The research was conducted on a sample including 166 participants - students of 'Combined Technical High School" of male sex from Travnik, who attended physical education classes regularly during the school year. In the research five variables were used to assess morphological status and nine variables to assess motor status of the participants according to the Eurofit Fitness Test Battery. The main aim of the research was to determine quantitative changes in morphological and motor status of secondary school students during one school year under the impact of programme content of regular physical education classes through a longitudinal study. Quantitative changes in morphological and motor status and analysis of differences between the initial and final measurements were determined by analysis of changes under the model of differences and SSDIF analysis (Bonacin, 2004). A hypothetical measurement matrix was defined by projecting the measurement data, and explicating a set of linear shifts on the association matrix resulted in obtaining structural vector describing quantitative changes, while taking into account relations of the initial variables. Results of the SSDIF analysis indicate that a one-year curriculum of physical education has caused statistically significant changes at global level (p = 0.0000) in both investigated areas, but the changes that have occurred are mild and without dramatic changes. Significant quantitative changes in the motor space occurred in body height and weight, and in the triceps skinfold, as well as in the following variables in the motor space: running 105 m (sideways), lifting the trunk from the lying on back position and the hand dynamometry, and the biggest and most statistically significant global quantitative changes occurred in the 20 m test run sideways with progressive acceleration (ATL20 0.8439). Key words: quantitative changes, morphological characteristics, motor skills, Physical and Health Culture Analiza kvantitativnih promjena morfoloko-motoričkih obilježja učenika srednje kole pod uticajem redovne nastave tjelesnog odgoja Istraživanje je provedeno na uzorku ispitanika koji je obuhvatio 166 ispitanika - učenika Mjeovite srednje tehničke kole mukog spola iz Travnika koji su u toku kolske godine redovno pohađali nastavu tjelesnog odgoja. U istraživanju je primijenjeno 5 varijabli za procjenu morfolokog statusa i 9 varijabli za procjenu motoričkog statusa ispitanika prema programu Eurofit baterije testova. Osnovni cilj istraživanja bio je da se longitudinalnom studijom u trajanju jedne kolske godine utvrde kvantitativne promjene morfolokog i motoričkog statusa učenika srednje kole pod utjecajem programskih sadržaja redovne nastave tjelesnog odgoja. Kvantitativne promjene morfolokog i motoričkog statusa i analiza razlika između inicijalnog i finalnog mjerenja utvrđeni su analizom promjena pod modelom razlika i SSDIF analizom (Bonacin, 2004). Projekcijom podataka mjerenja definisana je hipotetska matrica mjerenja, a eksplikacijom skupa linearnih pomaka na matricu asocijacije dolazi se do strukturnog vektora koji opisuje kvantitativne promjene, uvažavajući relacije inicijalnih varijabli. Rezultati SSDIF analize ukazuju da je jednogodinji nastavni program tjelesnog odgoja izazvao statistički značajne promjene na globalnom nivou (p = 0.0000) u oba istraživana prostora, ali su nastale promjene blage i bez dramatičnih promjena. Do statistički značajnih kvantitativnih promjena u motoričkom prostoru dolo je u tjelesnoj visini i težini, te kožnom naboru tricepsa, a u motoričkom prostoru u varijablama: trčanje 105 m (tamo-ovamo), dizanje trupa iz ležanja na leđima i dinamometrija ake, a najveće i statistički najznačajnije globalne kvantitativne promjene desile su se u testu trčanje na 20 m tamo - ovamo sa progresivnim ubrzavanjem (ATL20 0.8439). Ključne riječi: kvantitativne promjene, morfoloke odlike, motoričke spsosobnosti, tjelesna i zdravstvena kultura

