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A. Jakovljević, H. Fransson, A. Bakhsh, J. Jaćimović, Ema Krdžović Lazić, Katarina Beljic Ivanovic, A. Lemic, Elisabetta Cotti et al.

BACKGROUND There is limited and conflicting data on the reduction of circulatory inflammatory mediators in patients with apical periodontitis (AP) following endodontic treatment. OBJECTIVE To answer the following research question: in adult healthy patients with AP [Population (P)], is there a difference before [Comparator (C)] and after various endodontic treatments (nonsurgical, surgical or retreatment) [Intervention (I)] on systemic levels of inflammatory biomarkers [Outcome (O)] in the follow-up period [Time (T)]? METHODS An electronic literature search was conducted in the databases Scopus, PubMed, Clarivate Analytics' Web of Science, Cochrane Database of Systematic Reviews and Grey literature from inception to July 2024 with no language restrictions. Observational studies examining changes in serum levels of inflammatory mediators were included. Two independent reviewers selected studies, extracted data and critically appraised the included studies. Qualitative and quantitative (meta-analysis) data synthesis methods were employed. The Newcastle-Ottawa Scale was used to assess the quality of the included studies. RESULTS Sixteen studies met the inclusion criteria, of which six were included in the meta-analysis. These studies were published between 1992 and 2024, involving a total of 596 patients (54% females) aged between 16 and 75 years. The meta-analysis of pooled data showed a significant decrease in high-sensitive C-reactive protein (hs-CRP) levels in the serum of patients with AP 6 months after treatment [2.26 ± 1.76 versus 1.28 ± 1.06 mg/L, (Z = 2.03, p = .04)] and a decrease in interleukin-1β (IL-1β) levels 12 months after treatment [13.01 ± 5.95 versus 10.86 ± 3.52 pg/mL, (Z = 3.72, p < .01)]. One study was assessed as poor quality, while all others were considered high quality. DISCUSSION Despite the differences in methodologies across the included studies, it has been established that effective endodontic treatment leads to a reduction in systemic inflammatory biomarkers in the body. CONCLUSION Following effective endodontic treatment in patients with AP, the systemic levels of hs-CRP and IL-1β exhibit a significant reduction at 6 and 12 months, respectively. Further clinical studies should investigate whether effective endodontic treatment and reduced levels of investigated biomarkers may change the clinical presentation of systemic diseases. REGISTRATION PROSPERO database (CRD42024559271).

Liani G. Devito, Eugénie S. Lim, S. M. O'Toole, Scott T C Shepherd, Daqi Deng, Hugang Feng, Taja Barber, William M. Drake et al.

Samir Bojičić, Amra Hadžiomerović Mačak, B. Katana, Eldad Kaljić, Namik Trtak, Demir Džaferović, Nejra Jaganjac

Introduction: Children of school age are in a slow phase of growth and development in which the skeleton grows slowly, and due to the still unfinished process of ossification, the skeleton of the children is still subject to various deviations. Nowadays, the practical application of new possibilities of objective qualitative as well as quantitative determination of foot deformation in children and youth is becoming more and more widespread. Pedobarography is a special technical discipline that developed within podiatry, an orthopedic subspecialty that deals with the foot. Research objective: To determine the effect of swimming on the transverse arch of junior sports swimmers compared to the control groups. Methods: The research was carried out in the private practice of the physiatrist "Sporticus" - dr. Edin Buljugić and the “Otoka Olympic pool” in Sarajevo. The research method is retrospective-prospective, and the type of research is cross-sectional-observational. Results: The analysis revealed that the average age of the total sample was 10.85±2.50 years. Our results showed that swimming does not significantly change the longitudinal and transverse arch of the foot. Research findings show that swimmers had a better transmission of forces and pressure, especially on the lateral part of the foot, while subjects who did not swim had more pressure on the medial part. The research also showed that the status of the feet is significantly better in children who started swimming in early childhood, compared to the feet of children who started swimming after the age of 10. Conclusion: Swimming does not change the transversal arch of the foot.

