Seven days after surgery, a statistically significant impairment of cognitive functions was found in patients with the APOE ?4 allele in their genotype (p = 0.007). Patients 65 years old or above were more likely to have POCD three months after surgery compared to younger patients (80.0% vs. 52.9%; p = 0.003). Conclusion. The presence of the APOE ?4 allele is a potential predictor of the occurrence of POCD seven days after surgery, and age is a significant sociodemographic factor for the occurrence of POCD three months after CCS is performed under GA.

Regardless of the geopolitical and economic challenges the world as well as the European Union (EU) face, it appears that these issues have not, in the slightest, affected the EU's commitment to the green transition. The European Commission continues to provide strong support to member countries in implementing reforms that encourage the green transition. In conditions of sluggish economic growth, the investments in the green transition are characterized as a significant driver of economic growth. This paper analyzes and evaluates the implications of the EU's green transformation on the economic development of the Western Balkans (WB), with a special focus on the Green Deal and climate neutrality. The Green Deal represents the EU's key strategy for achieving climate goals and transitioning to a sustainable, green economy. Through an analytical approach, the impacts of the green transformation and related policies on the economic, social, and environmental aspects of the region are explored, considering the global Green Economy Index. The research methodology includes cluster analysis and analysis of the green economy index to assess the correlation between factors of the green economy and economic development, considering financial, institutional, and legal aspects of the Green Deal. Additionally, a comparison of development according to the Green Economy Index is applied to identify the position, potential, but also limitations of the Western Balkans in this context. Key indicators of the green economy, such as investments in renewable energy sources, energy efficiency, and sustainable infrastructure, are analyzed in terms of their impact on macroeconomic indicators such as gross domestic product per capita, unemployment, etc., in the Western Balkans. The paper identifies a range of opportunities for economic development, including increasing investments in renewable energy sources and developing sustainable infrastructure projects, but at the same time recognizes limitations, such as a lack of capacity, financial resources and public sector support to implement sustainable policies. Furthermore, there is a risk of increasing economic and social inequalities in the process of green transformation, as well as potential negative environmental consequences if appropriate measures are not taken.

Background: Aortic stenosis (AS) is the most common form of valvular disease in the elderly population, with degenerative calcified valves remaining the primary cause of this condition. Due to the progressive nature of the disease, a significant reduction in aortic valve area leads to increased left ventricular (LV) pressure overload, resulting in adaptive but ultimately maladaptive concentric hypertrophy and progressive myocardial remodeling. Objective: The main objectives of the study were to assess the regression of left ventricular (LV) hypertrophy, Methods: This retrospective study included 150 patients who underwent surgical aortic valve replacement (AVR) with the Sorin Freedom Solo (SFS) stentless bioprosthesis and the St. Jude Regent (STJ) mechanical valve. Patients were divided into three groups based on follow-up duration: six months, one year, and two years. changes in transvalvular gradient, perioperative outcomes, and survival rates. Results: The results showed a significant reduction in the transvalvular gradient for both valves (p < 0.0001), with a more pronounced decrease in patients with the SFS valve. The thickness of the interventricular septum (IVS) continuously decreased in SFS patients across all groups, whereas a significant reduction was observed only in Group 2 for STJ valves. Left ventricular ejection fraction (LVEF) showed a significantly greater increase in patients with the SFS valve (p < 0.024), particularly in Group 2. Overall mortality was 5.30% for STJ valves and 6.66% for SFS valves, with no statistically significant differences in Kaplan–Meier survival analysis (p > 0.05). Conclusion: The SFS valve demonstrated superior hemodynamic performance and more pronounced LV hypertrophy regression, making it a suitable option for high-risk patients. The STJ valve ensures stable long-term function and remains the preferred choice for younger patients with acceptable operative risk. These findings highlight the importance of a personalized approach in selecting valvular prostheses.