Objective - To present the most efficatious management of raised intracranial pressure after severe trauma brain injury in a pediatric patient. Case report - A 5-year-old Caucasian presented to the emergency room due to head injury caused by falling down stairs. At the time of admission the patient was comatose with pediatric Glasgow Coma Score 6 (V-1, E-1, M-4) and signs of recent posterior head trauma. Computed tomography (CT) scan showed a multifragmented fracture of the occipital bone above the “sinus lake” causing an epidural mass, contusion in the right cerebellar hemisphere, a skull base fracture without signs of midline shifting. Six hours later, during monitoring in the intensive care unit, the patient became cardiorespiratory unstable with signs of uncal brain herniation and Cushing’s triad. Control CT revealed previously verified posttraumatic changes with new signs of decompensating internal hydrocephalus. Considering that evacuation of the epidural collection and decompression of impaired bone fragments in the area of the “sinus lake” would be too risky, extraventricular drainage as the first tier management was properly selected as the option of treatment. Taking into account the hazard / benefit ratio it was shown to be the most effective form of treatment, which was confirmed after six-month follow-up without any form of neurocognitive impairment. Conclusion – Treatment of traumatic brain injury (TBI) in the pediatric population requires a multidisciplinary approach. Different mechanisms of pediatric TBI injury vary widely by age groups and its impact on the development of primary and secondary brain lesions differs. Although many general principles of managing pediatric TBI are similar to adults, cerebral plasticity is one of the features which ultimately always leaves space for a better final outcome of treatment.

Summary Background FTO, a gene recently discovered in genomewide associated studies for type 2 diabetes mellitus (T2D), play an important role in the management of energy homeostasis, nucleic acid demethylation and regulation of body fat mass by lipolysis. The aim of this study was to analyze the association of FTO rs8050136 A>C genetic variant with clinical and biochemical parameters of T2D in the population of West Balkan region (Bosnians and Herzegovinians and Kosovars). Methods The study included 638 patients with T2D and prediabetes and 360 healthy controls of both genders, aged from 40 to 65 years. Patients were recruited at the Clinical Centre University of Sarajevo, University Hospital of Clinical Centre in Banja Luka, General Hospital in Tešanj and Health Centre in Prizren. Genotyping of analyzed FTO polymorphism rs8050136 A>C was performed by qPCR allelic discrimination. Results Genotype frequencies of the analyzed polymorphism were comparable between patients with T2D, prediabetic patients, and healthy population. Logistic regression analyses didn’t show significant association of FTO rs8050136 A allele with increased risk of T2D. However, risk A allele was significantly associated with higher levels of HbA1c, insulin, HOMA-IR index, diastolic blood pressure, and inflammatory markers (fibrinogen and leukocytes) as well as showed tendency of association with increased values of obesity markers (BMI, waist and hip circumference). Conclusions Results of our study showed a significant association of FTO genetic variant rs8050136 A>C with the major markers of insulin resistance, obesity and inflammation, opening new avenues for solving many unclear questions in the pathogenesis of T2D.

In 2012, a European initiative called Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) was launched to optimise and disseminate diagnostic and management regimens in Europe for children and young adults with rheumatic diseases. Juvenile localised scleroderma (JLS) is a rare disease within the group of paediatric rheumatic diseases (PRD) and can lead to significant morbidity. Evidence-based guidelines are sparse and management is mostly based on physicians’ experience. This study aims to provide recommendations for assessment and treatment of JLS. Recommendations were developed by an evidence-informed consensus process using the European League Against Rheumatism standard operating procedures. A committee was formed, mainly from Europe, and consisted of 15 experienced paediatric rheumatologists and two young fellows. Recommendations derived from a validated systematic literature review were evaluated by an online survey and subsequently discussed at two consensus meetings using a nominal group technique. Recommendations were accepted if ≥80% agreement was reached. In total, 1 overarching principle, 10 recommendations on assessment and 6 recommendations on therapy were accepted with ≥80% agreement among experts. Topics covered include assessment of skin and extracutaneous involvement and suggested treatment pathways. The SHARE initiative aims to identify best practices for treatment of patients suffering from PRDs. Within this remit, recommendations for the assessment and treatment of JLS have been formulated by an evidence-informed consensus process to produce a standard of care for patients with JLS throughout Europe.

Abstract Recurrent myocarditis is rare with only few reports having been published for paediatric cases. Repeated use of extracorporeal membrane oxygenation is also uncommon. In this paper we will present a very rare case of a 7-year old girl with recurrent fulminant myocarditis with heart failure requiring cardiopulmonary resuscitation and mechanical circulatory support with extracorporeal membrane oxygenation. Both episodes were precipitated by a viral upper respiratory tract infection, and in both cases the cardiac function eventually completely recovered. The second episode of fulminant myocarditis was particularly complex with markedly elevated markers of myocardiocytolysis, multiorgan dysfunction and the need for prolonged mechanical circulatory support. Nevertheless, the patient made a remarkable recovery. A comprehensive diagnostic workup pointed towards an aberrant immune response as the likely cause of the girl’s susceptibility for fulminant myocarditis.