S. Stopić, Duško Kostić, Richard Schneider, Magnus Sievers, Florian Wegmann, Elif Emil Kaya, M. Perušić, Bernd Friedrich

Red mud is a by-product of alumina production, which is largely stored in landfills that can endanger the environment. Red mud, or bauxite residue, is a mixture of inorganic compounds of iron, aluminum, sodium, titanium, calcium and silicon mostly, as well as a large number of rare earth elements in small quantities. Although certain methods of using red mud already exist, none of them have been widely implemented on a large scale. This paper proposes a combination of two methods for the utilization of red mud, first by carbothermic reduction and then, by leaching under high pressure in an autoclave in order to extract useful components from it with a focus on titanium. In the first part of the work, the red mud was reduced with carbon at 1600 °C in an electric arc furnace, with the aim of removing as much iron as possible using magnetic separation. After separation, the slag is leached in an autoclave at different parameters in order to obtain the highest possible yield of titanium, aiming for the formation of titanium oxysulfate and avoiding silica gel formation. A maximal leaching efficiency of titanium of 95% was reached at 150 °C using 5 mol/L sulfuric acid with 9 bar oxygen in 2 h. We found that high-pressure conditions enabled avoiding the formation of silica gel during leaching of the slag using 5 mol/L sulfuric acid, which is a big problem at atmospheric pressure. Previously silica gel formation was prevented using the dry digestion process with 12 mol/L sulfuric acid under atmospheric pressure.

S. Herenda, Ivana Carev, Denis Hasković, Sabina Prevljak, Sara Causevic, E. Hasković

In this study, the impact of glucocorticoid, betamethasone dipropionate on enzyme activity in vitro and its effects on hematological parameters in vivo was investigated. The immobilized catalase, crucial for cell oxidative stress response via hydrogen peroxide reduction, exhibited a robust electrocatalytic response, maintaining its biological activity. The in vitro inhibition kinetics of catalase, as determined by electrocatalytic methods and expressed using Lineweaver-Burke diagrams, revealed an uncompetitive type of inhibition with altered Imax and Km in the presence of a range of betamethasone dipropionate concentrations. The in vivo experiments conducted on Rattus norvegicus demonstrated significant alterations in hematological parameters following betamethasone dipropionate administration. These changes included a decrease in erythrocyte count, an increase in hemoglobin, a reduction in mean corpuscular volume (MCV), and an elevation in mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC). Notably, the leukocyte counts substantially increased. The observed hematological shifts suggest an impact of betamethasone dipropionate on the hematopoietic system, reinforcing the need for cautious corticosteroid administration. The findings underline the necessity for judicious corticosteroid treatment, acknowledging both enzymatic and systemic repercussions.

Heidi B Borges, Johannes Zaar, E. Alickovic, C. B. Christensen, P. Kidmose

This study investigates the potential of speech-reception-threshold (SRT) estimation through electroencephalography (EEG) based envelope reconstruction techniques with continuous speech. Additionally, we investigate the influence of the stimuli’s signal-to-noise ratio (SNR) on the temporal response function (TRF). Twenty young normal-hearing participants listened to audiobook excerpts with varying background noise levels while EEG was recorded. A linear decoder was trained to reconstruct the speech envelope from the EEG data. The reconstruction accuracy was calculated as the Pearson’s correlation between the reconstructed and actual speech envelopes. An EEG SRT estimate (SRTneuro) was obtained as the midpoint of a sigmoid function fitted to the reconstruction accuracy versus SNR data points. Additionally, the TRF was estimated at each SNR level, followed by a statistical analysis to reveal significant effects of SNR levels on the latencies and amplitudes of the most prominent components. The SRTneuro was within 3 dB of the behavioral SRT for all participants. The TRF analysis showed a significant latency decrease for N1 and P2 and a significant amplitude magnitude increase for N1 and P2 with increasing SNR. The results suggest that both envelope reconstruction accuracy and the TRF components are influenced by changes in SNR, indicating they may be linked to the same underlying neural process.

Kanita Karaduzovic-Hadziabdic, Muhamed Adilovic, Lu Zhang, A. Lumley, Pranay Shah, Muhammad Shoaib, Venkata Satagopam, Prashant K Srivastava et al.

