Background: Allergic scalp contact dermatitis (ASCD) is a delayed type of hypersensitivity from contact with a specific allergen to which the patients has developed a specific sensitivity. The aim of the study was to evaluate the results of patch testing with standard series of contact allergen in patients suspected to have ASCD. Methods: 112 cases of scalp contact dermatitis were included in the study. Test substances were applied on the upper part of the patient's back, on clinically uninvolved and untreated skin. The patch test was removed and reaction were evaluated after 48 h and 72 h. The grading of negative (-) to positive (+ to ++++) patch test was done in accordance with the International Contact Dermatitis Research Group. Results: Among the 112 cases, 83 patients were female (74.1 %) and 29 were male (25.9 %). The age of participants spanned 17 to 72 years. The commonest age group affected was 41-50 years. The most common positive reactions were recorded to nickel sulphate 22 (26.2%), cobalt chloride 18 (21.4%), fragrance mix 16 (19%), balsam of Peru 14 (16.7%), carba mix 8 (9.5%) and paraphenylenediamine 5 (5.9%).  Females were more likely to show a positive response to two or more allergens. Scalp itching or burning were reported as the most common symptom. Conclusions: Scalp ACD predominantly affects middle-aged women. Our results suggest that nickel sulphate and cobalt are the predominant allergens responsible for the induction of ASCD. These findings are crucial in the treatment, long term management, and education of patients with ASCD.

Introduction Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) are increasingly used biomarkers in the evaluation of mild traumatic brain injury (mTBI), primarily to reduce the frequent overuse of head computed tomography (head CT). However, their specificity may be compromised by orthopedic trauma, which commonly accompanies mTBI. The aim of this study was to assess whether orthopedic trauma is associated with higher serum concentrations of GFAP and UCH-L1 in CT-negative mTBI patients, thereby potentially reducing their specificity for detecting CT-positive mTBI. Materials and methods This prospective observational study included 67 CT-negative mTBI patients, of whom 29 (0.43) had orthopedic trauma and 38 (0.57) had none. Blood samples were obtained within 12 hours of injury and serum concentrations of GFAP and UCH-L1 were measured using a chemiluminescent microparticle immunoassay (CMIA) on the Alinity analyzer, following the manufacturer's instructions. Statistical analysis included Mann-Whitney U test, chi-square test, Kruskal-Wallis test, post-hoc Dunn's test and logistic regression analysis with P < 0.05 considered significant. Results Serum GFAP concentrations were significantly higher in patients with orthopedic injuries (median (IQR): 70.0 (30.8 to 226.5) pg/mL) than in those without (24.95 (5.52 to 49.15) pg/mL; P < 0.001). Similarly, UCH-L1 concentrations were higher in the orthopedic injury group (median (IQR): 2494.3 (670.1 to 5708.1) pg/mL) compared with those without trauma (262.8 (153.8-595.3) pg/mL; P < 0.001). Conclusions Orthopedic trauma is associated with higher serum concentrations of GFAP and UCH-L1 in CT-negative mTBI patients, which may reduce the specificity of these biomarkers for ruling out intracranial injury.

Although persons with intellectual disabilities are entitled to sexual education and freedom of sexual expression, they are often discriminated against in this area and denied access to appropriate education. The attitudes of professional staff play a crucial role in shaping how sexuality is addressed in educational, social and care settings. Supportive and informed professional attitudes are essential for promoting healthy sexual development and safeguarding the well-being of persons with intellectual disabilities. The aim of this study was to examine the attitudes of professional staff who provide support to persons with intellectual disabilities toward the sexuality in relation to the respondents’ gender and age. To assess professionals’ attitudes toward the sexuality of persons with intellectual disabilities adopted version of ASQ-ID (Attitudes to Sexuality Questionnaire – Individuals with an Intellectual Disability) developed by Cuskelly and Gilmore (2007) was used. The study included a sample of 90 respondents (various profiles of professional staff who providing support to persons with intellectual disabilities). The results showed that there are differences in the attitudes of professional staff in relation to the age of respondents, while no statistically significant differences were found in relation to gender of professional staff.

OBJECTIVE Endoscopic endonasal transsphenoidal pituitary surgery is a diffuse and well-established surgical technique: over the years, the transseptal approach via a nasal mucosal incision has also gained popularity. Here we describe our preliminary experience with an entirely endoscopic one-nostril transseptal transsphenoidal approach (EONOTTA) for pituitary sellar tumor resection; the surgical corridor runs through the entire length of the nasal septum via an incision in the nasal mucosa. METHODS A total of 40 patients with a midline prevalent pituitary tumor who underwent EONOTTA from January 2022 to June 2023 were retrospectively reviewed for the evaluation of the safety and efficacy of this technique. RESULTS At 1 year follow-up, all patients had no recurrence, and the degree of tumor resection was comparable to that of the control group undergoing the traditional endoscopic endonasal approach. A low rate of nasal and post-surgical complications occurred; globally, EONOTTA was not time-consuming, and a better functional result was noticed, with a better quality of life for patients. CONCLUSIONS This study confirms, in our preliminary experience, the EONOTTA's excellent risk-benefit ratio in selected cases; for an experienced multidisciplinary team, it provides a good maneuverability and a functional outcome while preserving the integrity of the nasal mucosa.