Aim: The aim of this study was to analyze risk factors and outcome of neonatal pneumothorax in Tuzla Canton. Methods: Neonates with chest X-ray confirmed pneumothorax in University Clinical Center of Tuzla, within a three-year period, from January 2015 to December 2017, were retrospectively studied. Participants were evaluated for baseline characteristics, predisposing factors of neonatal pneumothorax, accompanying disorders and mortality. Results: During the observed three-year period 11425 neonates were born in Tuzla Canton, with 7.33 % of preterm births, and 604 neonates were treated in NICU, with 265 neonates who required mechanical ventilation. Neonatal pneumothorax (NP) was diagnosed in 22 patients (9 term, 13 preterm), 12 (54.5%) were male. The incidence was 0.20% of total births, respectively 3.64% of those treated in NICU. The mean gestational age were 35.1 ± 3.0 weeks and birth weight 2 506.8 ± 727.7 grams. NP was mostly unilateral (72.7%) and right-sided. The most commonly associated diseases were: respiratory distress syndrome, intracranial haemorrhage, pneumonia, transient tachypnea and sepsis. In 8 (36.4%) neonates, the underlying cause of NP could be mechanical ventilation (secondary), whereas in 14 (63.6%) NP was spontaneous, without previous mechanical ventilation, although 11 of them required mechanical ventilation after pneumothorax. Conclusion: All perinatal risk factors were investigate, and significant differences in two observed groups related to mechanical ventilation were found for birth weight, gestational age, Caesarean section, length of mechanical ventilation, surfactant replacement therapy and outcome. Three (13.64%) neonates with NP died, and among risk factors with poor outcome, significant was only Apgar score in the first minute ≤ 5.

SUMMARY The aim of the study was to analyze correlation between morphological characteristics of intracranial meningiomas and Ki67 labeling index (Ki67 LI), and their influence on peritumoral brain edema (PTBE). There were 41 consecutive patients with intracranial meningiomas surgically treated at the Department of Neurosurgery, Zenica Cantonal Hospital, Zenica, Bosnia and Herzegovina, during the period from January 2010 to December 2015. We reviewed clinical data including patient age, gender, magnetic resonance imaging (MRI) characteristics of the tumor and peritumoral edema, tumor margins, intraoperative characteristics, histopathologic grade and Ki67 LI. In all cases, follow up MRI was obtained at about three months after resection and PTBE was analyzed. Our research showed the tumor volume, tumor margins, and intraoperative signs of arachnoidal and pial invasion to be associated with PTBE in intracranial meningiomas. Ki67 LI expression correlated with PTBE. This study showed the resolution of PTBE to depend on invasive behavior of meningioma and KI67 LI. PTBE, pial/cortical and arachnoidal invasion significantly influence the extent of surgical resection.

Epidemics control is a continues struggle. In this paper is an attempt to model and then simulate an epidemiological disease known as Cutaneous Leishmaniasis (CL), which is currently affecting large communities in Libya. The model is developed to facilitate the Agent Based Models (ABM) as one of the many tools applied for epidemiological management. Validation of the model is considered by comparing the model's behavior with a trend of field data used by Libyan authorities. The methodology used for describing and designing CL model is derived from nature of the disease mechanisms. The ABM model involves three types of agents: Human, Rodent and Sand-fly. Each agent has its own properties. Additionally, global model parameters are used for following the human infection processes. Several experiments are given for illustrating the model performance, and monitor the number of people infected. Simulation results show that active human agents are more vulnerable to sand-fly bites, and infection rate is increasing or decreasing dependent on number of sand-fly vectors, number of host rodents, and human population awareness level.