Background: Benign acute childhood myositis (BACM) is a rare complication of viral URTIs, usually occurring in winter. It is characterized by acute onset of bilateral calf pain and difficulty/refusal to walk. A prodromal phase precedes these manifestations, consisting of catarrhal and constitutional symptoms. These are associated with increased muscle-specific enzymes, usually normal inflammatory parameters, and leukopenia. Objective: Our study aimed to define the demographic, clinical, and laboratory characteristics of BACM patients and determine the etiology leading to their development. Methods: Medical charts for patients diagnosed with BACM from October to April 2023/2024 at the Pediatric Clinic Clinical Center University of Sarajevo, Department of Allergology, Rheumatology, and Immunology were reviewed retrospectively. Relevant medical information was collected for 20 patients. Statistical analysis was done in Microsoft Excel 2013. Results: Demographic analysis demonstrated male predominance (75%), with primarily school-aged children affected (median age 8.36). Most cases occurred in winter (60%). The majority of patients presented with bilateral calf pain (100%), difficulty walking (90%), and fever (100%). All cases demonstrated increased CK levels, with median values of 3779 U/L; a notable number had leukopenia (70%). The most commonly isolated pathogen was Influenza B virus (75%). Conclusion: BACM is relatively rare but presents acutely and leads to plenty of distress for both patients and their parents. A child with coryzal symptoms complicated by bilateral calf pain or difficulty/refusal to walk and an increase in CK levels should raise suspicion of BACM. The condition is self-limiting and usually resolves without complications.

Introduction: Scoliosis is a spinal deformity that affects school-age children and adolescents the most. Excessive body weight, heavy school bags, improper sitting at school desks, and reduced physical activity are significant risk factors for the development of scoliosis in children. To prevent the occurrence of scoliosis of the spinal column, the focus of attention must be on early identification and education about scoliosis. The research aims to determine the presence of risk factors for scoliosis in sixth-grade elementary school students, assess knowledge about scoliosis of the spine, and determine whether the health system can respond. Research Method: From a total of 3.600 sixth-grade elementary school students in the Tuzla canton a cross-sectional study was conducted among 350 students using anthropometric measurements, full and empty school bag measurements, and the Nordic Musculoskeletal Questionnaire (NMQ). Data on the health system was collected using a retrospective method. Discussion: Obesity was recorded in 21.14% of the respondents. Based on the results obtained, in 39.43% of the respondents, the ratio of the weight of a full school bag to body weight was equal to or greater than 10%. Almost one-third of the respondents felt pain/discomfort when carrying a school bag, which indicates that only 38.57% of children carry the bag correctly. 42.86% of the respondents have the wrong posture when sitting. Based on the results collected, 52.86% of the respondents do not play sports. The results show insufficient knowledge about scoliosis among both school-age children and parents/guardians. The health system of the Tuzla Canton can respond to the presence of the risk of spinal deformity with the available resources. Conclusion: The results of the study have shown the presence of risk factors for the development of scoliosis, a low level of knowledge about scoliosis, and the unwillingness of the health system to provide treatment and prevention services. Mandatory screening examinations and education of students, parents, and teachers are necessary.

The aim of this paper is to conduct a semantic analysis of humour in the anecdotes about Nasreddin Hodja collected and edited by Alija Isaković in 1984. Humour research in linguistics is becoming increasingly popular in BiH, but is naturally focused mainly on contemporary humour, wheth er this be jokes, political discourse or some other contemporary corpus. Through Victor Raskin’s semantic script theory of humour (SSTH), the paper examines whether the three basic categories of analysis are present in the selected examples from the corpus: 1) to which of the three basic classes do scripts in binary opposition belong; 2) which subcategory do they belong to; 3) whether they are part of common, restricted or individu al scripts. The examples are analysed within the classification of anecdotes offered by Isaković. Special attention is given in the analysis to each of the categories in an effort to recognise the reasons for such a grouping of humorous text. The examples under consideration have a structure that bears more resemblance to short jokes than to longer anecdotes. This is because in ideal circumstances, not always, Raskin’s semantic theory applies to the verbal humour of jokes, but also because of the limitations placed on the length of this text. This is why this text should be seen as merely a hint of the layers of humour in anecdotes that are a part of our cultural heritage, although they are directed at a character who reached our region through another culture.