Background Proton pump inhibitors (PPIs) are widely used for the treatment of acid-related disorders, but inappropriate or prolonged use carries potential health risks. Physicians, due to their access to medication and clinical knowledge, may be prone to self-medicating with PPIs without appropriate oversight. Objective To assess the prevalence and patterns of personal PPI use and self-medication among practicing physicians in Bosnia and Herzegovina, and to identify demographic and professional predictors of such behavior. Methods A cross-sectional, questionnaire-based survey was conducted among 448 physicians who responded to the study invitation, out of approximately 600 invited, from various healthcare levels in Bosnia and Herzegovina between January and May 2025. The survey collected data on PPI use history, consultation behavior, awareness of adverse effects, and adherence to treatment guidelines. Multivariable logistic regression was used to identify independent predictors of self-medication. Results A total of 65.4% of respondents reported past PPI use, during their medical practice, and 31.7% were current users. Over half (52.2%) admitted using PPIs without consulting another physician, and only 17.4% referred to clinical guidelines prior to use. Occasional use was the most common pattern (59.0%), while adverse effects were rarely reported (1.8%). No demographic or professional variable was significantly associated with self-medication with PPIs (defined as PPI use without consulting another physician) in the multivariable analysis. Conclusion Self-medication with PPIs is highly prevalent among physicians and frequently occurs without clinical consultation or adherence to guidelines. This behavior appears to be widespread across age groups, sexes, and care levels, highlighting the need for institutional interventions that promote rational prescribing and raise awareness about responsible self-care within the medical profession.

Pannexins are transmembrane glycoproteins that share structural and functional similarities with the gap junction proteins innexins and connexins. They play a critical role in paracrine and intracellular signalling, including purinergic signalling via the release of extracellular ATP. The role of pannexins in renal function and the pathophysiology of renal diseases is being intensely studied. However, there are no data on the subcellular localization of pannexin 1 expression in the rat kidney. We studied the distribution of pannexin 1 in the rat kidney, combining light microscopy with immunofluorescent immunohistochemistry and transmission electron microscopy with immunogold pannexin labelling. We found strong expression of pannexin in glomerular podocytes, proximal tubules and collecting ducts; moderate expression in the endothelium of glomerular and peritubular capillaries; thin descending and thick ascending limbs of the loop of Henle; and weaker pannexin 1 expression in the distal tubular epithelium. We described the detailed ultrastructural localization of pannexin 1 expression. This is the first study describing the ultrastructural distribution of pannexin 1 in the rat kidney, one of the most used preclinical models in renal physiology and pathology research. These results provide previously missing data on the precise distribution of pannexin 1 in the rat kidney, which is a prerequisite for a proper understanding of its role in renal physiology and pathophysiology.

This is a study of some key properties of sustainable materials based on natural by-products (straw or hemp shives) and binders with zero CO2 emissions (natural clay or CO2-activated binders based on by-products), which can be used in the interiors of building structures in the form tiles and suspended ceilings to stabilize their thermal and moisture properties and to adjust the acoustic properties. It is specifically a study of the acoustic properties of these natural based ecological composites and a study of their reaction to fire. These properties are key, together with hygroaccumulation properties, for the use of these materials in the field of building structures. The aim of the work was to determine the dependence of the type and dosage of the binder on the resulting behavior of the composites from the point of view of fire, and then further reactions of the action of fire on organic particles during short-term exposure to a small flame. Furthermore, it is about the results of the study of acoustic properties, from the point of view of sound absorption, as well as on the adjustment/stabilization of the relative humidity or fluctuations in the production of water vapor in the room (e.g., different short-term occupancy of the spaces by people). The results of this study provide important insights for optimizing the use of ecological composites in construction applications.