Background and objectives: Pharmaceutical literacy skills of parents are crucial for appropriate and safe medication use in pre-school children (ages 1–7 years). A recent study on pharmacotherapy literacy from Serbia showed that one in five parents have difficulty understanding common information about the use of medicines. Because antipyretics are considered to be the most frequently used group of over-the-counter (OTC) medications during the pre-school period, we aimed to: (i) examine parental practice and expectations in antipyretic medication use, and (ii) analyze associations of parental practice and expectations related to socio-economic status and pharmacotherapy literacy. Materials and methods: A cross-sectional survey using a self- report validated specific instrument was conducted with the parents of pre-school children in kindergartens in Belgrade, Serbia. Pharmacotherapy literacy refers to the knowledge and personal skills needed to meet the complex demands of medicine use in both healthcare and non-healthcare settings. A comprehensive literature review, expert-focus group consultation, and pre-testing were employed in 4-item multiple-choice test development to explore practice and expectations related to the use of OTC pediatric antipyretic medicines. Results: The final analytical cohort was comprised of 813 participants, the majority (63.3%) chose a medicine based on a physician’s suggestion and only 15.4% of parents reported they would follow the advice of a pharmacist. More than a half of parents (54.1%) would need advice about antipyretic medicine from a pharmacist, firstly in a simpler language. Parents satisfied with the information given by a pharmacist had higher pharmacotherapy literacy, compared to parents with lower levels (OR–0.718, 95%CI (0.597–0.865), p < 0.001). Men had a higher expectation of pharmacists to explain medicine use in a simpler language (OR–1.630, 95%CI (1.063–2.501), p = 0.025), as well as parents with three or more children (OR–2.527, 95%CI (1.43–4.459), p = 0.001). Parents with higher knowledge about medicine use were less likely to ask for simpler information (OR–0,707; 95%CI (0,583–0,856), p < 0,001). Conclusions: Our main finding is that practice in antipyretic OTC medicine use was associated with levels of parental pharmacotherapy literacy. The expectations of pharmacists were higher among parents with lower levels of pharmacotherapy literacy, who expected more information in a simpler and more precise language. This study highlighted the need for pharmacists to identify risks in parental practice and to provide information about medicines to parents of pre-school children in a simpler and more appropriate way.

Introduction: Inadequate vitamin B 12, folate status and B6 are associated with an increased risk for chronic diseases that may have a negative impact on the health. Aim: The aim of our study was to investigate dietary intake of vitamin B12, B6 and folates from various foods among the university students. Methods: Dietary intake of foods having vitamins B12, B6 and folate was assessed among the students of University of Sarajevo, 19-22 years old, from 2017 to 2018. The participants were interviewed to collect information regarding age, socioeconomic status, B12, folate, B6 vitamin, and usual food intake during one week. Results: The main sources of vitamin B12 and B6 in the students’ diet were chicken white meat (51.8-53.7 %), beef (45-63 %), cream (62.2 -72.1 %), sardines in oil (47.9-52.2 %), tuna (55.2 -60.4 %), cheese edamer (80.1%) and cheese feta (67.4%-73%). The foods with a high source of vitamin B12 and B6 but rarely consumed were fish, shellfish, salmon, roasted trout and mackerel. Sufficient folate intake was mainly achieved through dietary intake of beans (48.5-57.2%) and oatmeal (46.3-48.2%), while folate-insufficient diet resulted from intake of spinach (30.9-35 %), turkey (26.2-33.4 %), lentils (16.9-19.7 %) and soy (9.4-15.5%). Conclusion: Our results show that there is an important percentage of the students in Canton Sarajevo that do not meet the recommended intakes for vitamin B12 and B6 and folate. Additional research is needed to establish the best cost-effective public health approach to achieve sufficient intake of these vitamins.

Abstract Throughout the history of the Mediterranean region, seafaring and trading played a significant role in the interaction between the cultures and people in the area. In order to engage the general public in learning about maritime cultural heritage we have designed and developed a serious game incorporating geospatially analyzed data from open GIS archaeological maritime sources, and archaeological data resulting from shipwreck excavations. We present a second prototype of the seafaring serious game, and discuss the results of an evaluation which involved a large multi-site user study with participants from three continents. More specifically, we present the evaluation of “The Seafarers” a strategy-based game which integrates knowledge from multiple disciplines in order to educate the user through playing. A first prototype was reported in Philbin-Briscoe et al. (2017) where an expert-user evaluation of the usability and the effectiveness of the game in terms of the learning objectives was performed. In this paper, we present how the outcomes of the evaluation of the first prototype “The Seafarers – 1” by expert-users were used in the redesign and development of the game mechanics for the second prototype “The Seafarers-2”. We then present our methodology for evaluating the game with respect to the game objective of engagement in learning about maritime cultural heritage, seafaring and trading in particular. Specifically, the evaluation was to test the hypothesis that game playing allows for more engaged learning thus improving longer-term knowledge retention. The evaluation was conducted in two phases and includes a pilot study, followed by a multi-site, multi-continent user-study involving a large number of participants. We analyze the results of the user evaluation and discuss the outcomes. This work is part of the EU-funded project iMareCulture and involves truly multi-continental, multi-institutional and multi-disciplinary cooperation – civil engineers and archaeologists from Cyprus, Human Computer Interaction (HCI) experts and Educationists from Bosnia and Herzegovina, Canada, and cultural sociologists and computer scientists from Canada.