Introduction/Background: Cardiovascular symptoms appear in a high proportion of patients in the few months following a severe SARS-CoV-2 infection. Non-invasive methods to predict disease severity could help personalizing healthcare and reducing the occurrence of these symptoms. Research Questions/Hypothesis: We hypothesized that blood long noncoding RNAs (lncRNAs) and machine learning (ML) could help predict COVID-19 severity. Goals/Aims: To develop a model based on lncRNAs and ML for predicting COVID-19 severity. Methods/Approach: Expression data of 2906 lncRNAs were obtained by targeted sequencing in plasma samples collected at baseline from four independent cohorts, totaling 564 COVID-19 patients. Patients were aged 18+ and were recruited from 2020 to 2023 in the PrediCOVID cohort (n=162; Luxembourg), the COVID19_OMICS-COVIRNA cohort (n=100, Italy), the TOCOVID cohort (n=233, Spain), and the MiRCOVID cohort (n=69, Germany). The study complied with the Declaration of Helsinki. Cohorts were approved by ethics committees and patients signed an informed consent. Results/Data: After data curation and pre-processing, 463 complete datasets were included in further analysis, representing 101 severe patients (in-hospital death or ICU admission) and 362 stable patients (no hospital admission or hospital admission but not ICU). Feature selection with Boruta, a random forest-based method, identified age and five lncRNAs (LINC01088-201, FGDP-AS1, LINC01088-209, AKAP13, and a novel lncRNA) associated with disease severity, which were used to build predictive models using six ML algorithms. A naïve Bayes model based on age and five lncRNAs predicted disease severity with an AUC of 0.875 [0.868-0.881] and an accuracy of 0.783 [0.775-0.791]. Conclusion: We developed a ML model including age and five lncRNAs predicting COVID-19 severity. This model could help improve patients’ management and cardiovascular outcomes.

Motivated by the article [Getz and Mills. Host–parasitoid coexistence and egg-limited encounter rates. Am Nat. 1996;148:301–315], in this paper, we explore a discrete model involving a host and a parasitoid with search and egg limitations and arbitrary host-escape function. We added proportional refuge for the hosts to the model. We focus on the system's behavior at the equilibrium points and the nearby regions. In addition to the topological classification of these points, we examined local behavior. In the case of the extinction equilibrium, we obtain the global result. We describe the dynamical behavior scenarios in the neighborhood of the non-isolated exclusion equilibrium point (1:1 resonant). For the unique coexisting equilibrium, we prove the emergence of the Neimark–Sacker bifurcation and calculate the first Lyapunov exponent. This bifurcation can be either super or sub-critical. We have also established the occurrence of the Chenciner bifurcation. Our findings indicate that proportional refuge may or may not stabilize the system, and the choice of host-escape function plays a crucial role in shaping the system's dynamics. We also provide numerical examples to support our theoretical results.

A. C. Carvalho Ferreira, V. Antunes, C. Guida, Luciana Vergara Ferraz de Souza, M. Defante, E. Bulhões, E. Begić, B. Aziri et al.

INTRODUCTION: AI-based EKG has shown good accuracy for diagnosing heart failure. However, due to the heterogeneity of studies regarding cutoff points, its precision for specifically detecting heart failure with reduced ejection fraction (LVEF <40%) is not yet well established. Research question: What it is the sensitivity and specificity of artificial-based electrocardiogram to diagnose heart failure with low ejection fraction(cut-off of 40%) Aims: We conducted a meta-analysis and systematic review to evaluate the accuracy of artificial intelligence electrocardiograms in predicting an ejection fraction below 40%. METHODS: We searched PubMed, Embase and Cochrane Library for studies evaluating the performance of AI EKGs in diagnosing HFrEF. We computed true positives, true negatives, false positives and false negatives events to estimate pooled sensitivity, specificity and area under the curve, using R software version 4.3.1, under a random-effects model. RESULTS: We identified 8 studies,including 136151 patients with a paired artificial intelligence enabled electrocardiogram with an echocardiography. 9349(6.8%) patients had an ejection fraction below 40% according to the echocardiogram. The AI-ECG data yielded areas under the receiver operator of, sensitivity of 0.861(0.815-0.897), and specificity of 0.874(0.834-0.905) , and area under the curve of 0.929(0.876-0.949). Mean/median age ranged from 60±9 to 67.8±14.4 years. CONCLUSIONS: In this systematic review and meta-analysis, the use of electrocardiogram-based artificial intelligence models demonstrated high sensitivity and specificity for the diagnosis of heart failure with an ejection fraction below 40%

B. Aziri, E. Begić, Catalina Herrán-Fonseca, Laura Jekov, Ana Gabriela Ponte Farias, Carlotta Persaud, Norma Gamarra, M. Vilbert et al.