Severe hypoglycemia increases the risk of cardiovascular disease (CVD) in people with diabetes. Large cohort studies and scientific statements show that severe hypoglycemia is linked to higher rates of coronary heart disease, cardiovascular events, and mortality in both type 1 and type 2 diabetes. This risk is especially high in individuals with significant vascular risk, such as older adults and those with multiple cardiovascular risk factors. Hypoglycemia triggers several pathophysiological changes that increase cardiovascular risk. These include activation of the sympathoadrenal system, promotion of proinflammatory and prothrombotic states, arrhythmogenic changes, and increased hemodynamic stress. Experimental evidence shows that recurrent hypoglycemia worsens microvascular dysfunction and promotes adverse cardiac remodeling, especially in people with diabetes. While the link between hypoglycemia and cardiovascular events is well established, the causality remains debated. Hypoglycemia may directly contribute to cardiovascular disease or indicate underlying vulnerability, especially in patients with advanced disease or comorbidities. Minimizing hypoglycemic episodes is recommended for all patients with diabetes, particularly those with established cardiovascular disease, due to the clear association with adverse outcomes.

The automotive industry is undergoing a significant transformation towards electric vehicles (EVs) with the main goal of reducing greenhouse gas emissions and for a sustainable and green environment. Different types of EVs are introduced every day in the market where selecting an optimal vehicle for purchase constitutes a complex decision-making. Therefore, the purpose of this research was to evaluate EVs in Albania using multi-criteria decision-making methods (MCDM). A total of 12 vehicles were analyzed based on 4 main criteria and 12 sub-criteria. The fuzzy Logarithm Methodology of Additive Weights (LMAW) method was applied to find the weights of the main criteria while the fuzzy Logarithmic Percentage Change-driven Objective Weighting (LOPCOW) method was applied to find the weights of the sub-criteria. For the EV ranking, the fuzzy Ranking of Alternatives with Weights of Criterion (RAWEC) method was applied. The findings showed that the most important criteria are the technical criteria and the Auto 11 vehicle showed the best results. The combination of Fuzzy LMAW-Fuzzy LOPCOW-Fuzzy RAWEC methods also constitutes the novelty of this research, which has not been applied before in this field. The contribution of this research consists in providing a comprehensive set of selection criteria to choose the best alternative of the EV fleet in Albania. Furthermore, the contribution of this research was the application of a hybrid methodology in the evaluation and selection of an electric vehicle as an ongoing choice faced by vehicle buyers.

Obesity is a global health challenge. According to the World Health Organization (WHO), between 1990 and 2022, adult obesity more than doubled. Weight management interventions (WMIs) support individuals in achieving and maintaining a healthy weight through dietary guidance, physical activity promotion and behavioural counselling. However, traditional WMIs often have limited accessibility. Digital WMIs or DWMIs are delivered via websites or smartphone applications and provide scalable and cost-effective alternatives. However, user needs for digital services and their prevalence in the existing commercial solutions remain underexplored. Hence, our study systematically identified 26 commercial DWMIs to identify their features, services, and data collection practices. Additionally, we performed a user needs analysis by recruiting 207 individuals involved in a real-life WMI. Our findings indicated that DWMIs integrated self-monitoring, goal setting, and behaviour change strategies, yet lack social support, virtual reality applications and adaptive personalisation. WMI clients prefer smartphone Apps and fitness trackers for tracking weight management progress and have varying levels of comfort in using digital resources. The presented results serve as recommendations for future directions in the design and implementation of services for DWMIs.

In sustainable portfolio management, categorizing assets as “brown“ or “green“ based solely on ESG ratings can be misleading. A positive ESG score does not inherently indicate environmental responsibility unless it is evaluated relative to a meaningful benchmark. We propose a rescaled ESG rating system that measures each asset’s environmental standing relative to a threshold set by policymakers, reflecting the urgency of the current climate crisis. In this system, assets are assigned positive scores if they exceed the threshold (green) and negative scores if they fall below it (brown), enhancing the interpretability of sustainability metrics in portfolio construction. However, a challenge arises when aggregating these scores into an overall portfolio rating. Under sustainable portfolio optimization developed in [11], short positions in brown assets, otherwise effectively betting against polluting companies, can paradoxically improve the portfolio’s sustainability score. This creates a misleading incentive structure. To address this, we introduce a constraint that prohibits short positions in brown assets, ensuring that such investments do not positively impact the portfolio’s sustainability rating. While this restriction better aligns with environmental objectives, it also introduces complexity into the optimization process. To resolve this, we present an intuitive algorithm inspired by the active set method, which we refer to as Green Portfolio Optimization, capable of handling these constraints efficiently even in high-dimensional settings.

In this paper, we investigate an open-access fishery model which is used to examine the dynamics of the resource and industry and to explain the current economic status of the anchovy fishery. We consider the local character of the interior and boundary equilibrium points. Also, we show that the considered system of difference equations exhibits Neimark-Sacker bifurcation under certain conditions. The existence of the repelling curve and invariant curve is demonstrated. We show that in a certain parameter region the corresponding map of the considered system is an area-preserving map, so the positive equilibrium point in that case is stable. Also, we produce numerical simulations to support our findings.