Breast cancer is the most frequent cause of cancer-related deaths among women worldwide. It is classified into four major molecular subtypes. Triple-negative breast cancers (TNBCs), a subgroup of breast cancer, are defined by the absence of estrogen and progesterone receptors and the lack of HER-2 expression; this subgroup accounts for ~15% of all breast cancers and exhibits the most aggressive metastatic behavior. Currently, very limited targeted therapies exist for the treatment of patients with TNBCs. On the other hand, it is important to highlight that knowledge of the molecular biology of breast cancer has recently changed the decision-making process regarding the course of cancer therapies. Thus, a number of new techniques, such as gene profiling and sequencing, proteomics, and microRNA analysis have been used to explore human breast carcinogenesis and metastasis including TNBC, which consequently could lead to new therapies. Nevertheless, based on evidence thus far, genomics profiles (gene and miRNA) can differ from one geographic location to another as well as in different ethnic groups. This review provides a comprehensive and updated information on the genomics profile alterations associated with TNBC pathogenesis associated with different ethnic backgrounds.

Abstract Background Previous studies reported conflicting results regarding association of insulin receptor substrate 1 (IRS1) gene variation with type 2 diabetes (T2D) and insulin resistance (IR) in different ethnic groups. We examined the association of rs7578326, rs2943641, and rs4675095 in the IRS1 gene with T2D and related traits in a population from Bosnia and Herzegovina, which is one of the European countries with the highest T2D prevalence of 12.5%. Methods Our study included 390 T2D patients and 252 control subjects. Biochemical parameters, including fasting glucose (FG), fasting insulin (FI), homeostasis model assessment insulin resistance index (HOMA-IR), and HbA1c were measured in all participants. Genotyping analysis was performed by Mass Array Sequenom iPlex platform. Results Our results demonstrated that rs7578326 and rs4675095 variants were associated with increased FG levels. The rs7578326 was also associated with higher FI, HOMA-IR (B = 0.08, 95% CI [0.01, 0.15], padd = 0.025; B = 0.079, 95% CI [0.006, 0.150], padd = 0.033, respectively) in T2D, and with HbA1c (B = 0.034, 95% CI [0.003, 0.065], pdom = 0.035) in non-drug-treated T2D. In contrast, rs2943641 C allele was associated with lower FG levels in control subjects (B = −0.17, 95% CI [−0.03, −0.002], padd = 0.030) and HbA1c (B = 0.03, 95% CI [0.002, 0.06], pdom = 0.040) in non-drug-treated T2D. Conclusions We report the association between common variants in IRS1 gene with insulin resistance, glucose, and HbA1c levels in Bosnia and Herzegovina’s population.

Propolis is a natural resinous substance collected by honey bees from buds and exudates of plant species, mixed with bee enzymes, pollen and wax. It has a complex composition with a wide range of effects, including antibacterial, antiviral, antifungal, antiflogistic, antioxidant, hepatoprotective, carcinostatic and immunomodulatory properties. It is often applied in the treatment of diseases involving the oral cavity and gums. The aim of this paper is to describe the therapeutic properties of propolis, chemical composition and its application in the oral cavity. Literature and systematic information on the composition and the effects of propolis on health were collected, with particular reference to the use in the treatment of oral cavity diseases. The chemical composition of propolis is very complex. The health impact depends on the biologically active components it contains. A particularly important application is in the treatment of diseases of the oral cavity. Studies show that propolis can help prevent dental caries and control gingivitis and plaque. It reduces halithosis (bad breath) and symptoms of periodontosis. It is also effective in fighting viruses. It can have significant application in orthodontics and restorative dentistry. A wide range of effects allows the multiple uses of propolis-based products. Recent research has been increasingly focused on diseases of the oral cavity. The development of novel propolis-based pharmaceutical forms could significantly reduce the use of antibiotics in conventional treatment of diseases of the oral cavity.