Background: Bruton Tyrosine Kinase inhibitors (BTKi) are targeted therapies that have demonstrated promising results in the treatment of hematological malignancies; however, they are associated with adverse cardiac events. Direct comparisons of the cardiotoxic profile between old-generation and new-generation BTKi are limited. Research Question: Are novel BTKi associated with a lower incidence of cardiac adverse events compared with ibrutinib? Aims: We aimed to perform a systematic review and meta-analysis of cardiac events from studies comparing new-generation BTKi versus ibrutinib in patients with hematological malignancies. Methods: We searched PubMed, Embase, and Cochrane Library for studies comparing any new-generation BTKi with ibrutinib in patients with hematological malignancies. Outcomes included 1) risk of cardiac events; 2) atrial fibrillation (AF); 3) rate of treatment discontinuations due to AF; and 4) hypertension. We pooled risk ratios (RR) with 95% confidence intervals (CI). Statistical analysis was performed using R software 4.3.1, under a random-effects model. Heterogeneity was assessed using I 2 statistics. Results: We included four randomized controlled trials with 1905 patients, of whom 957 (50%) received new-generation BTKi. Age ranged from 28 to 90 years, with 1337 (70%) male patients. Prior lines of systemic therapy ranged from none to 12. Overall cardiac events were significantly lower in patients who received novel BTKi compared with those who received ibrutinib (RR 0.75; 95% CI 0.63 to 0.90; p=0.002; I 2 =0%; Fig.1A). New-generation BTKis were associated with a statistically significant reduction in the risk of AF (RR 0.48; 95% 0.35 to 0.64; p<0.001; I2=0% Fig.1B) and treatment discontinuation due to AF (RR 0.07; 95% CI 0.01 to 0.34; p=0.001; I 2 =0%), compared with ibrutinib. However, there was no statistically significant reduction in the risk of hypertension with novel BTKi relative to ibrutinib (RR 0.58; 95% CI 0.34 to 1.01; p=0.053; I 2 =81%). Conclusion: Our findings suggest that treatment with new-generation BTKi is associated with a significant reduction in the risk of cardiac events, AF, and AF-related treatment discontinuation compared with the old-generation BTKi.

Catalina Herrán-Fonseca, Laura Jekov, B. Aziri, Carlotta Persaud, E. Begić, Fahad Alabbas

Background: Cyclophosphamide is an alkylating agent of the nitrogen mustard class that has become standard of care for graft-versus-host disease prophylaxis after hematopoietic stem cell transplantation. Although its cardiac toxicity in conditioning regimens is well-documented, data on cardiac events after administration of post-transplant cyclophosphamide (PT-Cy) administration remains limited. Research Question: Is PT-Cy associated with a higher incidence of cardiac adverse events compared with no PT-Cy? Aims: We aimed to perform a systematic review and meta-analysis of cardiac events from studies comparing PT-Cy versus no PT-Cy in patients with hematological disorders who received hematopoietic stem cell transplantation. Methods: We searched PubMed, Embase, and Cochrane Library for studies comparing PT-Cy versus no PT-Cy in patients with hematological conditions who received hematopoietic stem cell transplantation. We pooled risk ratios (RR) with 95% confidence intervals (CI). Statistical analyses were performed using Review Manager 5.4.1, under a random-effects model. Heterogeneity was assessed using I2 statistics. Results: We included four studies, all of which were retrospective, with 1,546 patients, of whom 826 (53%) received PT-Cy. Age ranged from 18 to 77 years, and 840 (54%) were male. A total of 1549 allogeneic transplants were performed, primarily for malignant hematological conditions. The conditioning regimens used were myeloablative (52%), reduced intensity (33%), non-myeloablative (8%), and sequential (7%). The most common cardiac events in patients receiving PT-Cy were heart failure (28%) and cardiomyopathy (27%), followed by arrhythmias (25%), pericarditis/pericardial effusion (14%) and acute coronary syndrome (5%). The incidence of adverse cardiac events was significantly higher in patients who received PT-Cy compared with those who did not receive PT-Cy (RR 2.05; 95% CI 1.36, 3.10; p<0.001; I 2 =44%). Conclusion: These findings suggest that PT-Cy is associated with a higher incidence of adverse cardiac events, the most common of which is heart failure/cardiomyopathy.

Lucas M. Barbosa, Beatriz Araujo, B. Aziri, E. Begić

Introduction: The efficacy and safety of use and impact of pulmonary artery catheter (PAC) in patients with cardiogenic shock (CS) treated with Impella remains unclear. The use of PAC in conjunction with Impella for patients with CS might be associated with improved clinical outcomes and increased safety compared to the use of Impella alone. We aimed to perform a systematic review and meta-analysis comparing Impella with versus without PAC for patients with CS. Methods: We systematically searched PubMed, Embase, and Cochrane databases for studies comparing PAC use in patients with CS treated with Impella. We pooled odds ratios (OR) with 95% confidence intervals (CI) applying random-effects model. We used R version 4.3.2 for statistical analyses. Results: We included two observational studies comprising 11,463 patients, of whom 6,058 (53%) had PAC. Compared with no PAC, the use of PAC was associated with a significantly lower in short-term mortality rates (37% vs. 42%; OR 0.83; 95% CI 0.77-0.90; p<0.01; Figure 1A). There was no significant difference in the incidence of arrhythmias 59% vs. 63%; OR 1.14; 95% CI 0.92-1.41 p=0.44; Figure 1B) or renal complications between groups (47% vs. 50%; OR 1.08; 95% CI 1.00-1.17; p=0.06; Figure 1C). Conclusions: In patients with CS, adjunctive PAC to Impella is associated with lower mortality rates, but no significant difference in arrhythmias and renal complications. Randomized controlled trials are warranted to further validate this results.

Microscopic signs indicative of drowning are not specific to drowning but also to any other form of suffocation where mechanical obstruction is involved. Our study aimed to evaluate both macroscopic and microscopic findings across different groups sharing a common mechanism of death but differing causes and to compare the diatom test with pathohistological examination.Twenty-nine adult Wistar rats, weighing within recommended ranges, were divided into four groups (L1-L4). The diatom test followed established guidelines for diatoms in water from the Bosna River. Microscopic examination revealed diatoms in the lungs of rats in L3 and L4 groups. Pathohistological findings showed varying degrees of changes including consolidation and inflammatory cell infiltration, dominated by lymphocytes and macrophages, with some samples also showing eosinophilic leukocytes.Significant differences were observed between animals whose cause of death was mechanical asphyxia (suffocatio) and those that were submersed for1 hour versus those that were submersed for 72 hours after death. Diatoms identified in group L4 samples 3, 4, and 5 included Navicula sp. (U3 and U6) and Ulnaria ulna (U4).Our findings suggest combining the diatom test with pathohistological analysis to support a drowning diagnosis. Further examination of other organs could enhance result reliability.

Ola Ali, Elma Dervić, Rainer Stütz, Ljubica Nedelkoska, Rafael Prieto-Curiel

Eamon Vale, Damir Mitric, Noor Raheem

This paper introduces a conceptual evaluation learning analytics (LA) model developed by Keypath Education and Melbourne Business School to analyse student engagement in an online learning environment. The paper describes how a targeted LA intervention was grounded within the ICAP theory for active learning to identify, visualise and analyse student engagement metrics in a 100% online setting. The architecture of the model, including its design principles and underlying assumptions, are broadly examined against the latest research in educational, LA, and data analytics research. This includes a discussion of our initial phase testing results of captured student data alongside a discussion of key questions and desired study outcomes for the upcoming phase 2 of the data intervention. As a result, this paper provides both specific insights into how we created an evidence based and pedagogically sound evaluation model of online student engagement within a specific suite of asynchronous educational tools, as well as more general and practical insights into how other universities could develop similar approaches to enhance understanding and support of a growing online student population.

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